The next time you’re sitting in the GP’s waiting room, think about this: it’s likely two in three of the women waiting with you have incontinence. Of these, half will be under the age of 50. Sadly, only 30% will seek help.
Urinary incontinence can have a significant impact on your everyday activities and quality of life. However, it’s often thought of as a condition that just happens with motherhood or ageing. Consequently, many women suffer in silence, either not knowing treatment is available or feeling too embarrassed to seek help.
It doesn’t have to be this way. Various treatment options are available. Seeing your GP is the first step towards getting relief. You might like to mention your symptoms at your next visit. You can rest assured your GP will understand and help you feel comfortable about seeking treatment.
Gynaecologist Dr Nevine te West from Northern Beaches Hospital in Sydney explains types of urinary incontinence and treatment options.
About urinary incontinence
There are two main types of incontinence:
1. Urge incontinence (UUI)
Urge incontinence occurs when you have a strong, sudden feeling that you need to urinate. This often leads to leakage of urine before you reach the bathroom. Urge incontinence can also be associated with needing to get up more than once a night to pass urine. Symptoms typically increase with age and can be related to caffeine, fizzy drinks, alcohol, smoking and constipation.
2. Stress Incontinence (SUI)
In stress incontinence, urine leaks when you do something that puts pressure on the pelvic floor, such as sneeze, cough, jump, laugh or exercise. It is often caused by stretching or weakening of the pelvic floor or nerves during pregnancy and childbirth. It can also be related to obesity, chronic cough, and constipation.
Some women may experience both types of incontinence.
Assessment of urinary incontinence
Your doctor will examine you to rule out other possible causes for your symptoms, including checking for a urinary tract infection. You might also need an ultrasound to see if any urine is left behind after you use your bladder. If you have any blood in your urine you may need some additional tests.
Treatment for urinary incontinence
Treatment for incontinence will depend on various things, including the type, severity and cause of your symptoms. It will usually start with non-surgical measures.
Conservative treatment
Pelvic floor muscle training for SUI and bladder training for UUI can improve or cure symptoms by up to 50%. If there’s not enough improvement, a continence dish (a small device that sits in the vagina) may be offered to women with SUI. Vaginal oestrogen cream may be helpful for postmenopausal women.
Additional non-surgical treatment options include medications, injections, and nerve stimulation.
Lifestyle changes
Other things that can improve incontinence symptoms include:
- losing weight if you are above a healthy weight
- addressing constipation and chronic coughing
- avoiding heavy lifting.
You should aim to avoid drinks that contain caffeine, such as coffee, tea and energy drinks. It’s also best to avoid fizzy drinks. Try to have about 1.5 litres of other drinks per day, most of which should be water.
Surgery for urinary incontinence
Surgery may be recommended if other options haven’t worked. Your specialist will talk to you about your alternatives and help you decide on the best course of action.
Northern Beaches Hospital’s Gynaecology Clinic provides specialist diagnosis and management of a wide range of gynaecological conditions, including incontinence.
Dr Nevine te West
MD MRCOG FRANZCOG
Gynaecology, Urogynaecology & Public Obstetrics
Dr te West works in the area of pelvic floor disorders, including prolapse, urinary incontinence, childbirth injuries, vaginal mesh removal, laparoscopic urogynae surgery and general gynaecological problems. She offers vaginal and minimal-access surgical techniques where appropriate.
Dr te West brings a wealth of international experience to Northern Beaches Hospital, having completed her training in the Netherlands, UK and Sydney. Taking a holistic approach, Dr te West is strongly focused on developing a treatment plan to support the needs of each person under her care.
To arrange an appointment with Dr Nevine te West, please contact:
Northern Beaches Hospital
Suite 4, Level 6
105 Frenchs Forest Road West
Frenchs Forest NSW 2086
P 02 9999 2977
F 02 9475 5003
E info@drnevinetewest.com
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