Following World Continence Awareness week, consultant gynaecologist Mr Gurminder Matharu from Spire Parkway Hospital in Solihull outlines some of the treatments available for women who suffer from urinary incontinence.
Urinary incontinence can affect both men and women and has a variety of causes. One in three women is affected by this problem that can have a significant impact on their quality of life.
In women, there are two main types of urinary incontinence:
- Urge incontinence (UUI) – where the muscle that controls the bladder becomes overactive and causes involuntary leakage of urine. In many cases, the cause is unknown.
- Stress incontinence (SUI) – this is caused by weakening of, or damage to, the pelvic floor muscles, urethra (tube through which you pass urine) or bladder, most commonly as a result of childbirth. This can result in leakage of urine on coughing, sneezing, exercise and sex.
Some women have both stress and urge incontinence.
Many women suffer in silence for many years because of embarrassment or thinking it is part of life after childbirth or getting older. The good news is that treatment and help are readily available.
Deciding upon the best approach will be a joint decision between a consultant gynaecologist and the patient, and will be selected based on that individual’s circumstances and presentation. Initially in most cases, we advise specialist physiotherapy to help with pelvic floor exercises and bladder retraining, along with any necessary adjustments to fluid intake.
If pelvic floor exercises do not help, you could consider surgery for stress incontinence and there are a number of different operations from which to choose:
- Tape procedure – A common operation to treat SUI. A tape is inserted through a small incision in the vagina and positioned in a U-shape behind the pubic bone so that it supports the urethra.
- Urethral bulking injection – this involves injecting a gel or silicone into the urethra.
- Fascial sling procedure – a sling made from your own tissue is used to support the neck of the bladder.
- Colposuspension – This type of surgery lifts the neck of the bladder and secures it in place using stitches.
Treatments for urge incontinence include:
- Drug therapy – tablets are commonly used and can be a simple and effective way of controlling this problem.
- Injection – if drug therapy does not work, the next step is to consider the injection of botulinum into the bladder.
- Neuromodulation – this is a treatment which involves the stimulation of nerves to bring the bladder back under control.
I would encourage women who suffer with urinary incontinence that is affecting their quality of life to seek professional advice – urinary incontinence can be treated and you do not have to live with it.