Female Incontinence Causes & Treatment

Female urinary incontinence

Although it’s known to be more commonplace amongst older women, urinary incontinence now affects as many as half of all women¹. Despite being disruptive to everyday life, many sufferers often due to embarrassment are reluctant to seek professional help to find the cause and treatments readily available to them.

Types of incontinence

There are two main types of incontinence, stress and urge;

Stress incontinence

This is caused by sudden abdominal pressure from coughing, laughing, physical exertion or sneezing. It is important to tell your doctor if this is the case as treatment is different.

Urge incontinence

This can be more difficult to diagnose and is caused by a hyperactive bladder and defined as regularly feeling a strong urge to urinate; sufferers will often urinate before reaching a toilet.

Female incontinence causes often remain unknown, but women meeting a combination of these criteria are evidently more prone;

• Menopause
• Post Pregnancy
• Those frequently suffering with long-term problematic constipation
• Prolapsed bowel
• Sedentary lifestyle
• Poor dexterity

Diagnosis

Alongside a physical examination a full review of a patient’s medical history should be undertaken. It might be advisable to keep a bladder diary to record personal fluid intake, output and leakage. This could prove helpful in diagnosing specific types of urinary incontinence. You may have apparatus used to monitor your bladder behaviour, called Urodynamic testing.

Treatment of urinary incontinence

As well as age, health and medical history, both the severity and type of a urinary incontinence will ultimately dictate a patient’s treatment options; this is often decided by a urologist or gynaecologist. Depending on the cause treatment options exist ranging from lifestyle changes, muscle relaxant medication, physiotherapy or surgery when all else fails.

Surgical treatment

Four surgical procedures are available for stress incontinence;

1. Colposuspension – stitches raise and attach the bladder neck to the pubic bone.
2. Mid-urethral sling procedure – supports the urethra using mesh
3. Rectus fascial sling – supports the urethra using small amounts of tough belly tissue)
4. Urethral bulking agents – strengthens the bladder neck using injections

After receiving either a local anaesthetic (numbing the operation site), general anaesthetic (full unconsciousness) or regional/spinal anaesthetic (numbing the entire pelvic region), patients will undergo key-hole surgery, where tiny cuts are made to the belly or vagina; under some circumstances, longer cuts to the belly could also be required.

¹ The Royal Women’s Hospital, Victoria, Australia, Incontinence, January 2021