What is urinary incontinence?

With a variety of treatment options available for incontinence, women can regain control and an active lifestyle. Learn more about urinary incontinence

References

1. Vulker, R. International Group Seeks to Dispel Incontinence “Taboo”, JAMA, 1998, No.11: 951-53

Urinary incontinence is the involuntary loss of urine from the body. It affects 200 million people worldwide (cf 1). Urinary incontinence that occurs with straining or physical activities is known as stress urinary incontinence (SUI).

Typical activities that can provoke leakage of urine are running, jumping, coughing, sneezing, laughing, and even sexual intercourse. While incontinence is often considered to be a part of aging, in many cases it can be treated.

There are non-surgical options for management and treatment including fluid restriction, pelvic floor muscle exercises, and vaginal incontinence pessaries. If none of these options provide acceptable relief, surgical correction may be considered.

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Signs and causes

Signs of incontinence Signs of incontinence Are you showing signs of incontinence? Take this quiz and find out. Take the quiz

Below are some simple questions to help start a dialogue with your doctor.

If you answered yes to any of these questions incontinence may be preventing you from enjoying your life. Speak to your doctor to find the most effective treatment option for you.

 

Do you leak urine unexpectedly?

 

 Yes No

 

What is the severity of leakage?

 

Mild
(a few drops)

Moderate (wet undergarments)

Severe (wet clothing)


 

Do you leak urine when you ...

Cough?
Sneeze?
Laugh?


Bend? Lift?


Change positions
(i.e. sitting or

laying to standing)?

Engage in sexual intercourse?



Do you leak urine continuously during the day?
 
Yes No


Do you leak urine while sleeping? 
 
Yes No


Has urine leakage caused you to change your lifestyle?

 

Yes No


If yes, how has your lifestyle changed? 
 

Limiting fluids 

Staying home
Limiting clothing to dark clothes
Stop exercising 
Other
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Causes of incontinence. Causes of incontinence. Stress urinary incontinence can develop with age, and may often be a result of childbirth. More about incontinence causes

Stress urinary incontinence can develop over time, as you get older, and is sometimes linked to childbirth. It can also occur as a result of chronic or repetitive straining (constipation, chronic coughing, high impact aerobics), from menopause or even a hysterectomy.

Damage, weakening or injury to the muscles supporting the urethra can result in stress urinary incontinence. It occurs when weak pelvic floor muscles, especially at the bladder neck opening and urethral sphincter, cannot reflexively tighten during times of increased pressure on the bladder and the urethra. This leads to the urine involuntarily escaping.

Stress urinary incontinence commonly occurs with:

  • Laughing
  • Sneezing
  • Coughing
  • Lifting
  • Exercising
  • Entering/exiting a vehicle
  • Sexual intercourse
  • Increasing abdominal pressure in any other way
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Treatment options

Incontinence treatment options without surgery If you have stress urinary incontinence, it’s a good idea to know about your different treatment options. Non-surgical treatment options

If you have been diagnosed with stress urinary incontinence, there are many options for treatment. Coloplast provides surgical treatment options that can provide relief, but surgery is not suitable for everyone. Your doctor will be able to discuss all the treatment possibilities with you.

Non-surgical options include pelvic muscle exercises, protective undergarments, behavioural therapy, catheters, vaginal pessaries and bulking injections.

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Surgical treatment options for incontinence If you have stress urinary incontinence, a sling may be the option you’ve been looking for. Surgical treatment options

Surgical treatments for incontinence include open bladder neck suspensions, and sling procedures. A sling procedure corrects stress incontinence by placing a small strip of synthetic or biologic material beneath the urethra. Like a backboard, it supports the urethra during activities that put a strain on the area and prevent leakage from occurring.

sling system

Are there any risks?

Like any surgery, there are some risks related to the procedure.

These include:

  • Vaginal extrusion
  • Erosion (e.g., vaginal, urethral)
  • Dyspareunia (i.e., painful intercourse)
  • Sling migration
  • Infection
  • Pain
  • Hematoma
  • Scarring
  • Transient or permanent urinary retention/obstruction
  • Urethral obstruction
  • Voiding dysfunction
  • Nerve injury
  • Vascular injury
  • Bladder, bowel, urethra, vessel and/or nerve perforation

Talk to your doctor to discuss these risks in detail.

The mesh used to correct incontinence may cause pain. You may also be able to feel the mesh inside of the vagina. When this occurs, it can interfere with intimate sexual activity. You may also experience an increased need to urinate, or your urine flow may be slower.

You may also not be able to urinate naturally following the procedure. This could be temporary, but it may last a month or longer. If this occurs, a catheter will be inserted to help you urinate, or you may need another operation to have the sling clipped or cut. Depending on how severe the symptoms are, further surgery may be necessary.

Another potential risk is having a reaction to the sling material itself, or getting an infection that requires treatment with antibiotics. Talk to your doctor about all these risks and reactions.

It’s a good idea to really understand and consider all the potential risks as well as the benefits of a permanent implant when you choose a treatment option.

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What happens before, during and after surgery?

