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Female incontinence Female incontinence

Female Incontinence

Are you experiencing accidental release of urine when you cough, sneeze or laugh?

Visit Steinberg Urology for a consultation with our urologists to address your concerns, perform diagnosis and provide you on advice as to what treatments are likely to fit your individual circumstances.
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FEMALE INCONTINENCE

Incontinence is a problem of the urinary system where the bladder does not reliably store urine until it is convenient to urinate. Incontinence occurs when urine involuntarily leaks from the bladder out the urethra.

When coughing or sneezing causes a woman to expel small amounts of urine, it’s called stress incontinence. It is a very common condition.

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles can’t support your bladder properly, the bladder drops down and pushes against the vagina. You can’t tighten the muscles that close off the urethra. So urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.

Many women experiencing stress incontinence suffer in silence. Feelings of embarrassment and self-consciousness overtake their emotional wellness and may lead to social isolation. In time, women suffering from SUI can begin to feel very distressed. Psychological problems associated with urinary incontinence include anxiety, depression, fear of intimacy, and relationship troubles.

You may feel uncomfortable discussing incontinence with your doctor. But if incontinence is frequent or is affecting your quality of life, it’s important to seek medical advice.

STRESS URINARY INCONTINENCE (SUI)

With SUI, weak pelvic muscles let urine escape. It is one of the most common types of urinary incontinence. It is common in older women. It is less common in men.

SUI happens when the pelvic floor muscles have stretched. Physical activity puts pressure on the bladder. Then the bladder leaks. Leaking may happen with exercise, walking, bending, lifting, or even sneezing and coughing. It can be a few drops of urine to a tablespoon or more. SUI can be mild, moderate or severe.

URGE INCONTINENCE – OVERACTIVE BLADDER (OAB)

OAB is another common type of urinary incontinence. It is also called “urgency” incontinence. OAB affects more than 30% of men and 40% of women in the U.S. It affects people’s lives. They may restrict activities. They may fear they will suddenly have to urinate when they aren’t near a bathroom. They may not even be able to get a good night’s sleep. Some people have both SUI and OAB and this is known as mixed incontinence.

With OAB, your brain tells your bladder to empty – even when it isn’t full. Or the bladder muscles are too active. They contract (squeeze) to pass urine before your bladder is full. This causes the urge (need) to urinate.

The main symptom of OAB is the sudden urge to urinate. You can’t control or ignore this “gotta go” feeling. Another symptom is having to urinate many times during the day and night.

OAB is more likely in men with prostate problems and in women after menopause. It is caused by many things. Even diet can affect OAB. There are a number of treatments. They include life style changes, drugs that relax the bladder muscle, or surgery. Some people have both SUI and OAB.

MIXED INCONTINENCE (SUI AND OAB)

Stress and urge incontinence often occur together in women. Combinations of incontinence — and this combination in particular — are sometimes referred to as mixed incontinence. Most women don’t have pure stress or urge incontinence, and many studies show that mixed incontinence is the most common type of urine loss in women.

OVERFLOW INCONTINENCE

With overflow incontinence, the body makes more urine than the bladder can hold or the bladder is full and cannot empty thereby causing it to leak urine. In addition, there may be something blocking the flow or the bladder muscle may not contract (squeeze) as it should.

One symptom is frequent urinating of a small amount. Another symptom is a constant drip, called “dribbling”. This type of urinary incontinences is rare in women. It is more common in men who have prostate problems or have had prostate surgery.

FUNCTIONAL INCONTINENCE

People with medical problems that interfere with thinking, moving, or communicating may have trouble reaching a toilet. A person with Alzheimer’s disease, for example, may not think well enough to plan a timely trip to a restroom. A person in a wheelchair may have a hard time getting to a toilet in time. Functional incontinence is the result of these physical and medical conditions. Conditions such as arthritis often develop with age and account for some of the incontinence of elderly women in nursing homes.

The symptoms of UI may look like other conditions or health problems. Always see your healthcare provider for a diagnosis.

SYMPTOMS

The main symptom is the accidental release of urine. Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

  • SUI – If you have stress incontinence, you may leak a small to medium amount of urine when you cough, sneeze, laugh, exercise, or do similar things. The activity and amount of leaking depends on how severe the SUI is.
  • OAB – If you have urge incontinence, you may feel a sudden urge to urinate and the need to urinate often. With this type of bladder control problem, you may leak a larger amount of urine that can soak your clothes or run down your legs.
  • Mixed incontinence (SUI and OAB) – The symptoms of mixed incontinence include leaking and a sudden, strong urge to urinate. Mixed incontinence is when you have more than one type of incontinence. Most often, people with mixed incontinence have SUI and OAB.
  • Overflow Incontinence – Frequent small urinations and constant dribbling are the main symptoms of overflow incontinence. The bladder is unable to empty. Symptoms happen when the bladder is full. This type is less often in women however, dropped bladders, prior bladder surgeries or diabetes may affect this. It is more common in men with a history of prostate problems or surgery.

The symptoms of UI may look like other conditions or health problems. Always see your healthcare provider for a diagnosis.

THINK YOU HAVE SYMPTOMS OF FEMALE INCONTINENCE?

Take a quiz on our website. Use your answers talk to your doctor about your symptoms. The quiz will assist your doctor to assess your symptoms and create a personalised management plan and and suitable treatment options.

