Urinary incontinence or the loss of bladder control is an embarrassing problem. Incontinence refers to the involuntary leakage of urine.
It is a common problem amongst women and tends to increase with advancing age. Some estimate the prevalence to be as high as 40 percent. However, the actual statistic is unknown, as many women might not seek help due to the embarrassment and stigma associated with the condition.
Continuous leakage of urine could be due to a fistula. This is when there is a hole or abnormal communication between the bladder and the vagina. This could be as a result of an injury sustained during childbirth or sometimes as a complication of surgery.
Urge incontinence is where the woman experiences involuntary spasms of their bladder muscle and often has increased frequency of urination with urgency and sometimes leakage.
Stress incontinence is when urine leaks due to increased abdominal pressure that might result from normal daily activities such as laughing, coughing, sneezing, or even exercising.
Urine incontinence should not be accepted as a normal and natural consequence of aging or childbirth as it has a negative impact on the quality of life for the affected individuals. Women suffering the condition must make drastic changes, such as avoiding social events, wearing continence pads, and limiting fluid intake.
There has to be meticulous planning about leaving the house, such as awareness of the location of toilet facilities and choice of attire to mask any small leaks. There is a negative impact on relationships and intimacy with partners. Many are devastated and not able to continue with demanding careers.
The good news is that the diagnosis and treatment of incontinence are usually relatively straightforward. A urogynaecologist is a doctor who has advanced training in the management of female pelvic floor problems, including incontinence of urine.
Evaluation by a urogynaecologist usually involves asking you a few questions and a physical examination to determine your type of incontinence. Some women might require a few tests.
Treatment of incontinence is usually tailored to the underlying cause. Most treatments might involve advice on lifestyle modifications, exercise, managing fluid intake, and weight loss if the woman is obese.
Many types of incontinence respond well to medication. Surgery might offer a permanent solution for some forms of incontinence not responsive to initial treatment options.
Remember that urine incontinence is a common problem in women. The first step to getting your life back is overcoming the embarrassment and seeking a urogynaecologist's help. Incontinence is not a life-threatening condition but significantly negatively impacts your quality of life. Solutions can be offered after a detailed evaluation. We can walk the journey together to restore your dignity and self-confidence.
Dr Achila is Consultant Urogynaecology at Aga Khan University Hospital, Nairobi.
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