Leakage of urine is a common problem in women. It affects more than 30% of women over the age of 40. In-spite of being very prevalent all over the world,not many women seek medical help due to the embarrassing nature of the problem.
There are many types of incontinence.
A description of some of the common types is as follows.
Mrs.K is a secretary at an office. She leaks urine every time she laughs or sneezes. She had two episodes where she wet her office chair. She kept going to the toilet every 15-30 minutes to keep her bladder empty. Her colleagues complained that she is avoiding work;she was too embarrassed to explain her predicament to management and resigned her job. She was the sole breadwinner for the family! Following a complete assessment she underwent the TVT operation and now works as a physical instructor in a gym.
Stress Incontinence is the leakage of urine when one coughs, walks or even laughs. This causes many women to avoid physical activities and exercise.
This can be treated by special exercises, tablets and surgery if needed.
Majority of the patients are easily treated with good expert input from a multidisciplinary team and non-surgically.
It is also necessary to be seen by an expert when these symptoms occur, as they are occasionally associated with abdominal masses, prolapse of the vagina or uterus and lack of oestrogen. Treatment of these causes also treats the incontinence in the vast majority.
Mrs.T was a health nurse who travelled a lot with her job. She developed urgency and urge incontinence very suddenly. She only seeked medical help after she sustained a fracture, when she fell when she was rushing to go to the toilet.
On assessment it was found she had a resistant infection of her bladder, which could have potentially gone up to her kidneys and caused a lot of harm.
Simple treatment of her infection treated all her bladder problems.
Urgency and Urge Incontinence is when the woman leaks with a sense of urgency, typically they have no control over this sensation of “needing to go “
Women who suffer from this type of incontinence will avoid going outside the house, travelling and socialising. This can be easily treated by special exercises that retrain the bladder and avoiding substances in your diet that irritate your bladder. In addition if necessary tablets can be prescribed.
Again new onset urgency and urge incontinence should prompt assessment with an expert as it might be the indication of a infection,bladder stone or early cancer of the bladder.
While they are plenty other types of incontinence the above presentations are the commonest. Timely help from an expert can sort these embarrassing problems and therefore women should be encouraged to seek help.
Finally urinary incontinence should never be accepted as an eventuality with ageing. Do not let Incontinence affect your quality of life
In the interest of public health and education
Dr.Vaishnavy V Laxman, MD
(Obstetrics and gynaecology; MRCOG (London; DFSRH (London)
Dr.Vaishnavy is the Urogynaecology consultant in Kauvery Hospital.
She was a consultant in the UK in Gynaecology with a special interest in Urogynaecology.
She is an expert in managing incontinence and prolapse in women