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Female incontinence

CAUSES AND ISSUES OF FEMALE INCONTINENCE

The most common type of urinary incontinence in women is stress incontinence or SUI.

Referring to physical stress rather than mental or emotional stress, this condition is defined by the pelvic muscles becoming unable to sustain any kind of sudden additional stress—or pressure. When sudden extra pressure occurs, so does involuntary leakage.

Bladder control problems

Bladder control problems may be caused by:

  • Weak muscles in the lower urinary tract.
  • Problems or damage either in the urinary tract or in the nerves that control urination.

Stress incontinence

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles.

Stress incontinence can be provoked by the following actions:

  • Coughing
  • Sneezing
  • Laughing
  • Exercising
  • Heavy lifting
  • Awkward movement (getting out of a car, for example)

Quality of life issues

Urinary incontinence has a far-reaching effect on women’s lives impacting their professional, mental and social well-being. The secondary impacts can include:

  • Reduced sexual activity
  • Avoiding going out in public
  • Becoming isolated
  • Struggling with depression
  • The condition is linked to an increase in falls and fractures among elderly women.
  • Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
  • Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.
  • Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.

RISK FACTORS

Factors that increase your risk of developing urinary incontinence include:

  • Gender. Women are more likely to have stress incontinence. Pregnancy, childbirth, menopause and normal female anatomy account for this difference. However, men with prostate gland problems are at increased risk of urge and overflow incontinence.
  • Age. As you get older, the muscles in your bladder and urethra lose some of their strength. Changes with age reduce how much your bladder can hold and increase the chances of involuntary urine release.
  • Being overweight. Extra weight increases pressure on your bladder and surrounding muscles, which weakens them and allows urine to leak out when you cough or sneeze.
  • Smoking. Tobacco use may increase your risk of urinary incontinence.
  • Family history. If a close family member has urinary incontinence, especially urge incontinence, your risk of developing the condition is higher.
  • Other diseases. Neurological disease or diabetes may increase your risk of incontinence.

DIAGNOSIS

The doctor will take a urine sample to check for infection. A discussion of symptoms, urges, frequency and fluid intake are typical for the first visit.

  • A pelvic exam (including a Kegel exercise to test the strength of the muscles)
  • A cough test (to assess the amount of urine leakage)
  • Urinalysis and urine culture – laboratory technicians test your urine for evidence of infection, urinary stones, or other contributing causes.
  • Ultrasound – this test uses sound waves to create an image of the kidneys, ureters, bladder, and urethra.
  • Cystoscopy : A thin scope with an attached tiny camera is inserted through the urethra to view inside the urethra and the bladder
  • Urodynamics – various techniques measure pressure in the bladder and the flow of urine.
  • Bladder scan – the doctor may also take measurements of the bladder to see how much urine is retained
diagnostics

Cystoscopy

diagnostics

Urodynamic Testing

diagnostics

Urinary Flow Test

diagnostics

Bladder Ultrasound

diagnostics

Lab Test

TREATMENT FOR FEMALE INCONTINENCE

There are many potential responses to female incontinence. The doctor will evaluate your situation and determine the best course of action. The list below shows some non-surgical therapies.

MEDICATION

Used to treat urge incontinence, in a way that it relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.
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VAGINAL LASER TREATMENTS

The diVa laser treatment is the newest evolution of laser vaginal therapy.

The treatment is quick and we can target specific regions to improve stress urinary incontinence or other localized issues – as well as the broader benefits in addressing dyspareunia or vaginal laxity.

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INJECTION THERAPY FOR WOMEN

The Injection therapy for women is a quick procedure using your own platelet-derived growth factors (blood) to help treat urinary incontinence and sexual dysfunctions. It stimulates the rejuvenation of cells, collagen, and blood vessels for younger, healthier clitoral and vaginal tissue.
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EMSELLA

A breakthrough treatment solution that can optimize pelvic floor muscle resilience. BTL EMSELLA™ is a great option for men & women of any age who desire solution for urinary incontinence and improvement in their quality of life.
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BLADDER INJECTIONS

Botulinum toxins injections into the bladder muscle may benefit women with incontinence due to overactive bladder. It is used to treat UI when other medicines or self-care treatments don’t work. Injecting Botulinum toxins into the bladder relaxes it, which makes more room for urine and lowers the chances of developing UI.
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SURGERY

Surgery may be a consideration for women with severe symptoms affecting quality of life.

Sling Procedures: Slings are placed under the urethra which supports the urethra.

Bladder Suspension: Resolves sagging of the bladder neck or urethra.

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DEVICES

  • Urethral insert is a small disposable plug inserted into the urethra before commencing an activity that triggers incontinence. It blocks leakages.
  • Pessary is a ring that is inserted into the vagina. A pessary helps support the bladder, to prevent urine leakage.

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BEHAVIOR MODIFICATION

  • Bladder training
  • Kegel exercises to strengthen bladder muscles
  • Smoking cessation
  • Weight loss
  • Biofeedback

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The images and/or videos are not presented as a guarantee of result. The results may vary. Patients gave their consent for the publication of images and/or videos.

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At Steinberg Urology we pride ourselves on our compassionate care we offer to those facing challenges that affect their quality of life. Our urologists have years of experience and a commitment to excellence.

If you need to discuss this sensitive medical concern, schedule a consultation at our clinic in a safe confidential environment. Let us help you achieve optimal health and wellness in a professional setting.

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