Involuntary urine leakage, stress urinary incontinence, loss of bladder control and urge urinary incontinence affect many adult women in Singapore. It is well known that about 50% of elderly females above 60 years old suffer from a weak bladder. These women commonly complain of frequent urination, leaking urine whenever they cough or exercise, and overactive bladder or sensitive bladder symptoms which lead to urge urinary incontinence. In order to keep dry, the women often need to use incontinence pads, incontinence diapers or incontinence pants. Their bladder problem may become so severe that the elderly women avoid drinking fluids and keep away from social activities, until they submit themselves to definitive incontinence treatment.
What is urinary incontinence?
When you experience involuntary loss of urine, you suffer from urinary incontinence. It may occur rarely, occasionally, frequently or daily; and the volume of urine leakage may be minimal or substantial. If it is mild leakage, you may not be bothered. On the other hand, frequent severe urine leak may cause you unending distress. No matter how you are affected, urinary incontinence is an abnormal condition. You should not brush it aside, attributing it as a consequence of growing old. Although more elderly women suffer from it, women of all ages suffer from it.
Control of micturition
The human body needs to be adequately hydrated to have normal physiological processes. Excess body fluid is expel in different ways, one of which ends up as urine - filtered through the kidneys and stored in the bladder before being released as urine. The bladder acts as a reservoir for urine. A healthy woman maintains bladder continence throughout most of the day, and only void when it is socially appropriate at her convenience. During the storage phase, it is essential that the bladder remains relaxed and the urethra remains contracted, so as to allow its capacity to build up. This is possible only when there is normal neurological control involving the brain and spinal cord. When this normal balance exists, urine does not leak out. In situation when one or more of the control elements become disordered, the woman fails to maintain urinary continence, resulting in involuntary loss of urine.
What are the causes of urinary incontinence?
Women may suffer from urinary incontinence as a transient phenomenon or as a progressive pathological condition. Transient urinary incontinence is often seen when a women complains of urinary tract infection, vaginal inflammation or constipation. When a women becomes restricted in physical movements as in the acute phase of a stroke, severe arthritis or Parkinson’s disease, the impaired mobility prevent her normal toileting capacity. Certain medications can cause of worsen urinary incontinence as well. These situations are mostly temporary and continence is usually restored with the resolution of the initial impediments. When the urinary incontinence persists or progresses over time, it implies that the integrity of the continence mechanism has been bridged. It is likely that the bladder, urethra or nervous system has sustained pathological damage. The damage may be a result of:
||Disruption of the ligament support of the urethra and bladder, usually from multiple child-bearing & labor, assisted or traumatic vaginal delivery.
||Connective tissue atrophy that accompanies the menopause
||Further damage to pelvic floor musculature from increasing body weight (obesity), regular and severe abdominal straining from physical weight, constipation and chronic cough.
||Neurological diseases (stroke and dementia) affecting the central nervous system
||Chronic lifestyle disease that impact on the normal functioning of the nervous system
Types of urinary incontinence
The leaking of urine occurs when the bladder control mechanism becomes defective. The position and the muscle tone of the water-pipe (urethra) usually keep the urine in the bladder effectively. When this continence device fails, urine flows out of the body at inappropriate times. Urinary incontinence is classified either as:
Genuine stress incontinenc
Loss of urine with coughing, sneezing, laughing or lifting a heavy weight.
Urge urinary incontinence
Loss of urine when the bladder fails to keep the urine in when a strong urge suddenly develops.
Mixed urinary incontinence
A combination of the above two types.
Overflow urinary incontinence
Intermittent loss of urine with the sensation of a full bladder and difficulty in completely emptying it.
Continuous urinary incontinence
Continuous loss of urine through a false passage that is formed between the bladder or the ureter and the vagina.
How does it impact?
The impact that urinary incontinence has on the suffering woman reflects on her anticipated quality of life desired. Urinary incontinence by and large is not a fatal illness; that is, no one dies directly from it. It does definitely has considerable bearing on how she lives her life – at home, at work, socially, financially and psychologically. The age and pre-morbid social and physical activity level affects how a woman copes with the inconvenience of urinary incontinence.