Urinary incontinence

Urinary leakage, or urinary incontinence as it is also called, is defined as any feeling of leakage. Many women are affected during their lifetime. In a Norwegian study, one in four women surveyed reported leakage in one form or another.

Stress incontinence.

The most common form of leakage is called stress incontinence. Then urine leaks from exertion or physical activity or from sneezing or coughing. 50% of those who have urine leakage have this form of leakage. It is most often due to a weakening in the attachment of the anterior vaginal wall with the urethra in relation to the pelvic wall and damage to the nerve that supplies the muscles in the pelvic floor and urethra. If you are older, overweight, have given birth to many children, had your uterus removed and have a mother with a urine leak, you have an increased risk of getting this type of incontinence. The treatment is in some cases diapers that can be refunded on a blue prescription. Weight loss and topical estrogen therapy (in the elderly) may be sufficient in some cases. Pelvic floor training led by a physiotherapist and some mechanical devices (for example Contrelle) can have an effect. Those who do not reach the goal of this type of treatment can be referred for surgical treatment (Retropubic tension-free vaginal tape, TVT and obturator slings TOT). This type of surgery has shown promising long-term results.

Emergency urinary incontinence.

Another type of leak is called "Urgency urinary incontinence". Those who have this have a rapid urge to urinate. Often they do not reach the toilet until it is too late. It can be socially disabling in that you always have to have a bathroom available. The cause is partly unknown, but it probably has to do with the brain's interpretation of the bladder and sphincter signals. This causes an involuntary urination reflex that can be triggered when the bladder fills up or when moving. Increasing age, obesity and heredity are known risk factors for developing the condition. The treatment is bladder training and possibly medication. These drugs (Muscarinic receptor antagonists) are effective but have several side effects. The most common side effect that causes the patient to stop taking the medicine is dry mouth, especially when sleeping. Other side effects are constipation, vision problems, difficulty urinating and fatigue.

Mixed urinary incontinence.

There is often a "mixed urinary incontinence". It includes elements from both stress incontinence and urgency incontinence. The condition is treated as both stress and urgency urinary incontinence. Urine leakage is a troublesome condition. Most can be helped. Investigation and treatment is a collaboration between patient, GP, gynaecologist, urotherapist and physiotherapist.

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