Chapter 6 – The Bladder and the Pelvic Floor

Urinary incontinence

Urinary incontinence is a term that describes any accidental or involuntary loss of urine from the bladder.

Urinary incontinence is a largely hidden problem as it is often under-reported due either to embarrassment or the mistaken view that it is a ‘normal’ aspect of childbirth, menopause and ageing. However, it is a very common problem which can often be substantially improved with the correct management.

It is estimated that in Australia there are over four million people with some degree of incontinence. The prevalence in women is estimated to be 37 per cent and in men 13 per cent.(12)

Urinary incontinence can be categorised as:

Stress urinary incontinence(13) Urge urinary incontinence(13) Mixed urinary incontinence(14) Incontinence associated with chronic retention or overflow urinary incontinence(13) Fistula related incontinence(14) Functional incontinence(13) Continuous incontinence(13)

Patients with concerns regarding urinary incontinence should be assessed with a thorough clinical history and examination. Two to three-day bladder diaries may be useful in patients with both stress and urge urinary incontinence. A urinalysis +/- urine culture and an estimation of post-void residual urine with a bladder scan or dedicated genitourinary ultrasound are sufficient in most patients prior to initiating treatment.

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