Urinary Incontinence

Urinary Incontinence

What are the types of incontinence?

Sometimes known as a 'wek bladder 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?

Urodynamcs is a simple test that identifies the cause of urinary incontinence to allow the correct treatment to be offered. 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 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 muscle. 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 can 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.

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