Urinary incontinence or leakage of urine is extremely common in women, affecting around four in every 10 women in the UK. However, many women feel too embarrassed to seek help, despite the availability of treatments to help reduce their symptoms. Here we’ll take a look at the symptoms of urinary incontinence, how to get a diagnosis and what treatments can help.
There are two types of urinary incontinence, stress incontinence, where urine leaks out when you cough, laugh, sneeze, lift something heavy or exercise, and urge incontinence, where you have sudden, frequent and uncontrollable urges to urinate, which can wake you up multiple times in the night.
Stress incontinence is caused by a weakness in your pelvic floor muscles — these are muscles that run from your tailbone (coccyx) at the back of your body to your pubic bone at the front of your body. They support your bladder, bowel, womb and vagina, and can weaken with age, pregnancy and obesity.
Urge incontinence is caused by an overactive bladder. Sometimes the cause of an overactive bladder can’t be found but common causes include drinking too much alcohol and caffeine, urinary tract infections and constipation.
If any of the above symptoms sound familiar and you’re concerned that you may have urinary incontinence, see your GP. They will ask you about your symptoms, so it can be helpful to keep a diary of how often you experience episodes of urinary incontinence, how often you urinate and how much you’re drinking.
Your GP will ask you about any medication you’re taking, which may increase your risk of urinary incontinence. They may also ask for a urine sample to check for infections and perform a physical examination of your abdomen, back passage (rectum) and vagina.
Depending on your answers and their examination, they may refer you for further tests to check the health and function of your bladder.
These tests may include an ultrasound scan to check that your bladder can empty properly, a cystoscopy to look inside your bladder for any problems and/or urodynamic tests to check how well your bladder and urethra (the tube through which urine passes out of your body) are working to store and release your urine.
The results of these tests can help your GP make a diagnosis of urinary incontinence.
Treatment for urinary incontinence will depend on the type of urinary incontinence you have.
If you have stress incontinence your doctor may recommend pelvic floor exercises to strengthen your pelvic floor muscles and losing excess weight if you are overweight or obese. If you have urge incontinence your doctor may recommend drinking less alcohol and caffeine, and taking medication to calm an overactive bladder.
If these treatments aren’t effective and urinary incontinence is significantly reducing your quality of life, your doctor may recommend surgery. There are different types of surgery, including surgery to implant mesh to support your bladder, surgery to strengthen your pelvic floor muscles or surgery to increase the size of your bladder.
With so many treatment options available, it is important to speak to your doctor if you’re concerned that you have urinary incontinence. Help is available to improve your symptoms and quality of life.
Miss Roopa Nair is a Consultant Gynaecologist and Urogynaecologist at Spire London East Hospital, Spire Hartswood Hospital, and Barking, Havering and Redbridge University Hospitals NHS Trust. She specialises in endometrial ablation surgery, hysterectomy and hysteroscopy, laparoscopy investigations and treatment, ovarian cyst removal and urinary incontinence. She also holds a Masters in Minimally Invasive and Robotic Surgery from Anglia Ruskin University, has completed advanced training in urogynaecology and vaginal surgery, and is the Lead for urogynaecology services at her NHS Trust.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.