What happens before surgery? There are a number of common tests used to diagnose stress urinary incontinence while you may also need to fill out a voiding diary. Before surgery

What to expect at the doctor’s office

Your doctor will want to diagnose your incontinence correctly to make sure the right treatment option is chosen. You will have to provide a complete medical and surgical history, a list of all medication and supplements you take, and information about your urinary habits and all fluids consumed. It’s important to accurately describe the problems you are having, such as when and under what conditions leakage occurs.

It may be a good idea to track your urination habits in a journal to share with your doctor. A three-day voiding or urination diary should include information such as what you drink, the number of times you urinate, and if you have episodes of leakage. Take a look at the one below. Click for downloading pdf (260 Kb). 

Voiding diary

Common tests used to diagnose incontinence:

  • Urinalysis – testing of the urine sample
  • Stress test – fluid is inserted into the bladder to check for leaking
  • Post-void residual – measures the amount of urine left in your bladder after urinating
  • Cystoscopy – use of a scope to examine your bladder
  • Urodynamics – testing that measures:
    - Amount of urine in the bladder before urinating
    - Force of the urine as it leaves the body
    - Internal pressure of the bladder as it fills with urine
    - Control of the urethral sphincter muscles

Voiding diary (pdf 260 Kb)

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What to expect during surgery Find out what happens during the minimally invasive sling procedure. During surgery

What happens during the surgery?

A sling procedure is the most common minimally invasive surgical option to correct stress urinary incontinence. There are many different types of slings available and a variety of ways to place a sling. A sling is chosen for treatment based on a number of factors, including the severity of incontinence, prior pelvic surgery and the patient and the doctor’s preferences.

Coloplast offers a variety of synthetic and biologic slings. The synthetic slings are made from polypropylene mesh that, when implanted, combines with new tissue growth to become a support structure for the urethra.

Regardless of type, all slings are placed in the vagina through a small incision under the urethra. There may be other small incisions within the groin creases or by the pubic hairline, depending on the type of sling placed. After the sling is properly positioned, it forms a cradle under your urethra, which provides support and helps to prevent urine from escaping during activities or straining.

 

Example of a sling

Example of Coloplast Aris® / Supris® / Altis® sling. The amount of sling material used during surgery is depends on the individual woman’s body structure.

Example of Coloplast Aris® / Supris® / Altis® sling. The amount of sling material used during surgery is depends on the individual woman’s body structure.

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What happens after surgery? Although every patient’s recovery is different, here are some basic results and guidelines for after surgery. After surgery

What happens after the surgery?

Your doctor will discuss recovery time and what you need to do after your operation with you. It’s important that you follow their instructions closely.

In general, expect to avoid exercise, physical activity or anything that puts strain on the area, as well as any sexual activity for a period of time. Your body needs time to heal properly from the surgery and allow the sling material to bind with your body’s natural tissue.

Should any problems occur after surgery, contact your doctor immediately. This is especially important if a high temperature occurs, or if the area becomes excessively painful, red or inflamed.

It’s important to know that future pregnancies may reverse the effects of the surgical procedure, resulting in further incontinence.

Your doctor will provide specific details about your recovery process, and he or she may have other recommendations based on your individual needs.

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Frequently asked questions

Get the answers to common questions about urinary incontinence. Incontinence FAQ

References

1. Vulker, R. International Group Seeks to Dispel Incontinence “Taboo”, JAMA, 1998, No.11: 951-53.

What is urinary incontinence?

Urinary incontinence is the loss of voluntary control over your urinary functions. This condition affects 200 million people worldwide.

 

Can urinary incontinence be successfully treated?

Yes. While incontinence may be connected to getting older, it is a treatable condition. 

 

What causes female stress incontinence?

Female stress incontinence can develop slowly over time, and may be a result of childbirth. It generally occurs when your pelvic muscles are not strong enough to keep the opening of the bladder neck closed under physical stress such as laughing, coughing, lifting, exercising, or any increased abdominal pressure.

 

What are the treatment options for stress urinary incontinence?

Today there are multiple treatment options available for patients, including surgical procedures with transobturator and suprapubic sling systems and single incision slings.

 Your doctor can discuss these and other treatment options with you.

 

What is a sling procedure?

A sling procedure is a minimally invasive surgical procedure to correct stress incontinence using a simple hammock or U-shaped sling to support your urethra.

 

Can I become incontinent again after having a sling procedure?

Currently, sling procedures have a success rate of about 85%, so it is possible to again become incontinent again after a sling procedure. Future pregnancies could also reverse the effects of your surgery, resulting in incontinence once again.

 

How long does it take to recover from a sling procedure?

Every patient’s recovery time is different. During your recovery, it’s important to avoid heavy lifting and sexual intercourse. Your doctor will be able to provide you with more specific details about your individual recovery process (1).

 

Are there any risks associated with a sling procedure?

While every surgical procedure carries some risk, serious complications from sling surgery are infrequent. You may experience some trouble with urination following the procedure, ranging from a slower flow to not being able to urinate at all, or you may feel you have to go more often. You may have a reaction to the sling material itself or an infection. Ask your doctor for more information about potential risks and complications, as well as your specific surgery and situation.

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