Urinary Incontinence (UI)

Urinary incontinence is the unintentional leakage of urine. It is a common condition, especially among women, and is not a normal part of aging. With proper care, most cases can be improved or cured.

1. Stress Incontinence: Leakage when coughing, sneezing, laughing, or exercising.
2. Urge Incontinence: Sudden, intense need to urinate followed by leakage (often called “overactive bladder”).
3. Mixed Incontinence: Combination of stress and urge incontinence.
4. Overflow Incontinence: Inability to fully empty the bladder, leading to frequent dribbling.

Types of Urinary Incontinence

Common Causes

• Childbirth: Weakens pelvic floor muscles.
• Menopause: Reduced oestrogen thins the urethra and bladder lining.
• Aging: Loss of bladder muscle strength.
• Obesity: Extra weight increases pressure on the bladder.
• Chronic conditions: Diabetes, UTIs, or neurological disorders (e.g., MS, stroke).

Symptoms

• Leaking urine during physical activities (e.g., lifting, laughing).
• Frequent urination (more than 8 times a day).
• Waking up multiple times at night to urinate (nocturia).
• Urgency that’s hard to control.

Diagnosis

1. History review: Discuss symptoms, fluid intake, and medications.
2. Perform a physical exam: Check pelvic floor strength and rule out infections.
3. Request tests:
   1. Urinalysis: Rule out infection.
   1. Bladder diary: Track fluid intake/urination patterns.
   1. Urodynamic testing: Measure bladder pressure and function.

Treatment Options

Lifestyle Changes

• Pelvic floor exercises (Kegels): Strengthen muscles that support the bladder.
• Weight management: Losing 5–10% of body weight can reduce symptoms.
• Avoid bladder irritants: Limit caffeine, alcohol, and acidic foods (e.g., citrus, tomatoes).

Medical Treatments

• Medications: Anticholinergics (e.g., oxybutynin) or mirabegron for urge incontinence.
• Pessary: A removable device inserted into the vagina to support the bladder.
• Botox injections: For severe overactive bladder (temporarily relaxes bladder muscles).

Advanced Options

• Nerve stimulation: PTNS (peripheral tibial nerve stimulation) or sacral neuromodulation.
• Surgery: Sling procedures (for stress incontinence) or bladder repair.

Frequently Asked Questions

Q: Is incontinence a normal part of aging?
A: No! While common, it’s treatable at any age.

Q: Can Kegel exercises really help?
A: Yes! Proper technique (squeezing pelvic muscles as if stopping urine flow) improves symptoms in 70% of cases.

Q: Are there products to manage leaks?
A: Absorbent pads or underwear can help temporarily—but don’t replace treatment.

Q: Can menopause worsen symptoms?
A: Yes. Vaginal oestrogen creams may restore tissue health and reduce leakage.

Q: Is surgery safe?
A: Minimally invasive surgeries (e.g., slings) have high success rates and low complication risks.

eGynaecologist Advice:

• You should practice daily pelvic floor exercises, stay hydrated and treat chronic coughs or constipation.
• Incontinence disrupts daily life (e.g., avoiding social activities) and simple lifestyle changes make a big difference. You should seek gynaecological consultation early to prevent complications
• You must seek gynaecological consultation if you experience pain, blood in urine, or sudden onset of symptoms.