How to manage female incontinence

Female incontinence is a prevalent condition that can significantly impact a woman’s quality of life. However, with the right treatment approach, including conservative and surgical options, incontinence symptoms can often be effectively managed.

Here, Mr Ian Beckley, renowned Consultant Urologist, offers an expert insight into female incontinence.

What is female incontinence?

Female incontinence is the term for the involuntary loss of urine in women. There are different types:

• Stress incontinence: Leakage occurs when there is pressure on the bladder due to activities like sneezing, coughing, exercising, or lifting heavy objects.
• Urge incontinence: A sudden and intense need to urinate, leading to the involuntary loss of urine.
• Overflow incontinence: The bladder fails to fully empty, resulting in frequent or continuous dribbling of urine.
• Mixed incontinence: Symptoms encompass both stress and urge incontinence.

The severity of female incontinence symptoms can range from occasional leakage to a complete loss of bladder control.

What are the most common causes of female incontinence?

Female incontinence can result from various factors. Common causes include:

• Weak pelvic floor muscles: Weakness in the muscles that support the bladder and urethra can lead to stress incontinence.
• Pregnancy and childbirth: The weight of the baby during pregnancy and the strain of childbirth on the body can damage the pelvic floor muscles and connective tissues, resulting in stress incontinence.
• The menopause: As oestrogen levels decrease during the menopause, the pelvic floor muscles and urethral tissues may become thinner and weaker, increasing the risk of incontinence. Additionally, menopausal symptoms such as vaginal dryness and atrophy can further contribute to urinary symptoms.
• Obesity: Excess weight can put pressure on the bladder and pelvic organs, leading to stress incontinence.
• Certain medical conditions: Conditions such as diabetes and neurological disorders can affect bladder function and contribute to incontinence.

How is female incontinence managed with conservative treatment?

Several non-surgical treatment options are available for managing female incontinence, including:

• Pelvic floor exercises (Kegel exercises): These exercises involve contracting and relaxing the muscles of the pelvic floor to strengthen them. Regular practice of pelvic floor exercises can improve bladder control and reduce symptoms of stress incontinence.
• Bladder training: This involves gradually increasing the intervals between urination to train the bladder to hold urine for longer periods.
• Lifestyle modifications: Making changes such as maintaining a healthy weight, avoiding bladder irritants (such as caffeine and alcohol), and practising good toilet habits can help manage incontinence symptoms.
• Medications: Certain medications, such as anticholinergics or beta-3 agonists, may be prescribed to reduce urinary urgency and frequency in cases of urge incontinence.

When is surgery recommended for female incontinence?

Surgery for female incontinence may be recommended when non-surgical treatments have been ineffective, or in cases of severe or persistent incontinence symptoms.

The type of surgery recommended will depend on the underlying cause and severity of the incontinence. Common surgical options include: 

• Urethral bulking: An inert substance is injected into the wall of the urethra at 3 or 4 sites to reduce urine leakage
• Sling procedure: A tissue sling is placed under the urethra to support it and reduce stress urinary incontinence.
• Colposuspension: This procedure involves lifting and supporting the bladder neck and urethra to improve urinary control.
• Artificial urinary sphincter: A device is implanted around the urethra to control the flow of urine, particularly in cases of severe urinary incontinence.

How can I prevent complications associated with female incontinence, such as urinary tract infections (UTIs)?

Preventing associated complications is essential for maintaining overall health and wellbeing. Some ways to prevent UTIs and other urinary complications include:

• Maintaining good hygiene: Practise proper perineal hygiene, especially after bowel movements, to reduce the risk of infection.
• Staying hydrated: Drink plenty of water to flush bacteria out of the urinary tract.
• Emptying the bladder regularly: Avoid holding urine for prolonged periods, as this can increase the risk of UTIs.
• Seeking prompt treatment: If you experience symptoms of a UTI, such as burning with urination or frequent urination, seek medical attention promptly.

Can female incontinence be cured?

While female incontinence may not always be curable, it’s often manageable with the right treatment approach. Many women experience significant improvement in symptoms with lifestyle modifications, pelvic floor exercises, medications, or surgical interventions. It's essential to work closely with a urology specialist to develop a personalised treatment plan that addresses individual needs and concerns.

If you would like to schedule an appointment with Mr Ian Beckley, head on over to his Top Doctors profile today.