Urinary Incontinence


19. 06. 2019

Urinary incontinence can generally be defined as a loss of ability to consciously hold urine, and thus be able to determine the time when to  empty your bladder. The condition  causes an unwanted and  involuntary leakage of urine, caused by the loss of bladder control. This condition can manifest whenever and wherever, during laughter, coughing, sneezing, or sports. 


Incontinence is a widespread problem that affects women as well as men of any age, even young people. 

  • 3x more women than men suffer from urinary incontinence
  • 30-50% of women suffer from urinary leakage at least once in their lifetime
  • Roughly 510 000 women in the Czech Republic suffers from urinary incontinence, with 20% of women aged around 45 years old are affected by stress-related incontinence
  • Only every 4th or 5th woman seeks the help of a doctor.


Causes of incontinence:

There are many possible factors that may be the cause of incontinence. One of the most common causes include mainly genetic predispositions, obesity, decrease in oestrogen levels in women going through menopause, and weakening of the pelvic floor muscles which increase in older age and after giving birth. Leakage of urine is generally caused by a decreased function of the closing mechanism of the bladder, of which the cause is an inborn, or acquired insufficiency of  the sphincter muscles in the urethra. 


If the occurrence of incontinence is only rare or occasional, it is usually caused by an acute urinary tract infection, constipation, or hormonal imbalance. However, if the condition is persistent, it may be caused by other risk factors that occur commonly throughout our life. 


Risk factors for urinary incontinence:

  • Weakening of the pelvic floor muscles- giving birth, old age, decreased levels of oestrogen hormones in women going through menopause, obesity, strenuous work.
  • surgery or injury  around the urethra sphincter muscles.


Types and stages of urinary incontinence: 

Depending on the type of signs and symptoms you present with, the doctor can determine the type of incontinence. In practice, we most commonly come across stress-related, urge, and mixed incontinence. 


Stress Incontinence:

Stress incontinence is the most commonly occurring type, in which the involuntary leakage of urine is linked with some sort of strenuous physical activity such as running, jumping, climbing the stairs, lifting heavy objects, coughing, sneezing and laughing. Stress incontinence is the most commonly occurring type of urinary incontinence in women. 


Urge Incontinence: 

A person suffering with urge incontinence experiences a strong and sudden need/urge to urinate, that they are not able to control. These situations come on unexpectedly and suddenly, and the urge is so strong that it may wake the person up at night. 


Mixed Incontinence

If the symptoms of both of the above described (stress and urge) types occur simultaneously, it is referred to as mixed incontinence. 


Treatment of Incontinence

The first choice of treatment  of incontinence aims to strengthen the pelvic floor muscles through regular exercises and lifestyle changes. However, if the symptoms persist, a doctor will perform a specialised examination, and may decide for pharmacological or surgical treatment. 


Conservative treatment

  • Strengthening of the pelvic floor muscles
  • Regularly practicing Kegel exercises
  • Lifestyle change: weight reduction, reducing the amount of strenuous work and refraining from lifting heavy objects, regular emptying of the bladder, refraining from drinking large volumes of liquid before exercise, reduction in consumption of coffee, tea and alcohol, treating constipation.


Pharmacological treatment

Drug therapy involves the administration of certain drugs- oestrogen, stimulators, β-adrenoreceptors and tricyclic antidepressants, which all work to increase the levels of serotonin and noradrenalin in the nervous system


Surgical treatment:

Prior to the decision to surgically treat the symptoms of incontinence, the patient has to go through a thorough and specialised urogynecological examination. The most basic surgical treatment is a so-called tape procedure (insertion of a thin strip or surgical mesh under the urethra). Other procedures  involve urethral bulking agents, or sling procedures. 



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