Female urinary incontinence is a common and often embarrassing condition. And it affects so many females; according to Mayo Clinic, up to 75% of women 65 years and above report urine leakage.
The impact that this condition can have on your quality of life is massive. That’s why it does help to be knowledgeable on the possible causes and your support options.
What Causes Urinary Incontinence in Females?
Going by the simplest definition, urinary incontinence is unintentional urine leakage. Poorly managed, female urinary incontinence can massively disrupt your daily activities, social interactions and even self-confidence,
Now, there are four main types of female urinary incontinence in Singapore. These include; urgency, stress, functional and mixed incontinence.
1. Urge/Urgency Urinary Incontinence
Urge or urgency urinary incontinence is a type of urinary incontinence that lead to sudden, intense urges to urinate. If you’re experiencing urge incontinence, you may unintentionally leak urine before reaching the bathroom.
Affecting about 40% of women at least once in their lives, urge incontinence is primarily associated with an overactive bladder. This typically occurs when the muscles in your bladder contract more frequently than necessary.
This increased muscle activity creates a sense of urgency to urinate. You may experience this urge to urinate even when your bladder is not yet full. Also worth mentioning is the contraction of the bladder muscles which can cause the sphincter muscle within the urethra to relax and cause urine leakage.
There are several factors that can contribute to the development of urge incontinence. Key among these factors includes:
- Prior pelvic surgeries, such as hysterectomy.
- Medications like antidepressants, diuretics, and blood pressure medicine.
- Neurological disorders
- Obesity
- Smoking
- Stroke
- Urinary tract infections (UTIs)
- Pregnancy and childbirth, most commonly, vaginal delivery
- Previous radiation therapy in your pelvic area
2. Stress Incontinence
This is the most prevalent types of female urinary incontinence in Singapore. It is causes by pressure being exerted to the bladder which leads to leakage. Activities like sneezing, physical exertion or even coughing may trigger the release of small amounts of urine if you’re having stress incontinence.
As for the causes, stress is caused by sudden pressure on the bladder and the urethra. This pesue may make the sphincter muscle inside the urethra to briefly open and allow space for urine to escape unintentionally. Common causes of stress incontinence include:
- Pregnancy and childbirth: Vaginal delivery, in particular, can weaken the pelvic floor muscles. This may cause damage to the nerves responsible for controlling bladder function.
- Menopause: Hormonal changes during menopause can lead to a decline in oestrogen levels. Deceased oestrogen levels may lead to weakening of bladder and urethral tissues.
- Nerve injuries to the pelvis or lower back: Trauma or damage to the nerves in these areas can affect the coordination of bladder control.
- Obesity: Excess weight puts additional pressure on the bladder. This may weaken the pelvic floor muscles and lead to stress incontinence.
- Pelvic surgery: If you’ve had pelvic surgery in the past, it could be to blame. Procedures like hysterectomy can disrupt the normal anatomical support of the bladder and urethra.
- Diabetes: High blood sugar levels can damage nerves. This includes even the nerves involved in bladder function.
- Uterine prolapse: Uterine prolapse is when the uterus descends into the vagina. This can exert pressure on the bladder and contribute to stress incontinence.
3. Functional Urinary Incontinence
Functional urinary incontinence occurs when you experience bladder control issues due to difficulties reaching a bathroom on time or recognising the need to urinate. There are several factors that have been identified as possible contributors to functional incontinence. These include;
- Cognitive disorders: Conditions like dementia, delirium, and intellectual disabilities affect the thought process. This may make it challenging for the patients to maintain control over bladder function.
- Neurological disorders: Conditions like multiple sclerosis (MS), Parkinson’s disease, and stroke are known to affect the brain, spinal cord, and nerves. For some patients, the impacts of these disorders may lead to impaired bladder control.
- Musculoskeletal conditions: Conditions like arthritis can make it difficult or even impossible to reach the bathroom or remove clothing on time. So patients dealing with musculoskeletal conditions may experience functional incontinence symptoms.
- Weak bladder or pelvic floor muscles: Weakened muscles can contribute to the inability to hold urine until reaching a restroom.
- Physical barriers: Stairs, poor lighting, and crowded environments can hinder timely bathroom access, leading to accidents.
- Thinning or irritation of vaginal tissues: Changes in vaginal tissues, such as thinning or irritation, can affect bladder control.
- Medications: Certain medications, such as those affecting cognitive function or increasing urine production (diuretics), can contribute to functional incontinence.
- Urinary tract infections (UTIs): Infections in the urinary tract can cause urgency and incontinence.
Functional incontinence risk factors include cognitive or neurological disorders. Other factors include muscle or joint conditions, and use of diuretics or sedating medications.
Also worth mentioning is old age as it is quite prevalent among people who are 65 years plus. Sedentary lifestyle may also increase your risks of developing functional incontinence.
4. Mixed Incontinence
Mixed incontinence is prevalent among older women. It manifests itself with symptoms of both stress incontinence and urge incontinence.
Causes of Mixed Incontinence:
- Weakened bladder muscles due to factors like childbirth, pregnancy, or increased pressure on the bladder.
- Damage to bladder nerves, the nervous system, or muscles caused by surgeries, neurological conditions, or diseases.
- Medical conditions such as uncontrolled diabetes or thyroid problems can exacerbate symptoms.
- Certain medications, such as diuretics, may contribute to the occurrence or severity of mixed incontinence.
Closing Thoughts
The key to identifying the right treatment approaches and addressing specific factors that may be contributing to you or your loved one’s condition is to understand the underlying causes. If you’re experiencing symptoms akin to female urinary incontinence or just concerned about the condition, consult a professional urogynaecologist for personalised advice and suitable treatment options.
If you’re in Singapore, take the next step towards finding relief today and contact DR. NG KAI LYN, our board-certified obstetrician/gynaecologist, to schedule your consultation. DR. NG KAI LYN specialises in addressing women’s health issues, including urinary incontinence. Contact details:
Dr Ng Kai Lyn | Female Gynaecologist | Women’s Health Specialist | Fertility Specialist Singapore
38 Irrawaddy Rd,
#05-34/35 Mt Elizabeth Novena Specialist Centre,
Singapore 329563
+65 6011 1531