Non-surgical treatment includes medication, bladder training, pelvic floor training and possibly lifestyle changes.
Most surgical treatment will involve some form of support for the bladder itself by using carefully placed stitches to lift it back up. The method used will depend on your own circumstances & symptoms.
Incontinence is very common and affects millions of people within the UK. Women are more commonly affected than men and the two main reasons for experiencing problems within the bladder are:
The are two main types of incontinence and you may suffer from either one of these or a combination of the two.
Diagnosis will involve taking a detailed history of your symptoms, a physical examination, testing the urine to check for any underlying infection and an ultrasound scan of your bladder.
It may also involve a procedure called a cystoscopy to look inside your bladder or urodynamic tests to check your bladder function.
This type of incontinence causes urine to leak out with either little or no warning and you may also need to empty your bladder more often.
It is usually caused by a weakening of the muscles in the walls of the bladder and this may be as a result of not drinking enough fluid, drinking too much caffeine or alcohol, frequent constipation, certain medications or medical conditions and repeated urine infections.
Urine is produced in the kidneys and passes through tubes called the ureters, into the bladder. As the bladder fills, it expands and the muscles around it, called the detrusor muscles, stay relaxed. The urethra is a tube that runs from the neck of the bladder to the outside of your body and it has a valve, called a urinary sphincter that keeps the opening at the bottom of the bladder tightly closed. The thick, spongy walls of the urethra help to form a watertight seal when compressed by the sphincter.
When you need to empty your bladder the detrusor muscles contract to help force the urine out of your body and the sphincter opens to allow the urine to pass through.
The sphincter, bladder, bladder neck and urethra must be in the correct position in order to work properly. They are held in the correct position by the pelvic muscles and other support structures. If the pelvic floor muscles are not strong enough to support a full bladder it will allow the sphincter to open and for urine to leak out. Therefore, with the added pressure of coughing, sneezing or lifting for example, leakage may occur.
This type of incontinence is characterised by suffering from a sudden loss of urine after coughing, sneezing, straining or laughing for example.
It is frequently caused by a weakening in the pelvic floor muscles which hold the bladder in place but can also be caused by other medical conditions such as cysts or fibroids which push down on the bladder. Being overweight, certain medications and damage to the bladder caused by previous surgery can also be factors.