There are different types of urinary incontinence. The most common are stress incontinence and urge incontinence.
Stress incontinence is triggered by pressure on your abdomen (like when you laugh, cough, sneeze or do something physical like playing sport, jump or lift heavy things).
Urge incontinence is triggered by an overactive bladder. It is characterised by strong ‘urges’ to go to the toilet and not making it in time.
Urinary incontinence can have a big impact on your quality of life. Many women find it so embarrassing that they don’t seek medical help but there are a range of treatments that can help.
What causes urinary incontinence?
We don’t always know what causes incontinence in a particular woman, though you are most likely to have urinary incontinence if you’ve had children and/or been through menopause.
During pregnancy, the extra weight and changes in hormones weaken your pelvic floor (the muscles, ligaments and tissues that support your bladder). The pelvic floor is then weakened again during labour by pushing and then after menopause, when your body makes less of the female hormone oestrogen that helps keep the pelvic floor strong.
You are also more likely to have urinary incontinence if you:
often have constipation and strain to empty your bowels or cannot empty them completely or easily
have a long history of poor bladder habits (e.g. going to the toilet ‘just in case’, straining too hard)
have a prolapse where your bladder, uterus or bowel has ‘dropped down’ into your vagina and puts pressure on your bladder
are over 65 years of age
have had a condition affecting your brain’s ability to send messages to your bladder (like a stroke, Parkinson’s disease or multiple sclerosis)
How is urinary incontinence diagnosed?
Your GP or gynaecologist will most likely:
ask you questions about the history of your health
examine your body
ask you to cough, push down or tighten your pelvic muscles.
They may send you for further testing (urodynamic) to try to ascertain what is causing the incontinence or they may ask you to keep a ‘bladder diary’ documenting fluids in and out to determine what type of incontinence you have
How is urinary incontinence treated?
The kind of treatment you have will depend on:
the type of urinary incontinence you have
your age, health and medical history
Your doctor may refer you to a women’s health physiotherapist or a doctor who specialises in women’s pelvic floor problems (called a urogynaecologist).
They may recommend one or more of these treatment options:
Lifestyle changes such as losing weight, quitting smoking, eating more fibre, drinking more water or lifting less.
Medication to help relax the bladder muscles, which play an important role in urge incontinence.
Physiotherapy to strengthen the pelvic floor, which supports your bladder. A physiotherapist can design a special pelvic exercise program for you.
Laser therapy such as IncontiLase™ to tighten the vaginal walls (vaginal mucosa tissue and collagen-rich endopelvic fascia), providing greater support to the bladder. This is a safe, effective treatment that requires no hospital admission, anaesthesia or incisions.
Bladder training with the aim of restoring the normal functions of your bladder. This is particularly helpful for ‘urgency’ (the sudden need to rush to the toilet) and for ‘urge incontinence’.
Surgery to support or ‘hold up’ your bladder or urethra (the tube that links your bladder to the outside of your body). Surgery is usually only considered if medication or physiotherapy have not been successful.
The success of treatment can vary. While treatment may not ‘cure’ your incontinence, it can still help you live more comfortably with it.