Urinary incontinence is an involuntary leakage of urine. Studies suggest that 40% to 50% of women who experience urinary incontinence never actually complain to anyone.
Seventy percent of women with urinary incontinence worry about coughing, sneezing and laughing in public in fear of having an accident, and 35% travel less frequently and avoid sexual intercourse. More than 60% wait a year or longer before discussing their condition with a doctor and 17% wait five or more years.
“Maybe we’re not doing a good enough job as doctors in asking our patients, as some people feel embarrassed to ask about their condition,” said Dr. Sachin Shenoy, an obstetrician and gynecologist at University Medical Center and assistant professor in the Department of Obstetrics and Gynecology at the UA College of Community Health Sciences.
Shenoy explained that there are three different types of urinary incontinence: stress, urge and mixed. Mixed Incontinence is a combination of stress and urge incontinence.
“Stress incontinence is in about 50% of the patients I see,” Shenoy said. “Urge incontinence is in about 14% and the mixture of the two is in about 32% of patients. Some patients have mobility issues, where they are unable to get to the bathroom in time. (Past) surgeries and other procedures can also be a cause as to patients getting to the bathroom on time.”
Stress urinary incontinence is the involuntary leakage of urine because of effort or exertion, or sneezing, coughing and sexual intercourse, among others. Stress incontinence can happen for various reasons: pregnancy, obesity/weight gain, stress on the pelvis, smoking, genetics and prolapse.
Treatments for stress incontinence include pelvic floor exercises or Kegel exercises. The patient squeezes pelvic muscles, as if trying to stop the stream of urine, for three to five seconds at a time with 10 repetitions. Another treatment is minimally invasive surgical approaches, such as pubovaginal slings and bulking agents. Pubovaginal slings provide support to the urethra with a synthetic mesh material. The surgical procedure takes 30 minutes. Post-surgery discomfort and pain are minimal and patients can usually return to work in a matter of days.
Urgency urinary incontinence is involuntary leakage accompanied by or immediately preceded by an urgency or a strong desire to void; it is often sudden and without warning. It may be precipitated by the sound of running water, cold weather and leaking on the way to the restroom. The symptoms of urgency incontinence are loss of urine before reaching the bathroom, frequency in voiding with small amounts of urine more than 10 times per day, waking up at night needing to void and bedwetting.
Treatments for urgency unitary incontinence include Kegel exercise, avoidance of bladder irritants in the diet, bladder retraining and medication.