About the condition
Urinary incontinence is the inability to control the release of urine from your bladder. It is a common and often embarrassing problem. The severity of urinary incontinence ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that is so sudden and strong that you do not get to a toilet in time.
Types of urinary incontinence include:
• Stress incontinence
• Urge incontinence
• Overflow incontinence
• Mixed incontinence
• Functional incontinence
• Gross total incontinence
Causes of the condition
Urinary incontinence is not a disease, it is a symptom. It can be caused by underlying medical conditions or physical problems. Some temporary causes of urinary incontinence include alcohol, excessive fluid intake, caffeine, medications, urinary tract infection or constipation.
Common causes of incontinence in women include, pregnancy/childbirth, changes with aging, post hysterectomy or painful bladder syndrome otherwise known as interstitial cystitis. For men, some of the causes of urinary incontinence include prostatitis, enlarged prostate or prostate cancer. Bladder cancer, bladder stones and neurological disorders can be some of the other causes of urinary incontinence
Diagnosis and treatment options
Treatment will depend on the type of urinary incontinence, the severity and the underlying cause. We will perform the necessary tests to clearly understand the specific cause of incontinence. This will include
- Urinalysis - A sample of urine is examined for the presence of infection, blood or other abnormalities.
- Post void residual measurement - After the patient urinates, the amount of urine left over in the bladder is measured. This can be done by placing a small catheter into the bladder through the urethra and measuring the urine that comes out or by examining the bladder with ultrasound.
- Ultrasound - Ultrasound can be used as a more comfortable way to measure the post void residual amount of urine. Ultrasound also demonstrates the size and shape of the kidneys, ureters, and bladder to evaluate whether urine has backed up within the kidneys (hydronephrosis).
- Urodynamic testing - This in depth examination evaluates bladder and urinary sphincter function as the bladder is filled and emptied. A small tube (known as a catheter) is placed through the urethra into the bladder to measure the pressure inside the bladder. At the same time, a catheter is place inside the rectum to measure the pressure in the abdomen. This test also assesses whether a patient has normal bladder sensation and capacity. The whole evaluation takes about 30 to 45 minutes.
- Voiding diary - The patient keeps a close record of when the urge to void occurs and when voiding and leakage occur. The amount of leakage is also recorded. This allows the physician to better understand the patient's incontinence.
- Cystoscopy - The urologist places a cystoscope into the bladder through the urethra. The cystoscope is a long, narrow tube with a lens at the tip, which allows the urologist to thoroughly inspect the inside of the bladder for any abnormalities.
Treatment options for urinary incontinence range from more conservative approaches, to more aggressive options, such as surgery. In most cases, we will suggest the least invasive treatments first and move on to other options only if these techniques fail. In many cases, a combination of treatments is used.