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Understanding the causes of urinary incontinence and the treatments available

10 September 2020

It’s estimated that urinary incontinence affects up to 6 million people in the UK, yet many people would feel too embarrassed to discuss their condition.  

This #UrologyAwarenessMonth we are breaking down the stigma associated with urological conditions and urging people to seek help. 

As part of Urology Awareness Month Consultant Urologist, Mr Jeremy Oates talks about urinary incontinence, its causes and available treatments. 

First, let’s define urinary incontinence.  This is when you lose control of your bladder, which is very common and can cause embarrassment for some people.  It varies in severity from occasional leakage of urine when you sneeze, cough, exercise (or even laugh), to having such a strong urge to urinate that you can’t get to the bathroom in time.  It can also happen when you don’t expect it, such as during sleep or after drinking water.

Urinary incontinence can impact quality of life so it’s important to seek help.  The last thing we want people to do is avoid exercise or other social activities due to this condition.  We want to encourage conversations between patients and doctors to make sure people get the help they need, so that activities are not limited and a full life can be enjoyed. In the majority of cases this problem is treatable.  

Whilst urinary incontinence can affect anybody, women are twice as likely to be affected as men due to reproductive health. During pregnancy and childbirth the pelvic floor muscles that support the bladder, urethra, uterus and bowels can get weaker or become damaged. When the muscles that support the urinary tract are weak, the muscles in the urinary tract must work harder to hold urine. This puts additional stress or pressure on the bladder and urethra, which can lead to urinary incontinence or leakage.

Age is also a factor, again particularly for women because of the hormonal changes that happen during menopause.  That being said, It’s not an inevitable part of aging and shouldn’t be over-looked, ignored or simply endured as ‘part of aging’.

When it comes to men, incontinence is often related to prostate problems or treatments. A man’s prostate will grow throughout their life and the older they get, the bigger their prostate gets. Equally, in the same way some men have big feet, some men have big ears and some men have big noses, some men will have bigger prostates than other men! Enlargement can result in a reduction of the flow of urine out of the bladder which can then cause other urinary symptoms, including incontinence. It can be very difficult for men to ask for help but treatment is usually very successful and can have a dramatic impact on quality of life.

It’s important to note that in some cases urinary incontinence can be a sign of a more serious problem, particularly if it has developed suddenly so it’s important that you do not ignore these symptoms and talk to your doctor as soon as possible.

Treatment for both sexes, and all ages, depends on the type of incontinence you have and to what extent it impacts your life. There are so many treatments available to treat incontinence, these may include medicines and surgery to help increase the amount of urine your bladder can hold, nerve stimulation to strengthen the muscles that help control the bladder, Botox injections to the bladder muscle, muscle training exercises or a combination of approaches depending on your individual diagnosis. 

Only a few people require surgery and the majority of people with incontinence do not, particularly given the range of treatments available.

There are also some simple lifestyle changes that can make a big difference to urinary incontinence:

-          Cutting back on caffeine (remember tea contains caffeine too!)

-          Limiting alcohol consumption

-          Stopping smoking

-          Staying at a healthy weight

-          Introducing some simple pelvic floor exercises

If you have symptoms of urinary incontinence, please don't be embarrassed to tell your doctor – we want to help, especially as most people with incontinence can be helped or cured.

For more information about Urology treatments at The Wilmslow Hospital read more here

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