How many times has a sneeze turned into an embarrassing “leak”? Do you tighten the muscles in your nether regions when you anticipate a cough? Well, you are not alone.

Urinary incontinence is an embarrassing but not uncommon problem that women both young and old, are afflicted with. Thankfully, they do not have to suffer in silence.

Stress urinary incontinence (SUI): The most common type of urinary incontinence

The accidental and involuntary leakage of urine at unfortunate moments is actually a medical condition known as stress urinary incontinence (SUI). It affects about 15 per cent of women in Singapore. It can be triggered by any physical exertion, such as sneezing, coughing, laughing or exercising, which increases pressure on the bladder.

Contrary to popular belief, SUI is neither a part of ageing nor a concern of older women only, although post-menopausal women do make up a large proportion of those with the condition. It can affect women of all ages, including young mothers and pre-menopausal women. One third of women with SUI actually start having symptoms before they turn 35.

The main cause of SUI is a weakening of the pelvic floor – which is the group of muscles and ligaments that keep the urethra closed so that urine remains in the bladder. Any weakening of the pelvic floor due to physical changes in the body, such as pregnancy, childbirth or menopause, can result in leakage of urine.

Sometimes, but to a lesser extent, the condition can be caused by problems in the urethra, which is the short tube through which urine flows from the bladder and out of the body.

Conditions like obesity, chronic coughing and constipation can worsen the problem

Conditions that continuously put pressure on the bladder may worsen the problem. These include obesity, chronic coughing, constipation and the lifting of heavy objects. In post-menopausal women, the situation can be aggravated by hormone deficiency.

Overactive bladder syndrome (OAB): Urge incontinence

SUI is the most common type of incontinence and affects about half the women with urinary leakage. Another type known as urge incontinence is the second most common, and is associated with what is known as overactive bladder syndrome (OAB). OAB involves a sudden, intense need to urinate which may be accompanied by the involuntary loss of urine.

Women with OAB may find themselves emptying their bladder more than seven times during the day and waking up more than once at night to do the same. Some may suffer leakage before they get to the toilet. In some women, it can happen during sex.

Women may develop symptoms of OAB if their bladder is not as stretchable as it should be, or if their bladder is hypersensitive or prone to abnormal contractions. The cause of these bladder problems is not usually known. A urinary tract infection, a tumour or an obstruction in the urethra can produce similar symptoms and therefore needs to be treated first before OAB can be conclusively diagnosed.

Certain medication, previous pelvic surgery or radiation therapy can also result in OAB. Conditions like constipation, diabetes, congestive heart failure and anxiety may contribute to a worsening of symptoms.

What about some women who experience both SUI and OAB? Read on for tips to manage urinary incontinence.

Ref: S13