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Urinary Incontinence and Female Bladder

Urinary Incontinence is the loss of control over one’s bladder. This means that the person has the tendency to urinate unintentionally.

Urinary Incontinence is the loss of control over one’s bladder. This means that the person has the tendency to urinate unintentionally. It is a common and often an uncomfortable problem. The severity varies from occasionally leaking urine when you cough or sneeze to persistent conditions that can still be treated.

What Causes Female Urinary Incontinence?

Urinary Incontinence usually happens when the regular process of storing and transporting of urine outside the body is interrupted, but it can also occur due to other reasons and factors. It can either be temporary or persistent.

Temporary Urinary Incontinence

Urinary Incontinence may happen all of a sudden and then go away after a short period of time. Certain drinks and foods may increase the volume of urine and stimulate your bladder. These consist of:

  • Foods that are high in spice, sugar or acid (citrus fruits)
  • Large doses of vitamin C
  • Alcohol
  • Caffeine
  • Carbonated drinks
  • Artificial sweeteners
  • Chocolate
  • Chili peppers

Persistent Urinary Incontinence

Urinary Incontinence may continue on a long-term basis and become a persistent condition. This may be caused by physical problems like:

  • Childbirth
    Vaginal delivery can damage the bladder nerves and supportive tissue that controls the bladder. It can also weaken the pelvic floor muscles, resulting into an overactive bladder. Having an overactive bladder means the person urinates more than the usual as the bladder have uncontrollable spasms.
  • Aging
    The aging of the bladder muscle can reduce the bladder's capacity to store urine. This means that as you get older, involuntary bladder contractions become recurrent.
  • Menopause
    After menopause, women produce less oestrogen - a kind of hormone that retains the lining of the bladder and urethra in good physical shape. Lack of oestrogen causes the pelvic muscles to deteriorate and may not be able to control the bladder.
  • Hysterectomy
    Any surgery that involves a woman's reproductive system like the removal of the uterus, may hurt the supporting pelvic floor muscles and cause an incontinence.

Actions That May Trigger Urinary Incontinence

  • Coughing
  • Sneezing
  • Laughing
  • Heavy lifting
  • Exercise
  • A sudden change in position
  • The sound of running water (for some people)
  • Sex (especially during orgasm)

Treatments for Stress and/or Urge Urinary Incontinence

Every treatment depends on the type and severity of the symptoms. Some cases can be treated by a simple change in habits that may prevent the actions that trigger urinary incontinence. Aside from this, here are some of the other treatments for Stress Urinary Incontinence:

Exercises

Pelvic floor exercises can toughen the muscles that help control urination. You can try doing Kegel exercises by contracting your muscles, holding it for 5 seconds and releasing it after about 5 seconds as well. You can also try doing squats by standing in an upright position and dropping down until your thighs are parallel to the ground, maintaining the weight in your heels and bowing the knees a little outward.

Bladder training

Bladder training helps the patient slowly gain back control over their bladder. These are the following techniques for bladder training:

  • Postponing the event - The patient learns how to delay urination whenever there is an impulse to do so. The aim is to control the urge.
  • Scheduled Toilet Trips – The patient learns to set a toilet time during the day, e.g. going every 2 hours. This strengthens the bladder as it learns to control the urge to urinate.

Medications for urinary incontinence

If you choose to have medications, exercises and bladder training are still necessary. Here are some of the medications that are prescribed to treat urinary incontinence:

  • Anticholinergics and newer oral therapy are now available to calm overcharged bladder– it calms overcharged bladders.
  • Topical oestrogen - reinforces tissue in the urethra and vaginal areas, which maintains the muscular and connective tissues.
  • Imipramine – it reduces the number of times you leak urine.

Surgery

Surgery is suggested if the other treatments and rehabilitations have not been effective. Some of the surgical treatments include the following:

  • Sling procedures – This supports the urethra to stop urine from leaking out by inserting a mesh under the neck of the bladder.
  • Artificial sphincter - an artificial sphincter is inserted from the bladder into the urethra to control the flow of urine.

For a detailed consultation and an effective treatment of urinary incontinence, consult our dedicated doctors at 6838-1212 today.

Women And Her Bladder Infections

URINARY TRACT INFECTION (UTI) IS A BACTERIAL INFECTION OF THE URINARY TRACT.

The commonest causative agent is Escherichia Coli. It must be remembered that even though urine contains so called waste products of the body, it does not contain bacteria. However if bacteria enters the urinary system and multiplies, it can reach a critical concentration to cause a urinary infection which in selected situations can cause sepsis and even death.

There are two kinds of urinary infections, upper tract or kidney infection and lower tract or bladder infection. Lower tracts infection are more common and occur >95% of all UTI and the women present with pain passing urine (dysuria), urinary urgency and frequency and sometimes blood in the urine with fever. Upper tract infection are less common but potentially more serious. Patients can complain of flank pain and high fever and may even have a drop in blood pressure if sepsis occurs. Elderly patients with lower immunity status example in diabetics or those with retention of urine are at higher risk to be overwhelmed with infection.

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Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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