Your health

Urinary incontinence means any involuntary leakage of urine from the bladder. This is then further described as:-

• Stress urinary incontinence – The leakage of urine when you sneeze, cough, laugh or exercise.

• Urge urinary incontinence – The leakage of urine that occurs immediately after a feeling of urgency to urinate.

Mixed urinary incontinence is a combination of stress urinary incontinence and urge urinary incontinence.

The symptom of urinary urgency (a strong and sudden urge to pass urine with little or no ability to postpone urination), whether it leads to leakage of urine or not is described as the overactive bladder syndrome.

Most people find that urgency followed by sudden urine leakage (i.e. urge urinary incontinence) is more bothersome than urine leakage from sneezing, coughing or laughing (i.e. stress incontinence). ²⁴

European data show that frequency is the most commonly reported symptom (85%), while 54% of people complain of urgency and 36% report urge incontinence. ⁹

Overall 60% of people with symptoms had consulted a doctor, but only 27% receive treatment. ⁹

Urgency is the central symptom of overactive bladder. 10 It is felt as a strong and sudden urge to pass urine with little or no ability to postpone urination.

While urinary incontinence may be more bothersome in patients with overactive bladder than in patients with stress incontinence, about 50% of patients with overactive bladder do not suffer from urinary incontinence. ^9,10 Urgency is the key problem for these individuals. 10 A treatment that relieves urgency, therefore, is useful. ¹⁰

Sufferers often assume that urinary incontinence and overactive bladder are an inevitable consequence of old age. As a result, the affected person may withdraw from social life and is reluctant to discuss the problem with a doctor, family or friends.

However, urinary incontinence is NOT a normal part of ageing. Many cases can be cured or managed using a combination of the currently available treatments.

While the exact incidence of urinary incontinence and overactive bladder (OAB) is not known in South Africa, studies from other countries suggest that the magnitude of the problem is much higher than is apparent. While studies suggest that OAB is widespread, many people do not seek treatment for the disorder.

The prevalence of these disorders increases with age in both men and women. The prevalence of OAB is 30 to 40% in people over the age of 75 years. To put this in perspective, OAB is more common in the elderly than diabetes.

Overactive bladder (OAB) affects people of all ages and occurs in both men and women. 10 The prevalence of OAB is similar in men and women and increases with age in both genders. ^9,10

Do you believe that overactive bladder is not a major problem in your life? After all, it is certainly not a life-threatening condition. You may not even remember that you've modified your activities because of your overactive bladder or maybe you're reasonably satisfied with the way you've adapted your life around your symptoms.

You should know, however, that overactive bladder can be easily treated, and it is not normal at any age. Maybe it's time to take a look at the many ways that overactive bladder may be interrupting or limiting your everyday life. Having an overactive bladder may cause you to:

• Experience disturbed sleep and loss of daytime productivity due to waking up to go to the bathroom 2 or more times during the night.

• Withdraw from sexual intimacy to avoid the anxiety and embarrassment caused by urine leakage during lovemaking.

• Repeatedly leave important meetings because of frequent trips to the bathroom.

• Avoid exercise because of fear of being too far away from a bathroom.

• Habitually look for toilet locations, planning activities such as travelling and shopping based on knowing where toilets can be easily reached.

• Pass up invitations to socialise with friends and family because of the embarrassment of having to visit the bathroom regularly or the fear of having a wetting accident.

• Only sit in the aisle seat in public transportation, places of worship, the theater, or at movies to be able to leave quickly to find a bathroom.

• Always carry a spare set of clothing in case of a wetting accident.

• Wear dark and baggy clothing to disguise disposable pads or the signs of a wetting accident.

• Carry a bottle in the car in case of the need to urinate while traveling long distances between gas stations.

• Silently endure a condition that no one is talking about and falsely believe that there is no hope or treatment.

The pelvic floor muscles act as a sling to help hold the bladder and urethra in place. These muscles also help
to keep the urethra closed. Weak pelvic floor muscles may allow urine to leak.

Kegel exercises help to strengthen pelvic floor muscles and thereby improve urine control. Daily pelvic floor exercises make the pelvic floor muscles stronger and tighter. This helps prevent urine leakage.

If you are experiencing a lack of bladder control, see your doctor.