Leakage of urine without warning is a common problem for many women over 40 years old. Some of the causes are:
- Childbirth with long labours and instrumental delivery
- Obesity and chronic cough
- The short female urethra
- Ageing of the pelvic muscles
A lot of women practice pelvic floor exercises to try and help themselves as well as restricting fluids and emptying the bladder frequently.
If the loss occurs after coughing or straining it is called Stress Incontinence and results in small frequent leakages. If the loss happens at any time and without warning it is called Detrusor Instability as the bladder muscle is called the detrusor muscle and can start to contract and squeeze out urine without the bladder being full or the woman ever being aware she needed to go to the toilet.
Some women have urge incontinence which means leakage on the way to the toilet after the signal to go is felt. Small amounts of urine start to leak prior to the woman sitting down comfortably on the toilet. The cost of wearing pantie pads daily can be high and feeling compromised takes away a woman’s confidence in her femininity.
Urinary incontinence can also be associated with faecal incontinence, a feeling of ‘something coming down’ - a prolapse and problems with sexual feelings. The assessment of your problem of urinary leakage will include:
- A full history of the problem
- A pelvic examination to detect prolapse
- A bladder scan to detect volumes that can be held and residual amounts after passing urine
- An infection screen for bacteria in the urine
- A urodynamic test if indicated
- A volume and frequency chart
After these investigations a diagnosis can be made as to the type of urinary leakage. If it is pure stress incontinence caused by lax muscles and a leaking urethral canal a very good procedure called a Tension Free Tape can be done. One night in hospital is required after the little tape is inserted under the bladder through a small cut in the vaginal wall. Many thousands of these operations have now been done with good results and complete cure in 95% of cases.
If the leakage is caused by an overactive bladder muscle – the detrusor – tablets can be prescribed to relax the bladder and bladder drill exercises started. There are several different types of tablets to relax the bladder and this will be discussed with you.
These two approaches are tried and tested and have helped thousands of women to live with and cure the problem.
At The Wellington Women’s Clinic we can do these assessments and advise you on what you need to do to help yourself.
Please phone 020 7722 8328 for an appointment.