Urinary incontinence

Urinary incontinence (UI) is a common problem that can cause a great deal of distress and embarrassment to many women, with reported prevalence ranging up to 40% in the community. 

Urinary continence relies on the integrity of the bladder and  urethra, surrounding connective tissue and pelvic floor muscles, peripheral and central  nervous system.

Damage or disruption to this integral environment may be caused biochemical changes associated with pregnancy and aging,  anatomical or neuro-muscular injury associated with childbirth, chronic straining or constipation, neurological disorders or side-effects from certain types of medications. 

Urinary incontinence in women is generally categorised as:

• Stress urinary incontinence (SUI)
• Urge urinary incontinence (UUI)
• Mixed urinary incontinence (MUI)
• Overflow urinary incontinence (OUI)
• Fistula related
• Functional incontinence

Stress urinary incontinence (SUI) appears to be the most common, accounting for 50 % of all cases. At times, there may be more than one type of incontinence. 

In most instances, it is possible to overcome or improve urinary incontinence by seeking opinion(s) and assessment from your family doctor and /or a specialist.

Through a process involving detailed history,  thorough clinical examination, basic investigations (urinalysis, post-void residual volume, bladder diary https://www.yourpelvicfloor.org/resources/bladder-diary/, and in selected cases, urodynamic test https://www.yourpelvicfloor.org/conditions/urodynamics/ or a cystoscopy https://www.yourpelvicfloor.org/conditions/cystoscopy/ , the underlying type of incontinence can be diagnosed and effective treatment option(s) can be offered. 

In view of recent conflicting scientific-medico-legal publicity and negative media reports concerning surgical management of pelvic organ prolapse and urinary incontinence, the Australian Commission for Safety and Quality  and the Royal Australian College of Obstetricians and Gynaecologists RANZCOG Stress-Urinary-Incontinence have developed and published care pathways and guidelines to help patients and doctors. 

Useful patient information pamphlets are also available from the International Urogynecological Association (IUGA), a professional medical association dedicated to the global advancement of urogynecological knowledge and patient care through education and the promotion of basic and clinical research on disorders of the female pelvic floor https://www.yourpelvicfloor.org/leaflets/

IUGA Urodynamics

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