Urinary Incontinence

Almost 3.3 million Canadians suffer from urinary incontinence, with twice as many women as men. One Canadian out of 5 is affected after 65 years of age and this condition will alter their quality of life. It should not be considered a normal process of aging, and is a subject that still is still not discussed today.

Urinary incontinence is an involuntary (undesired) urinary loss. This condition could be transient, following a urinary track infection, a restricted mobility or adverse effects to certain medication.

THERE ARE THREE MAIN TYPES OF URINARY INCONTINENCE

1. Stress Urinary Incontinence

This term describes accidental urinary loss which occurs during physical activity, such as sneezing, coughing or exercise.

It is estimated that nearly 65 million women suffer from stress urinary incontinence, most of them being 25 to 45 years of age.

Treatment includes a change in lifestyle, perineal reeducation and surgery.

2. Uncontrolled Incontinence

This term refers to an involuntary loss of urine preceding or accompanying an urgent need to urinate.

Urge incontinence is a sign of a hyperactive bladder and causes an urgent need to urinate, an inability to reach the toilet in time when the need to urinate is felt, or urine leakage upon hearing water running. Urinary frequency can increase during the day and at night. The bladder contracts, causing a sudden need to urinate.

Treatment includes a change in lifestyle, perineal reeducation and medication.

3. Mixed Urinary Incontinence

This an involuntary loss of urine caused by a combination of the urgency and stress symptoms.

TREATMENT OF URINARY INCONTINENCE

• Change in lifestyle

This includes weight loss, an improvement with regard to constipation, stopping smoking and avoiding caffeine.

• Perineal Reeducation

This method, supervised by a physiotherapist, helps strengthen the muscles of the vagina and around the urethra. It is painless and beneficial over the long term.

• Surgery

Surgery is indicated should conservative treatment fail. The goal is to restore support at the base of the bladder and at the urethra. The procedure is successful in 60% to 90% of cases. Colposuspension, suburethral slings, or urethral sphincter injections are some of the options available. Complications (bladder perforation, urinary urgency, mesh erosion) occur in fewer than 10% of cases.