What is urinary incontinence?

Urinary incontinence or involuntary loss of urine is a very distressing symptom.It is estimated that 10% of the population in the UK suffer from urinary incontinence. It affects both men and women of all ages and does not simply reflect the ageing process. Therefore if you are worried, you should see your GP.


What are the causes of incontinence of urine?

Urinary incontinence is predominantly of two types - stress and urgency incontinence. You can also have a combination of both. Stress incontinence is due to weakening of the pelvic floor muscles and support to the bladder neck and urethra, whilst urgency urinary incontinence is due to the bladder become overactive i.e. the muscles of the bladder having a tendency to squeeze on itself. A third type called overflow incontinence, results from chronic retention i.e. inability to empty the bladder.


Can it be treated?

You don't have to suffer in silence. In the first instance you should see your GP, who will be able to tell you the cause of your incontinence. After an initial assessment, he can refer you to the bladder and bowel team who can assess and teach you pelvic floor exercises. Your GP can also start you on some medication. You can make simple lifestyle changes such as lose weight or cutting out caffeine from your diet.


What surgical treatments are available?

In most cases you will need a trial of conservative treatment including pelvic physiotherapy, bladder retraining and tablets. If these are not successful, you may need a special test of bladder function called urodynamics. We may also need to do a cystoscopy to exclude any sinister pathology . Further surgical treatment will depend on the type of incontinence you have. If you have stress incontinence, we can put a sling under the urethra vaginally. This acts as a hammock and stops you from leaking with stress. If on the other hand you have urgency incontinence, intravesical Botox may be the right treatment for you.