URINARY INCONTINENCE

Some people experience occasional, minor leaks of urine. Others wet their clothes frequently.

Types of urinary incontinence include:

• Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
• Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as neurologic disorder or diabetes.
• Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
• Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
• Mixed incontinence. You experience more than one type of urinary incontinence.

DIAGNOSIS

Your doctor is likely to start with a thorough history and physical exam. You may then be asked to do a simple maneuver that can demonstrate incontinence: close your mouth, pinch your nose shut and exhale hard.

After that, your doctor will likely recommend:

• Urinalysis. A sample of your urine is checked for signs of infection, traces of blood or other abnormalities.
• Bladder diary. Losing weight, pelvic floor muscle training and bladder training may be recommended before other treatments are considered.For several days you record how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes.
• Post-void residual measurement. You’re asked to urinate (void) into a container that measures urine output. Then your doctor checks the amount of leftover urine in your bladder using a catheter or ultrasound test. A large amount of leftover urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.

TREATMENT/RECOMMENDED MEDICATIONS

Losing weight, pelvic floor muscle training and bladder training may be recommended before other treatments are considered.

Surgical treatment for urinary incontinence

If behavioural treatments and medication for urinary incontinence have not been successful, an operation or other procedures may be recommended. The decision to have surgery will be taken after the risks and benefits have been weighed up.