Urinary incontinence is the involuntary leakage of urine and is a common condition affecting people of different ages. It can range from occasional leakage to more frequent symptoms that affect daily activities and quality of life.
Incontinence is not an inevitable part of ageing, but it can have several possible causes. Understanding the type of incontinence and the factors contributing to it can help guide appropriate assessment and management.
What Is Urinary Incontinence?
Urinary incontinence occurs when urine leaks involuntarily from the bladder.
There are several types of urinary incontinence, and symptoms and treatment options can differ depending on the type and underlying cause.
Stress Urinary Incontinence
Stress urinary incontinence (SUI) occurs when urine leaks during activities that increase pressure on the bladder.
Common triggers include:
- Coughing
- Sneezing
- Laughing
- Exercising
- Lifting
- Other physical activities
Stress incontinence can be associated with changes in pelvic floor muscle function and support. Pregnancy and childbirth, ageing and other factors may contribute.
Urge Urinary Incontinence
Urge urinary incontinence involves a sudden and strong need to urinate that may be difficult to control and can result in urine leakage.
People with urge incontinence may also experience:
- Urinary urgency
- Frequent urination
- Night-time urination
- Difficulty delaying urination
Urge symptoms can be associated with overactive bladder, urinary tract infections, certain neurological conditions and other factors.
Mixed Urinary Incontinence
Mixed urinary incontinence involves symptoms of both stress and urge incontinence.
Because the two types can have different contributing factors, assessment is important when both types of symptoms are present.
Overflow Incontinence
Overflow incontinence occurs when the bladder does not empty properly and urine subsequently leaks.
Possible causes include bladder outlet obstruction, impaired bladder muscle function, certain medications and neurological conditions.
Overflow symptoms should be medically assessed because incomplete bladder emptying may require specific investigation and management.
Functional Incontinence
Functional incontinence occurs when a person has difficulty reaching or using the toilet in time because of physical, cognitive or environmental factors.
Mobility difficulties and certain cognitive conditions may contribute.
What Causes Urinary Incontinence?
There is no single cause of urinary incontinence.
Factors that may contribute include:
- Pregnancy and childbirth
- Pelvic floor muscle dysfunction
- Ageing
- Menopause and hormonal changes
- Constipation
- Changes affecting the bladder or urinary tract
- Urinary tract infections
- Neurological conditions
- Diabetes
- Chronic coughing
- Certain medications
- Prostate conditions or prostate surgery
- Previous pelvic surgery
- Changes in mobility
Being overweight can also increase pressure on the bladder and pelvic floor.
Because the causes are varied, an assessment is important before deciding which treatment or management approach is appropriate.
How Is Urinary Incontinence Diagnosed?
Assessment usually begins with a discussion about your symptoms and medical history.
Your practitioner may ask about:
- When the leakage started
- How frequently leakage occurs
- What activities or situations trigger symptoms
- Urinary urgency and frequency
- Night-time urination
- Fluid intake
- Pregnancy and childbirth history
- Previous pelvic or prostate surgery
- Current medications
- Other medical conditions
Depending on your symptoms, assessment may include a physical examination, pelvic floor assessment, bladder diary or urine testing.
Additional investigations or referral to a specialist or continence health professional may be recommended where appropriate.
Treatment and Management Options
Treatment depends on the type of incontinence, its underlying cause and the individual's circumstances.
Pelvic Floor Muscle Training
Pelvic floor muscle training can help improve pelvic floor function and is commonly recommended for stress urinary incontinence.
A pelvic floor physiotherapist or other appropriately qualified health professional can provide individual guidance on pelvic floor exercises.
Bladder Training
Bladder training may be recommended for some people experiencing urgency or urge incontinence.
It involves gradually developing strategies to increase the time between the urge to urinate and using the toilet, under appropriate professional guidance.
Lifestyle Measures
Depending on the individual, lifestyle measures may form part of an incontinence management plan.
These may include:
- Managing constipation
- Maintaining a healthy weight where appropriate
- Reviewing bladder irritants such as caffeine and alcohol
- Maintaining appropriate fluid intake
- Addressing smoking or chronic coughing
- Adjusting toileting habits
Fluid restriction is not appropriate for everyone, so discuss your individual fluid needs with your healthcare professional.
Medicines
Medication may be considered for certain types of urinary incontinence, particularly some forms of urge incontinence.
A qualified medical practitioner can determine whether medication is appropriate based on your symptoms and medical history.
Other Non-Surgical Treatment Options
Depending on the cause of urinary symptoms, other non-surgical treatments may be discussed.
Some vaginal treatments use controlled energy to produce a thermal response within vaginal tissues. Research has investigated these treatments for certain urinary symptoms, including stress urinary incontinence.
The evidence varies according to the treatment, condition and patient population studied. Treatment is not appropriate for everyone, and outcomes cannot be guaranteed.
Where this type of treatment is being considered, your practitioner should explain the available evidence, potential benefits, limitations, risks and alternatives before treatment.
Surgical Treatment
Surgical treatment may be considered for some patients when conservative or non-surgical approaches have not adequately addressed their symptoms.
Whether surgery is appropriate depends on the type and severity of incontinence, underlying causes, previous treatment and individual circumstances.
Living With Urinary Incontinence
While seeking assessment or treatment, practical strategies can help manage urinary symptoms.
These may include:
- Keeping a bladder diary
- Planning access to toilets when away from home
- Using appropriate continence products when required
- Following an individual pelvic floor exercise program
- Managing constipation
- Discussing persistent symptoms with a healthcare professional
Urinary incontinence is common, but ongoing leakage should not simply be assumed to be a normal consequence of ageing or childbirth.
When Should You Seek Medical Advice?
Consider speaking with a doctor or other appropriately qualified healthcare professional if you:
- Experience recurring urinary leakage
- Have sudden or persistent urinary urgency
- Need to urinate unusually frequently
- Wake repeatedly during the night to urinate
- Feel that your bladder does not empty completely
- Experience difficulty passing urine
- Have symptoms that are affecting your daily activities or quality of life
Some urinary symptoms can have causes that require investigation, so appropriate assessment is important.
A Consultation-Led Approach
Urinary incontinence is not a single condition, and treatment should be based on the individual's symptoms and clinical circumstances.
At Géniale Intimate, a consultation provides an opportunity to discuss your urinary symptoms, relevant medical history and available management options.
Where appropriate, your practitioner may recommend further assessment or referral to another healthcare professional.
Any treatment recommendation should be based on an individual clinical assessment rather than a general expectation of benefit.
Discuss Your Symptoms With a Qualified Practitioner
If urinary leakage, urgency or other bladder symptoms are affecting your daily life, a medical assessment can help identify the likely cause and appropriate management options.
Géniale Intimate provides doctor-led consultations for urinary and intimate health concerns, with treatment recommendations based on individual clinical assessment.
