Urinary incontinence

Does your bladder rule your life?
Urinary incontinence (the involuntary leakage of urine) is a common problem. Three million British women of all ages are affected at some point. It is well recognised that this affects many aspects of women’s lives. We want you to know that you don’t have to just “live with it.”

What is urinary incontinence?
Urinary incontinence is defined as the involuntary leakage of urine from the bladder. It is broadly divided into three types:

• Stress incontinence
• Urge incontinence
• Mixed incontinence

The self assessment questionnaire below may help you to find out what type of incontinence you have – but sometimes further tests may be required.

It is not always easy to tell what the underlying cause of incontinence is. Urodynamics is a specialist test that can give valuable information about the way your bladder is working and can help to tell what is causing the incontinence.

What causes incontinence?
Occasionally incontinence can be a symptom of other medical problems, so it is important to get things checked out by a specialist. In women, leakage of urine is usually caused by problems with three sets of muscles:

Bladder muscle – an overactive bladder may start squeezing out urine before you are ready to go to the toilet. This is known as urge incontinence

Sphincter muscle – the sphincter holds urine in the bladder until you are ready to pass urine. If this muscle is weak, you may leak when you cough, laugh or exercise. This is the most common type of incontinence – known as stress incontinence

Pelvic floor muscles – these help support the bladder and womb. If these muscles are weakened, a prolapse may occur (a bulge in the vagina). This can also affect your ability to control the bladder and pass urine.

To provide the patient with the correct treatment, an accurate diagnosis of the type of incontinence needs to be made. The tests most commonly used are:

• urodynamic assessment (bladder pressure studies)
• cystoscopy (telescopic camera which looks inside the bladder)

What is Urodynamics? A test which provides useful information about how your bladder is working. It is sometimes used to decide what sort of incontinence you may have and therefore what the most appropriate treatment is.

How is it performed? A soft, narrow tube is passed into the bladder so that the bladder can be slowly filled with fluid. An even smaller tube is put inside the back passage (rectum) to detect when the bladder is squeezing. It usually takes about 30-45 minutes to do the test.

Is it painful? Most people do not experience any discomfort.

What is it? This is an examination of the bladder using a narrow telescopic camera. It allows the surgeon to see the inside of the bladder and check if it looks healthy.

How is it performed? Some local anaesthetic gel is used to make the procedure more comfortable. The telescope is inserted through the urethra (the water pipe that drains the bladder).

Is it painful? Although some people find the test uncomfortable, it is not usually painful.