Undesirable leakage of urine, or urinary incontinence

I have a problem with urine leakage.

How the problem manifests itself

Undesirable leakage of urine, or urinary incontinence, occurs in many people and much more frequently in women. It often occurs in the course of pregnancy and more than 40% of women notice it after the birth. This incontinence can sometimes correct itself spontaneously, but often, however, recurs with the advancement of age.

It affects around 40% of women over 50 years of age, and if it is left untreated it will gradually get worse.

It consists of leakage when coughing, sneezing, standing up, jumping, unexpected abrupt movements or when lifting heavy objects. This form of incontinence is called stress incontinence.

In another form, the main problem is a pressing need to urinate. This problem occurs in 34% of the adult female population. If this sense of urgency leads to leakage of urine before a toilet can be reached then this condition is known as urge incontinence. This problem occurs in 30% of cases and usually worsens overall quality of life.

There are even other types of urinary incontinence: incontinence during sexual intercourse, incontinence during sleep, or even combined incontinence, when two or more types occur in one women.

How the problem is diagnosed

For adequate solutions, consultation with a specialist, specialized urogynecological examination, elimination of urinary infection and often urodynamic examination are required.

How the problem is treated

The solution depends on the seriousness and type of incontinence as well as the results of a diagnostic examination. The goal is to improve the function of one or more structures on which the holding of urine depends: ligaments, muscles, vessels, nerves and hormones.

Stress incontinence is treated by exercising the pelvic floor (physiotherapy), surgically (with the help of TVT tape) or the application of so called bulking agents.

Urge incontinence is usually treated with the aid of tablets which lessen the contraction of the muscle in the wall of the bladder (detrusor), or increase its relaxation. A further possibility is the application of botulotoxin into the bladder wall or, alternatively neuromodulation, which influences the function of the nerves leading to the bladder.

One of the newest proposed options for dealing with incontinence or urgency is the application of a laser to the anterior vaginal wall. It should be noted that this method does not yet have sufficient scientific evidence that it is effective in treatment.