Urinary Incontinence

Incontinence or urinary incontinence is a condition that occurs when a patient loses control of their bladder and occasionally leaks urine involuntarily. The leakage may be minor or complete emptying of the contents in the bladder.  

There are usually three types of incontinence:

Stress incontinence 

Stress incontinence occurs when stress is put on the sphincter muscle that controls urine in the bladder. Activities like exercising, coughing, sneezing, and laughing can cause the sphincter to release urine.

Urge incontinence 

Urge incontinence occurs after a strong and sudden urge to urinate. When this happens, the patient may lose control causing bladder leakage.

Overflow incontinence

Overflow incontinence or dribbling occurs when a patient urinates and does not empty the bladder. After the urination process, some of the remaining urine may leak from the bladder.

Some patients can experience more than one of these three types of incontinence at the same time. The most common causes of urinary incontinence are physical damage to floor muscles of the pelvic, weakened bladder muscles due to ageing, and cancer.

The other causes may include urinary tract infections (UTIs), kidney or bladder stones, constipation, side effects from certain medications, and the effect of too much alcohol, caffeine, and fluids that can affect the proper functioning of the bladder. Some of the causes are easy to treat and only cause temporary incontinence, and others are more serious, persistent, and require advanced treatment. 

Incontinence Diagnosis

Diagnosis for incontinence involves carrying out some examinations, both physical and medical, including Urinalysis, keeping a diary of the patient's fluid consumption and urination habits, and measurements.

Incontinence treatment depends on the type, severity, and prevalent symptoms. Available treatment methods are bladder training, fluid and diet management, pelvic floor exercises, pelvic floor stimulation and strengthening, medications, urethral and vaginal inserts, injections and nerve stimulators, and surgery. 

Surgical options for incontinence

If your urinary incontinence symptoms are severe or you have an overactive bladder, surgery may provide a lasting solution. Surgical procedures for incontinence include. 

Sling surgery

Sling surgery involves making an incision in the lower abdomen and vagina to allow a sling to be placed around the neck of the bladder to support it and prevent leaking urine. The sling is made from tissues that are taken from another part of the patient's body, tissues donated by another person, or tissues taken from an animal. More often than not, the tissue from the patient's body is used. 

There are different types of sling procedures, Tension-free sling, and Conventional sling. Dr Cilly will discuss the risks and benefits of each type and help you to make the right choice depending on your situation.

Colposuspension

The procedure of colposuspension involves making an incision in the lower abdomen, lifting the neck of the bladder, and stitching it in the lifted position to prevent involuntary urine leaks. There are two types of colposuspension:

• Laproscopic Colposuspension, which involves one or more small incisions (keyhole surgery)  and requires short post-operative healing time.

• Open Colposuspension, which is done with a large incision, takes a longer post-operative healing time and has better long-term success rates.

Vaginal mesh surgery (tape surgery)

In vaginal mesh surgery, a strip of mesh is inserted behind the urethra (the tube that carries urine out of the body) to support it. The mesh, which is made from synthetic materials or animal tissue, stays in the body permanently.

You want to consult with Dr. Cilly to discuss your medical history, the procedure, and any other concerns.