Urinary Incontinence
What are the types of incontinence?
There are two main types of urinary incontinence; the first is
stress urinary incontinence, where urinary leakage occurs with
activity. The second is bladder overactivity incontinence. Stress
urinary incontinence is caused by alteration of the continence
mechanism, which can happen due to age or childbirth. It is
associated with urinary leakage during activity, coughing and
sneezing. The second type of urinary incontinence is associated
with bladder overactivity. This type of incontinence is typically
associated with feeling of urinary urgency (a sudden compelling
desire to pass urine which is difficult to defer) and the constant
need to pass urine during day and night.
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What is Urodynamic Testing?
Urodynamcis is a simple test that is done to diagnose the cause
of urinary incontinence and test the strength of bladder muscle to
achieve normal voiding. It is a simple test that takes around
twenty minutes to do and involves inserting a small tube into the
bladder to fill the bladder with saline (salt water) and a small
tube into the vagina or occasionally the back passage. The bladder
is then filled with saline and the pressure inside the bladder is
measured throughout with the computer attached to the bladder tube.
You will then be asked to cough and sneeze to assess the exact
cause of urinary leakage. The final stage involves emptying your
bladder into an electric loo which measures the strength of your
bladder wall muscles. Based on the results of the test, a decision
will be made regarding surgery.
What is the surgical treatment of stress incontinence?
Surgical treatment of urinary incontinence depends on the type
of incontinence. A diagnosis is normally made with a test called
urodynamics. This is a simple test that takes around twenty minutes
to do to assess the strength of the continence mechanisms in the
bladder and the function of the bladder wall muscle. Modern
treatments of urinary incontinence include inserting the tension
free vaginal tape in the vagina. This is a simple procedure that
could be done as a day-case, with only two tiny cuts in the lower
abdomen, with more than 80% success rate.
Are there less invasive treatments available for the
elderly?
Urinary incontinence affects all age groups but tends to be much
commoner in the elderly population. The tape procedure may be
inappropriate for elderly ladies, especially with medical
conditions. We offer a minimally invasive procedure to treat
urinary incontinence under local anaesthetic using bulking agents
of the bladder neck. The procedure takes around fifteen minutes and
patients can go home on the same day.
What is the treatment of overactivity incontinence?
The treatment of this condition is generally medical, by the use
of tablets called anti-muscarinincs and bladder retraining
including cutting down on caffeinated drinks. If the tablets fail
to improve the symptoms, then surgical intervention is needed to
treat the overactivity.
What is the surgical treatment of overactivity?
Overactive bladder resistant to treatment with medical therapy
can be easily treated nowadays with injections of botulinium into
the bladder wall. This is a short procedure done through a small
telescope into the bladder, with no cuts involved. This can also be
performed as a day procedure. Pinehill Hospital is among few
providers of private healthcare offering patients this treatment
for overactive bladder.