Continence

Incontinence refers to the involuntary loss of urine (urinary incontinence) or faeces (faecal incontinence). It’s a common condition that affects millions of women worldwide, yet many suffer in silence due to embarrassment or shame.

Types of Urinary Incontinence

Stress incontinence

• Occurs when pressure is placed on the bladder during physical activities
• Common triggers: coughing, sneezing, laughing, exercising
• Most common type in younger women

Urge incontinence

• Sudden, intense urge to urinate followed by involuntary loss of urine
• Also known as “overactive bladder”
• More common as women age

Mixed incontinence

• Combination of stress and urge incontinence
• Many women experience both types

What’s happening in your body

Your bladder and pelvic floor muscles work together to control urination. When these muscles weaken or don’t coordinate properly, incontinence can occur.

The pelvic floor muscles act like a hammock, supporting your bladder, uterus, and bowel. During pregnancy, childbirth, and aging, these muscles can stretch and weaken.

Remember: Incontinence is a medical condition, not a normal part of aging, and effective treatments are available.

Medical terminology can be overwhelming. This guide breaks down common terms you might hear when discussing incontinence with healthcare providers.

Common medical terms

Detrusor

• The muscle that makes up the wall of the bladder
• When it contracts, it helps empty the bladder
• “Your detrusor muscle is overactive” = Your bladder muscle contracts too often

Sphincter

• Ring-shaped muscles that control the flow of urine
• External sphincter: muscle you can consciously control
• Internal sphincter: works automatically

Pelvic floor

• Group of muscles that support your pelvic organs
• Acts like a hammock holding up bladder, uterus, and bowel
• “Pelvic floor dysfunction” = These muscles aren’t working properly

Urodynamics

• Tests that measure how well your bladder stores and releases urine
• “We need urodynamic studies” = Tests to see how your bladder functions

Types of incontinence (medical terms)

Stress Urinary Incontinence (SUI)

• Leakage when pressure is put on the bladder
• Not related to emotional stress

Detrusor Overactivity (DO)

• Previously called “unstable bladder”
• Bladder muscle contracts when it shouldn’t

Mixed Urinary Incontinence (MUI)

• Having both stress and urge incontinence

Overflow Incontinence

• Bladder doesn’t empty completely
• Small amounts leak out when bladder is too full

Treatment Terms

Kegel exercises

• Pelvic floor muscle exercises
• Named after Dr. Arnold Kegel

Biofeedback

• Using equipment to help you learn proper muscle exercises
• Visual or audio feedback shows if you’re doing exercises correctly

Pessary

• Small device inserted into vagina to support organs
• Non-surgical treatment option

Sling procedure

• Surgical procedure using a mesh “sling” to support the urethra
• Common treatment for stress incontinence

Botulinum Toxin (Botox)

• Injection into bladder muscle to reduce overactivity
• “Intravesical botulinum toxin” = Botox injected into the bladder

Questions to ask your doctor

• “Can you explain that term in simple language?”
• “What does this mean for my treatment options?”
• “Are there other names for this condition?”
• “Can you write down the medical terms for me?”

Don’t hesitate to ask for clarification – understanding your condition is crucial for making informed decisions about your care.

Understanding the causes and risk factors for incontinence empowers you to take control of your pelvic health and make informed decisions about prevention and treatment.

Common causes

Pregnancy and childbirth

• Hormonal changes during pregnancy
• Weight of growing baby putting pressure on pelvic floor
• Vaginal delivery can stretch and weaken pelvic muscles
• Forceps or vacuum delivery increases risk

Hormonal changes

• Menopause reduces estrogen levels
• Estrogen helps maintain bladder and urethral tissue health
• Perimenopause can cause temporary symptoms

Age-related changes

• Natural weakening of pelvic floor muscles
• Decreased bladder capacity
• Changes in nervous system function

Risk factors you can control

Lifestyle factors

• Weight management: Excess weight increases pressure on the bladder
• Fluid intake: Both too much and too little can cause problems
• Caffeine and alcohol: Can irritate the bladder
• Smoking: Chronic coughing weakens pelvic muscles

Exercise and activity

• High-impact activities: Can stress the pelvic floor
• Heavy lifting: Increases abdominal pressure
• Constipation: Straining can weaken pelvic muscles

Risk factors you cannot control

• Family history of incontinence
• Previous pelvic surgeries
• Neurological conditions
• Certain medications
• Age and natural aging process

Prevention strategies

Strengthen your pelvic floor

• Regular pelvic floor exercises (Kegels)
• Consider physiotherapy assessment
• Maintain good posture

Healthy habits

• Maintain a healthy weight
• Stay hydrated but avoid excessive fluids
• Limit bladder irritants
• Don’t delay urination when you feel the urge

Remember: Many risk factors are modifiable through lifestyle changes and appropriate treatment.

Medical terminology can be overwhelming. This guide breaks down common terms you might hear when discussing incontinence with healthcare providers.

Common medical terms

Detrusor

• The muscle that makes up the wall of the bladder
• When it contracts, it helps empty the bladder
• “Your detrusor muscle is overactive” = Your bladder muscle contracts too often

Sphincter

• Ring-shaped muscles that control the flow of urine
• External sphincter: muscle you can consciously control
• Internal sphincter: works automatically

Pelvic floor

• Group of muscles that support your pelvic organs
• Acts like a hammock holding up bladder, uterus, and bowel
• “Pelvic floor dysfunction” = These muscles aren’t working properly

Urodynamics

• Tests that measure how well your bladder stores and releases urine
• “We need urodynamic studies” = Tests to see how your bladder functions

Types of Incontinence (Medical Terms)

Stress Urinary Incontinence (SUI)

• Leakage when pressure is put on the bladder
• Not related to emotional stress

Detrusor Overactivity (DO)

• Previously called “unstable bladder”
• Bladder muscle contracts when it shouldn’t

Mixed Urinary Incontinence (MUI)

• Having both stress and urge incontinence

Overflow Incontinence

• Bladder doesn’t empty completely
• Small amounts leak out when bladder is too full

Treatment Terms

Kegel Exercises

• Pelvic floor muscle exercises
• Named after Dr. Arnold Kegel

Biofeedback

• Using equipment to help you learn proper muscle exercises
• Visual or audio feedback shows if you’re doing exercises correctly

Pessary

• Small device inserted into vagina to support organs
• Non-surgical treatment option

Sling Procedure

• Surgical procedure using a mesh “sling” to support the urethra
• Common treatment for stress incontinence

Botulinum Toxin (Botox)

• Injection into bladder muscle to reduce overactivity
• “Intravesical botulinum toxin” = Botox injected into the bladder

Questions to Ask Your Doctor

• Can you explain that term in simple language?
• What does this mean for my treatment options?
• Are there other names for this condition?
• Can you write down the medical terms for me?

Don’t hesitate to ask for clarification – understanding your condition is crucial for making informed decisions about your care.