What is it?
Urinary Incontinence refers to any involuntary leakage of urine. It is a huge problem. Together urinary and faecal incontinence affects about 4 million Australians of all ages costing about $1.5 billion per year. This cost is predicted to increase to $4.5 billion by 2031. Urinary incontinence is much more common than faecal incontinence and many patients with faecal incontinence also have urinary incontinence. Despite the large numbers of people affected most are too embarrassed to tell anyone, even their doctor. They do not realise that there are treatments available and they think they just have to put up with it, or that it is part of getting old or having children.
Different Types of Urinary Incontinence
Stress Incontinence refers to the involuntary leakage of urine with effort or exertion such as coughing, sneezing, laughing, bending, lifting, running or sport. Sometimes is can be so bad that people leak with minimal exertion such as getting out of a chair or walking. There are different types of stress incontinence - Types I, II and III. Stress Incontinence occurs in one in three women after childbirth. It can also occur later in life, in women who haven’t had any children or even in teenagers. It can occur in men after prostate surgery. (Stress Incontinence has nothing to do with emotional stress or anxiety.)
Urge Incontinence refers to a condition where there is a sudden involuntary loss of urine. It may be preceded by a compelling or urgent desire to void. This can be seen in some people with neurological conditions. It is usually due to involuntary bladder contractions which can be diagnosed on fluoroscopic urodynamics studies. This is referred to a an ‘Overactive Bladder’
Mixed Incontinence: People can have more than one type of incontinence e.g. both stress and urge incontinence.
Overflow Incontinence is seen in people with urinary retention. This is where their bladder is full and cannot empty. As a result the urine overflows and leaks out.
Neurogenic Incontinence refers to incontinence problems in patients who have a neurological condition e.g. spinal cord injury, multiple sclerosis.
Enuresis or bedwetting can occur from childhood and persist even into adulthood, or it can occur in people who have previously been dry overnight.
Transient Incontinence: There are also transient causes where people may become incontinent for example when they have a severe urine infection but once the infection is treated their incontinence resolves.
It can be difficult to tell just based on symptoms what the cause of incontinence is and further tests may be required such as Fluoroscopic Urodynamic Studies. This test can also distinguish different types of Stress Incontinence.