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URINARY INCONTINENCE IN WOMEN
Urinary incontinence is the complaint of involuntary urine leakage.
Stress urinary incontinence is the involuntary urine leakage on effort or exertion or when coughing or sneezing.
Urge urinary incontinence is the one associated with or immediately preceded by urgency.
Mixed urinary incontinence is the involuntary urine leakage associated with both urgency and with exertion, effort, coughing or sneezing.

Lifestyle Modification

Fluid Intake
  • Average amount of fluid needed per day is calculated based on patient’s lean body mass
  • Encourage patients to modify their fluid intake to produce a 24-hour urinary output between 1-2 L
    • A very large or small urine volume output can contribute to urinary incontinence
Diet
  • Certain foods contain stimulants that may exacerbate symptoms of incontinence
    • Heavy or hot spices
    • Fruits or juices with acidic pH
    • Corn syrup, sugar, honey
  • Use of artificial sweeteners may also contribute to urge incontinence
Caffeine
  • Studies suggest that decreasing caffeine may improve frequency and urgency but not incontinence
  • Eg Coffee, tea, carbonated drinks and hot chocolate
Weight Loss
  • In morbidly obese women, massive (surgically induced) weight loss has been shown to significantly decrease incontinence
    • Should be considered as first-line treatment
  • Moderate weight loss may also decrease incontinence
Smoking Cessation
  • Smoking >20 cigarettes per day is considered to reinforce urinary incontinence
Use of Anti-incontinence Products
  • Pads and products that help contain urine loss may be beneficial
  • Absorbent products are temporary means to absorb urine and help protect skin and clothing
    • May also be used as adjunct to behavioral and pharmacological treatment
  • Urethral occlusive products
    • Artificial device inserted into or placed over urethral meatus
    • Keep patients drier, but more difficult and expensive to use compared to absorbent products
  • Catheters
    • Eg Indwelling urethral catheters, suprapubic tubes and intermittent self-catheterization
    • Some patients improve with temporary continuous Foley catheterization wherein bladder capacity returns to normal and voluntary detrusor function improves
    • Intermittent catheterization is the best form of bladder draining for those who are not physically or mentally handicapped
  • Intravaginal devices for select women may improve stress incontinence
Catheters
Catheters
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