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What is urinary incontinence?

With a variety of treatment options available for incontinence, women can regain control and an active lifestyle. Learn more about urinary incontinece

References

1. Vulker, R. International Group Seeks to Dispel Incontinence “Taboo”, JAMA, 1998, No.11: 951-53

Urinary incontinence is the involuntary loss of urine from the body. It affects 200 million people worldwide (cf 1). Urinary incontinence that occurs with straining or physical activities is known as stress urinary incontinence (SUI).

Typical activities that can provoke leakage of urine are running, jumping, coughing, sneezing, laughing, and even sexual intercourse. While incontinence is often considered to be a part of aging, in many cases it can be treated.

There are non-surgical options for management and treatment including fluid restriction, pelvic floor muscle exercises, and vaginal incontinence pessaries. If none of these options provide acceptable relief, surgical correction may be considered.

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Signs and causes

Signs of incontinence Signs of incontinence Are you showing signs of incontinence? Take this quiz and find out. Take the quiz

Below are some simple questions to help start a dialogue with your doctor.

If you answered yes to any of these questions incontinence may be preventing you from enjoying your life. Speak to your doctor to find the most effective treatment option for you.

 

Do you leak urine unexpectedly?

 

 Yes No

 

What is the severity of leakage?

 

Mild
(a few drops)

Moderate (wet undergarments)

Severe (wet clothing)


 

Do you leak urine when you ...

Cough?
Sneeze?
Laugh?


Bend? Lift?


Change positions
(i.e. sitting or

laying to standing)?

Engage in sexual intercourse?



Do you leak urine continuously during the day?
 
Yes No


Do you leak urine while sleeping? 
 
Yes No


Has urine leakage caused you to change your lifestyle?

 

Yes No


If yes, how has your lifestyle changed? 
 

Limiting fluids 

Staying home
Limiting clothing to dark clothes
Stop exercising 
Other
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Causes of incontinence. Causes of incontinence. Stress urinary incontinence can develop with age, and may often be a result of childbirth. More about incontinence causes

Stress urinary incontinence can develop over time, as you get older, and is sometimes linked to childbirth. It can also occur as a result of chronic or repetitive straining (constipation, chronic coughing, high impact aerobics), from menopause or even a hysterectomy.

Damage, weakening or injury to the muscles supporting the urethra can result in stress urinary incontinence. It occurs when weak pelvic floor muscles, especially at the bladder neck opening and urethral sphincter, cannot reflexively tighten during times of increased pressure on the bladder and the urethra. This leads to the urine involuntarily escaping.

Stress urinary incontinence commonly occurs with:

  • Laughing
  • Sneezing
  • Coughing
  • Lifting
  • Exercising
  • Entering/exiting a vehicle
  • Sexual intercourse
  • Increasing abdominal pressure in any other way
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Treatment options

Incontinence treatment options without surgery If you have stress urinary incontinence, it’s a good idea to know about your different treatment options. Non-surgical treatment options

If you have been diagnosed with stress urinary incontinence, there are many options for treatment. Your doctor will be able to discuss all the treatment possibilities with you.

 

Non-surgical options include pelvic muscle exercises, protective undergarments, behavioural therapy, catheters, vaginal pessaries and bulking injections.

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Surgical treatment options for incontinence Surgical treatment options

Surgical treatments for incontinence may include open bladder neck suspensions, and sling procedures. A sling procedure may be prescribed by your doctor that places a small strip of synthetic or biologic material beneath the urethra. Like a backboard, it supports the urethra during activities that put a strain on the area and prevent leakage from occurring.

sling system

Are there any risks?

Like any surgery, there are some risks related to the procedure.

These include:

  • Vaginal extrusion
  • Erosion (e.g., vaginal, urethral)
  • Dyspareunia (i.e., painful intercourse)
  • Sling migration
  • Infection
  • Pain
  • Hematoma
  • Scarring
  • Transient or permanent urinary retention/obstruction
  • Urethral obstruction
  • Voiding dysfunction
  • Nerve injury
  • Vascular injury
  • Bladder, bowel, urethra, vessel and/or nerve perforation

Talk to your doctor to discuss these risks in detail.

 

The mesh used to correct incontinence may cause pain. You may also be able to feel the mesh inside of the vagina. When this occurs, it can interfere with intimate sexual activity. You may also experience an increased need to urinate, or your urine flow may be slower.

 

You may also not be able to urinate naturally following the procedure. This could be temporary, but it may last a month or longer. If this occurs, a catheter will be inserted to help you urinate, or you may need another operation to have the sling clipped or cut. Depending on how severe the symptoms are, further surgery may be necessary.

 

Another potential risk is having a reaction to the sling material itself, or getting an infection that requires treatment with antibiotics. Talk to your doctor about all these risks and reactions.

It’s a good idea to really understand and consider all the potential risks as well as the benefits of a permanent implant when you choose a treatment option.

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Frequently asked questions

Get the answers to common questions about urinary incontinence. Incontinence FAQ

References

1. Vulker, R. International Group Seeks to Dispel Incontinence “Taboo”, JAMA, 1998, No.11: 951-53.

What is urinary incontinence?

Urinary incontinence is the loss of voluntary control over your urinary functions. This condition affects 200 million people worldwide.

 

What causes female stress incontinence?

Female stress incontinence can develop slowly over time. It generally occurs when your pelvic muscles are not strong enough to keep the opening of the bladder neck closed under physical stress such as laughing, coughing, lifting, exercising, or any increased abdominal pressure.

 

If you have been diagnosed with stress urinary incontinence, there are many options for treatment.

Your doctor can discuss the treatment options with you.

 

What is a sling procedure?

A sling procedure is a minimally invasive surgical procedure to correct stress incontinence using a simple hammock or U-shaped sling to support your urethra.

 

Are there any risks associated with a sling procedure?

While every surgical procedure carries some risk including bleeding, infection, or organ damage, with sling surgeries you may experience some complications after the procedure, including pain, mesh exposure, infection, urinary problems, or pain during intercourse. You may have a reaction to the sling material itself. Ask your doctor for more information about potential risks and complications, as well as your specific surgery and situation.

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