Incontinence

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Urinary leakage of urine is a common problem. Affecting women more than men it causes anxiety, social isolation and can occur due to underlying bladder problems. There are 3 main types of urine leakage; the first is stress urinary incontinence (urine leakage on coughing, sneezing, laughing or heavy lifting); the second is urge urinary incontinence or the overactive bladder (urine leakage due to the inability to get to the toilet in time) and thirdly overflow incontience (urine leakage due to a full bladder). Often these types of leakage can exist together.

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Assessment and treatment concentrate on identifying the underlying problems with the bladder. Your specialist will need to talk through your symptoms with you (History) and then examine you. The investigations required are very variable but include flow tests, a bladder scan or urodynamics (pressure testing of the bladder). Your specialist may ask you to record your fluid intake and how much urine you produce each day (input/output chart). You may need a cystoscopy (bladder examination) [/tab]

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The treatment of urinary incontinence ranges from simple measures to more complex treatments. This is best thought as levels of treatment.

Level 1 – Lifestyle changes and pelvic floor exercises

By decreasing your caffeinated fluid intake (Coffee, Tea, Cola drinks) many patients will improve their urinary incontinence. Weight loss can be very affective as can stopping smoking. In many patients pelvic floor exercises are very important in improving continence. Simply avoiding diuretics can give relief.

Level 2 – Medication

If you have predominately urge urinary incontinence then some medications can be very affective in improving your symptoms. These are drugs called anti-cholinergics and stop the nervous impulses to your bladder.

Level 3 – Minimally invasive treatments

If other treatments have not been successful urge urinary incontinence can be treated with either nerve stimulation (percutaneous tibial nerve stimulation or PTNS) or intravesical botox injections. PTNS is a non-operative technique, whereas intravesical botox involves a cystoscopy operation with injections inside the bladder. Intravesical botox can be performed under general anaesthetic as a daycase, or there is the option of having it performed under local anaesthetic as an outpatient procedure. These treatments will need a complete discussion with your consultant before they are offered.

Level 4 – Surgery

Many surgical treatments are available for urinary incontinence. The appropriate treatment will depend on your particular symptoms and circumstances. We tailor all our treatments to our individual patients needs after detailed assessement.

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