Urinary incontinence (UI) is the involuntary loss of urine. The problem afflicts an estimated 13 million adults in the United States, 85% of them being women. Because of the embarrassment of UI, only a one-third to one-half of people that have UI seek treatment, yet UI can be improved in approximately 8 out of 10 cases. Often, women with UI are reported to be depressed and/or embarrassed about their appearance and odor.
Consequently, social interaction with friends and sexual activity may be avoided. In a survey of American women from 2002, 26% reported experiencing UI over the last year, and 37% over the past thirty days. UI begins to be reported by women in their thirties, but even women active into their eighties experience it.
Some of the common causes of female UI include: childbirth, menopause/aging, pelvic surgery (hysterectomy), obesity, repetitive straining (chronic cough), and neurological diseases such as multiple sclerosis or Parkinson’s Disease. Other types of incontinence that can often be reversible include: delirium/dementia, urinary tract infection, vaginal atrophy, drug effects and side effects, depression, diabetes, restricted mobility and constipation.
There are two general categories of UI in women: stress urinary incontinence (SUI) and urge urinary incontinence (UUI), which a component of overactive bladder (OAB). SUI is the involuntary loss of urine in the absence of a bladder contraction during a rise in abdominal pressure, such as leaking provoked by coughing, sneezing, laughing, exercise, lifting, or bending over. UUI is the involuntary loss of urine during an episode of uncontrolled urgency. OAB is the constellation of “gotta go” symptoms such as urinary frequency, urgency and UUI in the absence of infection or other bladder disease. Often, nocturia, getting up at night to void, is included in this category but there are several non-bladder causes of nocturia.
Mixed incontinence is when someone experiences both SUI and UUI.
The impact on a woman’s quality of life depends on the frequency and severity of the UI, the desire for physical and sexual activity and its influence on the person’s social functioning.