Incontinence in women

Many women experience increased urinary frequency and urgency with or without night time frequency. Some may notice leak of urine while coughing, sneezing or with exercise.

Urinary symptoms can be variable in terms of severity and effect on the quality of life.

Pregnancy and childbirth, increasing age and menopause predispose to urinary problems.

The Overactive Bladder (OAB)

Symptoms such as frequency and urgency indicate an overactive bladder and treatment includes

avoidance of caffeine and fizzy drinks, restricted fluid intake, weight loss (if overweight), bladder retraining and treatment with medications such as solifenacin, tolterodine and mirabegron.

Urinary Stress Incontinence

Symptoms of leak of urine with movements, exercise, coughing or sneezing indicate stress incontinence, and management includes pelvic floor muscle training and surgical procedures such as mid-urethral slings. Mid urethral slings may be done as a transvaginal tape (TVT) or transobturator tape (TOT).

Sometimes, there can be symptoms of both overactive bladder and stress incontinence, when it is called mixed incontinence. The overactive bladder should be treated before surgery for stress incontinence. Frequently, treating the overactive bladder may improve all urinary symptoms, and surgery may not be necessary.