OverviewUrinary Incontinence in women is very common. Approximately 38 percent of women experience urinary incontinence, and 135,000 women each year will undergo surgery to correct incontinence.
There are two types of urinary incontinence. The first and most common is stress urinary incontinence or SUI. Stress urinary incontinence is the result of weak urethral muscle and support. Patients with the condition complain of incontinence with activity.
The second type of incontinence is urinary urge incontinence (UUI), which is the result of over-active bladder muscles. Patients with urinary urge incontinence complain of incontinence with a strong urge to go to the bathroom. Some women have a combination of both types. This is called mixed urinary incontinence (MUI).
SymptomsWomen with SUI will leak urinary during activities that increase abdominal pressure, such as coughing, laughing, sneezing, bending, lifting, walking down hill or running.
Women with UUI will leak urine with strong urges to get to the bathroom. The leakage amount might be quite large at times. They may also leak when they hear or see running water, when they place a key in the door upon returning home, or when they stand up from a chair or get out of bed. Women with MUI experience both symptoms.
CausesDoctors do not know with certainty what causes incontinence. But it is believed that certain experiences such as vaginal delivery or repetitive heavy lifting injure the support to the bladder and urethra. Genetic factors also likely increase the risk of developing SUI. Women who are obese, have excessive fluid in the abdomen (ascites) and women who have a chronic cough from asthma or emphysema may also be at risk. The causes of UUI are not known.
DiagnosisUrinary incontinence is diagnosed by a physician. Some physicians may not ask about urinary symptoms as part of a general exam, so patients should discuss any symptoms with a doctor who may then evaluate or refer them to a specialist.
With a referral, the specialist will discuss medical history and conduct a physical examination, including a vaginal exam. Some specialists may request other tests, such as a bladder diary, wet pad collection or a urodynamic study before recommending therapy. A urodynamic study evaluates bladder function and helps the specialist recommend the best therapy.
ComplicationsThe effect that incontinence may have on a patient’s quality of life is immeasurable. Some women stop exercising for fear of incontinence. Others will not travel or even leave their home for any duration of time for fear of embarrassing accidents. Some women with severe incontinence may have rashes and skin breakdown from chronic skin exposure to urine.
RecoveryUrinary incontinence has a significant impact on quality of life and yet it frequently goes unmentioned by both patients and physicians. Surgical and non-surgical approaches to this problem often enable women to realize significant if not complete resolution of symptoms. Don’t be afraid to start the discussion with your health-care provider. It’s an important first step in improving your quality of life.