Bladder and continence problems
Many women of all age groups will complain of some degree of urinary problems. There are different symptoms ranging from bladder pain and cystitis type symptoms, to overactive bladder symptoms and stress incontinence. Many of these have a significant detrimental impact on a woman’s quality of life.
Bladder pain, cystitis and repeat urinary infections are common chronic complaints. They can be caused by problems anywhere along the urinary tract (kidneys, bladder and/or urethra). There are a range of lifestyle and medical treatments that can successfully prevent recurrent attacks.
An overactive bladder typically gives rise to symptoms that include going to the toilet too often (“frequency”), getting up at night to pass urine (“nocturia”), a compelling or desperate desire to pass urine (“urgency”), and sometimes not being able to make it in time to the toilet (“urge incontinence”). It is a common condition, and many women will have a degree of these symptoms before seeking medical attention.
Stress incontinence is the involuntary loss of urine. Provoking factors typically include coughing, laughing, running and sneezing. The amount of urine lost will vary from woman to woman, ranging from a few drops, to soaking clothes and requiring pads. There may be many causes for stress incontinence. There is normally a supporting mechanism to the urethra (the outlet pipe leading from the bladder through which urine passes when urinating, or going to the toilet). If this supporting mechanism becomes weakened as a result of pregnancy and childbirth, chronic straining (for example coughing, heavy lifting, constipation), or genetically weak muscles/supporting tissue, then urinary incontinence may result.
In order to distinguish between some of the different underlying diagnoses, and investigations such as urine tests, frequency volume charts and urodynamics (a special test where bladder function is measured) may be necessary. It is important to realise that many of the problems can be improved, and often with relatively simple treatments. Often your doctor will work in close liaison with a physiotherapist to help with your symptoms. Depending on the underlying cause, medical treatments may be advised and in other cases surgery may be offered.