Urinary Incontinence

Urinary incontinence is the accidental loss of urine control, from an occasional leakage to the complete inability to hold urine. Its onset can be sudden and temporary, or chronic and ongoing. It often occurs in women who have had multiple pregnancies or after menopause. In men, it can occur following prostate cancer surgery. Pelvic trauma, certain disease and strokes can also cause urinary incontinence. iStock_000005613330XSmall

Types of urinary incontinence

There are two main types of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence occurs during certain activities including coughing, sneezing, laughing or exercises. Urge incontinence comes on suddenly without warning and results in the involuntary loss of urine. It is often associated with an overactive bladder.

Other types of urinary incontinence are mixed and overflow incontinence.Mixed incontinence is a combination of both stress and urge incontinence. Overflow incontinence may occur when the bladder muscle loses its ability to contract or tighten.

Treatment

Treatment depends upon the type of urinary incontinence and its severity, and progresses from the least invasive technique to surgery, if necessary.

Absorbent products. Pads & undergarments

Behavioral modification

Kegel exercises. Exercises to tighten pelvic floor muscles and urinary sphincter, by stopping and restarting urine stream.
Bladder retraining (to hold urine for increasing lengths of time)
Changing fluid intake patterns (especially at night)
Avoiding dietary irritants

Medication

Antibiotics in case incontinence is caused by infection.
Oral medication to calm an overactive bladder or relax the urinary sphincter

Surgery

Pubo-vaginal sling. Surgeon lifts the urethra back to normal position with a sling. Is performed through a small vaginal incision.
Mid-urethral sling. A mesh-like synthetic tape used to restore urinary function by lifting and supporting the urethra. Is performed through the vagina. A less invasive approach.
Artificial urinary sphincter. A donut-shaped device placed around the bladder neck to keep the urethra closed until you are ready to urinate. Treatment of choice for incontinent men who have had prostate surgery.