​Urinary Incontinence

Urinary incontinence is the loss of bladder control ranging from slight leakage while coughing or sneezing, to uncontrollable wetting before you can reach the toilet. It is a common condition that is generally treatable and it affects women and men. The disorder is more common amongst women due to weakening of the pelvic muscles after childbirth or thinning of the urethral lining after menopause. This condition is also exprerienced by the elderly population. Other causes include bladder infection, incapability of the bladder outlet to stay closed or a side-effect of any prescribed medications.

If you are experiencing urinary incontinence you may report of occasional leaking or frequent wetting.

There are different types of urinary incontinence including:

  • Stress incontinence in which minor leakage occurs when you exert pressure on the bladder during coughing, sneezing, laughing, exercising or lifting something heavy.

  • Urge incontinence in which the overactive bladder contracts unexpectedly causing an involuntary loss of urine. You may feel the need to urinate frequently and it can be caused by an infection, diabetes, or some neurologic disorder.

  • Overflow incontinence in which you experience constant leakage.

  • Mixed incontinence in which you experience more than one type of incontinence.

It may be uncomfortable for you to discuss about urinary incontinence with a doctor but the Women’s Health Care Services at the Aga Khan University Hospital houses a team of highly qualified doctors ensuring your satisfaction by providing quality healthcare. You can also make an appointment with the Kidney and Bladder Service Line at The Aga Khan University Hospital if you notice any of the above mentioned symptoms that have been persistent for more than two weeks.

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

 Your consultant will likely start with a thorough medical history and a physical exam. This will be followed by the following tests:
  • Urinalysis in which the urine will be tested for infections, blood or other abnormalities.
  • Post-void residual measurement to check the amount of urine left behind in your bladder, using an ultrasound scan or a catheter, after you have emptied your bladder as much as you can.
  • Urodynamic testing in which the strength of the bladder and urethra sphincter muscles function will be checked. This will be done by filling the bladder with water using a catheter inserted into the bladder via the urethra. Pressure of the bladder will then be checked and recorded using a pressure monitor.
  • Cystoscopy in which a small viewing telescope, called the cystoscope, will be inserted into the bladder to visually check for problems.
  • Cystogram in which a dye will be injected into the bladder using a catheter and then X-ray images of the bladder and urethra will be taken.
  • Stress test in which you may be asked to cough, stand and do other activities with a full bladder.

Treatments for urinary incontinence include:

  • Behavioral therapy in which our specialist may provide with some simple exercises to strengthen your pelvic floor in order to regain continence and better pelvic support. You may be asked to schedule your toilet visits or empty your bladder then wait for a few minutes before trying again for complete void.

  • Medications may be prescribed along with some other treatment for optimum results.

  • Medical devices, such as urethral insert, will be positioned in your urethra to prevent leakage which can be removed before urination. Other devices include pessary, a stiff ring, which will be inserted in your vagina to hold the bladder.

  • Surgery, in case other treatments fail to work. Surgical procedures include:

    • Sling surgery in which a pelvic sling will be created around the urethra and the bladder neck (area where the urethra connects to the bladder), which will help in keeping the urethra closed while sneezing or coughing. This procedure is used for stress incontinence.

    • Bladder neck suspension in which support will be provided to the urethra and bladder neck. It is an invasive surgery as it requires an abdominal incision.

    • Prolapse surgery can be used to treat mixed incontinence and pelvic organ prolapsed. It includes a combination of sling procedure and prolapsed surgery.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.