Suzanne Biers
Urology Consultant Lead for Female, Functional and Reconstructive Urology
Addenbrooke’s Hospital, Cambridge University Hospitals Trust, Cambridge
On behalf of The Female Neurological and Urodynamic Urology Section Committee of the British Association of Urological Surgeons (BAUS)
Urinary incontinence does not need to be accepted as part of getting older, recognising the signs and symptoms is the first step to finding the right treatment.
Urinary incontinence is the involuntary leaking of urine. It affects around 13% of women and 5% of men and becomes more common as people get older.
Stress urinary incontinence is a urine leak which can be triggered by exertion, exercise, coughing, laughing and sneezing. In women, it accounts for nearly 50% of all incontinence and is influenced by childbirth and the menopause. In men, it is much less common but can occur after prostate surgery or radiotherapy.
Urgency incontinence is a urine leak when the toilet cannot be reached in time, usually accompanied by passing urine frequently (day and night-time). This is also referred to as an overactive bladder. It affects around 17% of people over the age of 40 and increases steadily with age. A combination of stress and urgency incontinence symptoms is termed mixed urinary incontinence.
Treatment options are available
Urinary incontinence can be improved with simple measures and changes to lifestyle alone. However for some, medication or surgery may be needed. Stress incontinence can be helped by physiotherapy supervised pelvic floor exercises, weight loss and avoiding constipation. After trying this, surgical options are generally more effective than medicines. Operations involve supporting or ‘bulking-up’ the waterpipe (urethra). Different operations have their pros and cons and carry risks which will be discussed by your specialist. Sometimes additional tests are offered to help with decision making, such as urodynamics (bladder function test). The National Institute for Health and Care Excellence (NICE) and the British Association of Urological Surgeons (BAUS) provide guidelines for the management and treatment of urological conditions.
Urinary incontinence can be improved with simple measures and changes to lifestyle alone. However for some, medication or surgery may be needed.
Urgency incontinence can be treated by moderating the volume and types of fluids consumed, such as avoiding caffeinated drinks, fizzy drinks and alcohol. Several different types of medication can be offered. If these are ineffective, procedures (injection of Botox into the bladder under local anaesthetic) and operations can be considered.
Speak to your GP for advice
There are a range of effective options for urinary incontinence including lifestyle and diet changes, pelvic floor physiotherapy and medications. If these fail, surgery may be considered. Alternatively, containment devices (pads or sheaths) or catheters may be opted for after consideration of the pros and cons. The aim of treatment is to facilitate a full and active life. Urinary incontinence can be managed effectively and should not just be accepted or ignored.
