Urinary Incontinence
What is urinary incontinence?
Urinary incontinence is a medical term used to describe leakage of urine. There are several types of urinary incontinence,
- stress incontinence
- urge incontinence
- overflow incontinence
- functional incontinence
- reflex incontinence
- mixed type incontinence
The type of incontinence that most women who have reached menopause experience is stress incontinence.
What is stress incontinence?
Stress incontinence is the most common type of incontinence in women, especially women who have reached menopause or had children. In stress incontinence, urine leaks when a woman sneezes, coughs, laughs, goes jogging, lifts heavy objects or during any other physical activity that puts pressure on the abdomen and bladder.
Stress incontinence occurs when the urethral sphincter and pelvic muscles that support the bladder and urethra is weakened and unable to stop the flow of urine when pressure is applied to the abdomen.
How is estrogen involved with urinary incontinence?
The female hormone, estrogen helps to maintain urethral sphincter and pelvic muscle strength.
How does menopause cause urinary incontinence?
Women who have reached menopause have low estrogen levels. The decreased estrogen levels causes weakening of the the pelvic muscles and urethral sphincter. When pressure is applied to the abdomen and bladder, the pelvic muscles and urethral sphincter are not strong enough to hold the urine in, and leakage occurs.
What can be done about stress incontinence?
There are various treatments for stress incontinence, all of which should be discussed with your physician. These treatments are:
- performing Kegel exercises
- using vaginal devices
- using injections
- having surgery
Kegel exercises, or pelvic floor exercises, strengthen the pelvic muscles that support the bladder and help hold in urine. It is possible to perform these exercises incorrectly, so it’s best to check with your continence advisor, physiotherapist or physician to make sure the exercises are performed correctly. For instructions on how to perform Kegel exercises, please see this page.
A vaginal device such as a pessary can be used to mechanically keep pressure on the urethra. The pessary is shaped in a stiff ring and is inserted your a physician or nurse into the vagina. The ring presses against the wall of the vagina and the nearby urethra. The pressure on the urethra helps to lessen stress leakage.
Injections of bulking materials, such as collagen, is made into the tissues surrounding the bladder neck and urethra to adds bulk and closes the bladder opening to reduce stress incontinence. Repeat injections are usually needed as the body will slowly metabolize and eliminate the collagen.
Surgery is usually the last option to treat stress incontinence. There are several procedures that can be performed such as retropubic suspension and the sling procedure. It’s best to discuss these options with your physician.