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Incontinence

Urinary incontinence affects your quality of life, self-confidence, physical activity and relationships.

More than three million women in Britain have urinary incontinence and it can affect all age-groups. Only a small number seek help because women often think incontinence is unavoidable, especially after having children or don't realise that effective treatments are available.

Urinary incontinence can have a major impact on your quality of life affecting self-confidence, physical activity, and relationships.

What is Incontinence?

Incontinence is the leakage of urine from the bladder. There are different types of urinary incontinence and it's essential to get the diagnosis right so that you get the correct treatment.

  • Stress incontinence
  • Urge incontinence
  • Mixed incontinence
  • Overflow incontinence

Stress Incontinence

Stress urinary incontinence (or SUI) is when urine leaks after coughing, sneezing or physical activity. SUI is caused by weakness of the muscles that hold the urine in the bladder.

Urge Incontinence

This is when you get a sudden urgent desire to pass urine that you can’t resist, and urine starts to pass before you can get to the toilet. Having to rush to the toilet urgently is called Overactive Bladder. Urge incontinence affects around 6% of women and also many men.

Mixed Incontinence

This is when there is both urge and stress incontinence.

Overflow incontinence

This when you can’t hold urine in a full bladder because the urinary tract is blocked or nerves supplying the bladder are damaged

How is it diagnosed?

A bladder diary is a chart on which you write down how often you have to pass urine and also the amount of urine. You also record what drinks you have, and any leaks that occur. This can be a useful way of recording the bladder's behaviour and helps the specialist to diagnose what kind of incontinence you have.

The specialist will take a detailed account of your symptoms and perform a simple urine test in clinic. You will need to have an examination also. Usually, this is all that is needed to make a diagnosis and start treatment. Sometimes, additional tests may be recommended, such as urodynamics.

Urodynamics

Urodynamics (or Bladder Pressure Studies) is a test which measures the pressures inside the bladder while it is filling up and emptying. This shows how the bladder behaves and can help to diagnose the underlying problem. Not every patient will need urodynamics diagnose the problem.

Treatments for Urge Incontinence

Common treatments for urge incontinence and overactive bladder include:

  • Bladder retraining
  • Oestrogens therapy
  • Medications
  • Bladder injections
  • Sacral Neuromodulation 
  • Surgery

Usually, the doctor will try simple things to treat your symptoms first. Patients often respond well to “conservative measures” and tablets can make the bladder less sensitive.

For people who do not get better with simple treatments, treatment injections can be very effective.

Treatments for Stress Incontinence

Stress incontinence can be managed in a number of ways. Your specialist will go through the benefits of each and any side effects or complications.

  • Pelvic floor exercises
  • Medication
  • Vaginal tapes (eg TVT, TOT)
  • Urethral injections
  • Colposuspension

We usually recommend that you try pelvic floor exercises before considering operations. If further therapy is needed, vaginal tapes are a highly effective treatment.

Which specialist should you see?

It is important to see a specialist who has expertise in dealing with incontinence. This will usually be a urologist of urogynaecologist. BMI have specialists all over the UK who will help you find the right treatment for you.

The National Institute Of Clinical Excellence says: “The expertise of the surgeon is one of the factors that influence surgical outcomes. The best outcomes are achieved when surgeons and their teams have specialist training and regular practice in continence surgery.”

“Some procedures for incontinence are technically simple, yet potentially harmful if carried out incompetently or in inappropriate patients. Others are complex and require higher levels of expertise.”

Paying for the treatment

Incontinence treatment costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost will be explained and confirmed in writing when you book. Ask the hospital for a quote beforehand, and ensure that this includes all associated costs.

Acknowledgements

Author: Mr Richard Parkinson Ph.D FRCS(Urol), Consultant Urological Surgeon, BMI The Park Hospital, Nottingham

Further information: www.nottinghamurologygroup.co.uk

Specialists Offering Incontinence

Mr Ahmed Raafat

Consultant Gynaecologist/Minimal Access Surgeon

MB BCH, MSc in Obstetrics and Gynaecology, MRCOG

BMI The Princess Margaret Hospital

View profile Book online

Mr Guy Webster

Consultant Urologist

MB ChB , FRCS Ed , Eng , (Urol) , FEBU

BMI The Cavell Hospital 3 more BMI Hendon Hospital BMI The Kings Oak Hospital BMI The Saxon Clinic

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Mr Parijat Bhattacharjee

Consultant Gynaecologist & Obstetrician

MRCOG, DGO, MBBS

BMI Bishops Wood Hospital 2 more BMI The Clementine Churchill Hospital BMI Syon Clinic

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Mr Alan Gillespie

Consultant in Gynaecology

MBBS, MD, FRCOG,MFSTEd, Batchelor of Medicine and Surgery (University of London), 1992, Doctor of Medicine (University of Sheffield), 2000, Member of Royal College of Obstetricians and Gynaecologists, 2000, Dual Specialist Accreditation Obstetrics/Gynaecology and Gynaecological Oncology, 2003

BMI Thornbury Hospital

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