What is urinary incontinence?
Urinary incontinence involves the involuntary loss of urine. It can occur at any age, but its causes tend to differ according to the age of the patient. The overall incidence of urinary incontinence increases progressively with age.
Approximately one in three elderly people experience some problems with bladder control, and women are twice as likely to be affected as men. Urinary incontinence can provide sufficient cause for admitting elderly patients and can contribute to the development of pressure sores, infections of the kidney and bladder, and depression. Urinary incontinence can also be a cause of embarrassment and frustration, which can have a significant psychological and social impact on the patient’s quality of life.
How do different types of incontinence differ and what are their causes?
| Type | Symptoms | Possible causes |
| Incontinence due to urgency or desperation | Urgent desire to urinate followed by an uncontrolled loss of urine. | Urinary tract infection.
Hyperactivity of the bladder. Obstruction of the urine flow. Stones and tumours in the bladder. Drugs |
| Stress incontinence. | Urine leakage due to increased abdominal pressure caused by coughing, laughing, sneezing or lifting heavy objects. | Weakness of the urinary sphincter (the muscle responsible for controlling the flow of urine from the bladder) and/or the pelvic floor muscles
In women, anatomical alterations caused by childbirth or pelvic surgery. In men, excision of the prostate or lesions on the upper part of the urethra or the neck of the bladder. |
| Overflow incontinence. | Retention of urine in the bladder that creates too much pressure for the urinary sphincter to contain, so urine is released intermittently and involuntarily due to hyperpressure. | Obstruction of the flow of urine
Weakened bladder musculature. Poor nerve functioning Drugs. |
| Mixed incontinence. | Occurs in instances of exertion and is associated with an urgency to void. | The symptoms of stress incontinence and urge incontinence are experienced. |
| Neurogenic bladder. | Incontinence resulting from a neurological condition. | Alzheimer’s.
Parkinson’s. Multiple sclerosis. Spinal injury. |
Treatment
The optimal treatment for urinary incontinence can only be determined through a thorough and personalised analysis, and will vary depending on the specific nature of the problem. Through an urodynamic examination, our specialists can explore the functioning of the bladder to provide a precise diagnosis of the voiding disorder. This makes it possible to identify the best possible treatment in each case.
The therapeutic options that we provide at the Serrate & Ribal Institute of Urology include:
- Pharmacological treatment
- Pelvic floor rehabilitation
- Injection of the detrusor muscle with botulinum toxin
TMinimally invasive vaginal route surgery for female stress incontinence:
- Retropubic sling (TVT)
- Transobturator tape (TOT)
- Suburethral mini-slings
- Bladder prolapse surgery with or without mesh
Male stress incontinence surgery following a prostatectomy:
Post-radical prostatectomy urinary incontinence is a complication that occurs in a small percentage of patients that undergo this treatment. At present, an artificial sphincter is the most effective treatment for urinary incontinence following a radical prostatectomy. A significant improvement in quality of life is attained for patients who achieve continence due to the implantation of an artificial sphincter.