Recently I went to a conference run by The incontinence society of New Zealand. It was attended by a wide range of health professionals including gynaecologists, urogynaecologistes, physios, nurses and people dealing with incontinence.
As always with such a diverse group of people there were so many options and such a variety of options that people can follow.
Let me spend a few minutes going over what we mean by the different term we use to define incontinence. I will stick to urinary incontinence and not faecal incontinence.
Urinary Incontinence is the involuntary passage of urine.
1) Urinary Stress incontinence or USI: This is the involuntary passage of urine when there is an increase in intra abdominal pressure such as coughing sneezing or laughing. This is extremely common; in fact almost all women may at some point in their lives may experience this. The causes are often related to child birth and vaginal prolapsed. During childbirth the pelvic floor muscles are often damaged resulting often in a prolapse. As one get older and the hormones change this will further aggravate the situation. Last but by no means is least what you inherit from your mum, aunts and grandmother.
If it is a minor irritant and occasional it best to follow the conservative approach which involves pelvic floor exercise alone or under the guidance of a physiotherapist. If it is of such a problem that you need to constantly wear pads and it adversely affect your life then surgery may be the answer.
2) Urgency and urge incontinence UI :
The woman who always knows where the nearest toilet is is probably suffering from urgency. This is the need to go feeling and if you can’t make you will wet. It is the urgent desire to pass urine often small amount.
The commonest cause is a cystitis or bladder infection. However, it also occurs in older women who lack oestrogen or hormone support of their vaginas. Other causes are neurological disease, tumours, small capacity bladders and a condition called interstitial cystitis.
This is an extremely debilitating condition and should always be medically addressed.
3) Overflow incontinence: the bladder overfills, the desire to empty is not felt or their is an obstruction to the outflow and the bladder gets overfull. Causes are neurological or obstructive.
Often the incontinence is mixed and has components of one two or three.
With each of these types there are specific treatments most of which are extremely successful.
Often a test called urodynamics is performed. These are pressure testing where we would be able to determine which incontinence you have and then the correct treatment can be offered.
Talk to your health care professional about this. It is often embarrassing but there is help at hand which as I say is usually excellent