Incontinence

Incontinence and urine leakage

Urine leakage, or urinary incontinence as it is also called, is defined as any sensation of leakage. Many women are affected in the course of their lives. In a Norwegian study, ¼ of the women surveyed indicated leakage in some form.

Stress incontinence

The most common form of leakage is called stress incontinence. Then urine leaks through exertion or physical activity, or when sneezing or coughing. 50% of those who have urine leakage have this form of leakage. It is most often caused by a weakening of the attachment of the anterior vaginal wall with the urethra relative to the pelvic wall and damage to the nerve supplying the muscles of the pelvic floor and urethra. If you are old, overweight, have given birth to many children, have had your uterus removed and have a mother with urine leakage, you are at increased risk of having this type of leakage.

The treatment in some cases is diapers that can be reimbursed on blue prescription. Weight reduction and local estrogen therapy (in the elderly) may be sufficient in some cases. Pelvic floor exercise led by a physiotherapist as well as some mechanical devices (such as Contrelle) can have an effect.

Those who do not reach the goal of this type of treatment can be referred for surgical treatment (Retropubic tensionless vaginal tape, TVT and obturator slings TOT). This type of surgery has shown good long-term results.

Urgency urinary incontinence

Another type of leakage is called “Urgency urinary incontinence”. Those who have this get a quick onset irresistible urge to launder the water. Often they do not reach the toilet until it is too late. It can be socially disabling because you always have to have a toilet available.

The cause is partly unknown, but it probably has to do with the brain's interpretation of signals from the urinary bladder and sphincter. This produces an involuntary urination reflex that can be triggered when the bladder fills up or by movement.

Increasing age, obesity and heredity are known risk factors for developing the condition.

The treatment is bladder training and possibly drugs. These drugs (muscarinic receptor antagonists) are effective, but have some side effects. The most common side effect that causes the patient to stop taking the medication is dry mouth, especially at night when sleeping. Other side effects are constipation, vision problems, difficulty leaving the water, and fatigue.

Blanding's urinary incontinence

Often there is a “Blanding's urinary incontinence”. It includes elements of both stress incontinence and urgency incontinence. The condition is treated as both stress and urgency urinary incontinence.

Urine leakage is a troublesome condition. Most people can be helped. Examination and treatment is a collaboration between the patient, the general practitioner, the gynecologist, the urotherapist and the physiotherapist.