The Facts

More than 3 million women in the UK (of all ages) experience urinary incontinence at some point in their lives. In fact, it is twice as common in women as it is in men¹. As a Healthcare Professional, you will know that this can severely impact on a woman's sexuality, femininity and social relationships.

Up to 10% of all women over the age of 25 wear some form of pad or protection at all times, with this proportion increasing during sporting activity.

What is Urinary Incontinence?

Urinary incontinence (UI) is a common condition that may affect women of all ages, with a range of severity and nature. Although rarely life threatening , UI may seriously influence the physical, psychological and social wellbeing of those affected. The impact on families and careers of women with UI may be profound and the resource implications for the health service considerable.

UI is defined by the International Continence Society (ICS) as 'the complaint if any involuntary leakage of urine'. UI may occur as a result of a number of abnormalities of function of the lower urinary tract or as a result of other illnesses, which tend to cause leakage in different situations (Ref CG40, NICE) 

Various abnormalities of the lower urinary tract (LUT) and pelvic floor can exist and lead to congenital defects of the ureters, urethra or urinary fistulae resulting in an increased prevalence of urinary incontinence.

Three sets of muscles are involved:

• Bladder muscles. During urination, muscles in the bladder wall contract, forcing urine out of the bladder and into the urethra.
• Sphincter muscles. Sphincter muscles are located at the base of the bladder. They relax to open the urethra and then they contract to close the urethra and stop urine flow.
• Pelvic floor muscles. The pelvic floor musculature, predominantly the levatores ani support the uterus and organs of the lower urinary tract, including the bladder and rectum.

Incontinence can occur if bladder muscles suddenly contract and the sphincter muscles suddenly relax, or if the levatores ani weaken.

View more details about urinary incontinence in women (PDF: 18 KB).

Types of Incontinence

• Stress Urinary Incontinence is involuntary urine leakage on effort, exertion, sneezing or coughing.
• Urge Urinary Incontinence is involuntary urine leakage accompanied or immediately preceded by urgency (a sudden compelling desire to urinate that is difficult to defer)
• Mixed Urinary Incontinence is involuntary urine leakage assocaited with both urgency and exertion, effort, sneezing or coughing.
• Overactive Bladder Syndrome (OAB) is defined as urgency that occurs with or without urge UI and usually with frequency and nocturia. OAB that occurs with urge UI is know as 'OAB wet'. OAB that occurs without urge UI is known as 'OAB dry'. These combinations of symptoms are suggestive of the urodynamic finding of detrusor overactivity, but can be the result of other forms of urethrovesical dysfunction (Ref CG40, NICE).

Assessment & Investigation

The following assessments and investigations may be required for the diagnosis of incontinence. These include:

• Stress test
• Pelvic ultrasound
• Urodynamic testing
• Cystoscopy

Treatment Options

In patients for whom conservative therapy has failed, surgery may be an option. ETHICON™ Women's Health & Urology UK offers a family of four solutions for treating female Stress Urinary Incontinence (SUI), which are listed on the right hand side at the top of this page.

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References