Urinary Incontinence

Urinary incontinence is involuntary leakage of urine and it can affect both men and women. In addition to incontinence, many experience frequent urination, night time voiding and sudden urge to pass urine. This urge is often unexpected and some may even leak urine before reaching the toilet. For some, they experience urinary incontinence on coughing, laughing or sneezing. Oftentimes, these urinary symptoms negatively impact the lifestyle, forcing many to change their social habits such as avoiding functions, prefering to stay at home.

There are different types of urinary incontinence and, depending on the underlying cause, the treatment options are different. The more common ones are urge incontinence and stress incontinence.

Urge incontinence

It is primarily a bladder condition. The bladder can be likened to a receptacle, which contains urine, and within the lining of the bladder are muscles. Sometimes, these muscles go into unwanted contractions. These unwanted contractions result in feeling of urge to pass urine, frequent urination, night time voids and urge incontinence.

Treatment is aimed at decreasing or abolishing these contractions. The mainstay of treatment for urge incontinence is oral medication using an anti-cholinergic agent. There are different ones available in the market e.g. oxybutynin, tolterodine, solifenacin and darifenacin.

Sometimes, oral medication is not effective and in such instances, other treatment options are available. One such alternative is injection of botulinum into the bladder muscles.

Stress incontinence

This refers to urinary leakage on coughing, laughing, sneezing, etc. It usually affects women who have had many childbirths. The cause is due to the inability to hold urine when the bladder outlet is ‘stressed’. The bladder outlet is conduit through which urine is passed out of the bladder. It’s function, among others, is maintained by the health of the tissues around it as well as the strength of the pelvic floor muscles. After menopause and multiple childbirths, these tissues are weakened, resulting in stress incontinence.

Treatment is aimed at strengthening the outlet and this can be accomplished by pelvic floor exercise. This is also known as Kegel exercise and is highly effective. For some, other forms of treatment, such as surgery, is needed. There are many types of surgery for stress incontinence and one is mid-urethral sling. The sling surgery involves placing a synthetic material beneath the bladder outlet and acts as a backstop during urination. This is an effective way of treating stress incontinence.