From the Guidelines
Incontinence is the involuntary leakage of urine or stool due to a loss of bladder or bowel control, occurring when the muscles and nerves that help hold or release urine or stool are damaged or weakened. This condition can significantly impact an individual's quality of life, as noted in a recent guideline update on the surgical treatment of female stress urinary incontinence 1. There are several types of incontinence, including:
- Stress incontinence: leakage during physical activity
- Urge incontinence: sudden, intense urge to urinate
- Overflow incontinence: bladder doesn't empty completely
- Fecal incontinence: inability to control bowel movements
Treatment depends on the type and cause but may include:
- Pelvic floor exercises (Kegels)
- Bladder training
- Medications like anticholinergics (oxybutynin, tolterodine) for overactive bladder, or mirabegron for bladder relaxation
- Lifestyle changes such as limiting caffeine and alcohol, maintaining a healthy weight, and scheduled toileting to help manage symptoms
- Medical devices like pessaries or surgical interventions may be necessary in severe cases
According to the most recent guideline update on the surgical treatment of female stress urinary incontinence 1, the purpose of treatment is to provide a clinical structure with which to approach the diagnosis, counseling, and treatment of female patients with stress urinary incontinence (SUI). Incontinence occurs because the coordinated function between the brain, nerves, and pelvic floor muscles becomes disrupted, often due to aging, childbirth, prostate issues, neurological conditions, or certain medications, as discussed in a study on the effectiveness of treatments for urinary incontinence 1. The most effective treatment approach should prioritize non-surgical management, such as pelvic floor muscle training and bladder training, due to their effectiveness, low adverse effects, and cost-effectiveness, as recommended by the American College of Physicians 1.
From the FDA Drug Label
• Urge urinary incontinence: a strong need to urinate with leaking or wetting accidents Overactive bladder happens when you cannot control your bladder muscle. When the muscle contracts too often or cannot be controlled, you get symptoms of overactive bladder, which are leakage of urine (urge urinary incontinence), needing to urinate right away (urgency), and needing to urinate often (frequency)
Incontinence is defined as a strong need to urinate with leaking or wetting accidents, also referred to as leakage of urine. This is a symptom of overactive bladder, which occurs when the bladder muscle cannot be controlled, leading to unintentional loss of urine 2.
From the Research
Definition of Incontinence
- Incontinence is a common problem that can have a significant effect on an individual's quality of life 3
- It is often under-reported due to the embarrassing nature and social stigma attached 3
Types of Incontinence
- Urinary incontinence can be categorized into different types, including stress incontinence, urge incontinence, and overactive bladder (OAB) 4
- Functional urinary incontinence is a type of incontinence that causes considerable morbidity in school-age children, mainly girls 5
Symptoms and Effects
- Incontinence can cause daytime incontinence with or without urinary tract infections 5
- It can also lead to unpredictable changes in urodynamic patterns over time, and the response to cognitive treatment may vary 5
Treatment Options
- Conservative treatment options, including pelvic floor exercises, bladder retraining, and fluid modification, are recommended before referral to secondary services 3
- Pelvic floor muscle training (PFMT) is a widely recommended conservative treatment for incontinence, and can be combined with other treatment modalities 4
- Cognitive treatment and pelvic floor training have been shown to be effective in treating functional urinary incontinence in children 5
- Pelvic floor muscle exercise (PFME) is defined as exercise to improve pelvic floor muscle strength, power, endurance, relaxation, or a combination of these parameters, and can help strengthen the pelvic floor muscles to provide urethral support and prevent urine leakage 6