Daijiworld Media Network - Mumbai

Mumbai, Oct 28: Urinary incontinence, the involuntary or uncontrollable leakage of urine, is one of the most common urological disorders affecting both men and women, often leading to embarrassment and social withdrawal. Though more prevalent among people above 65, it can affect women as early as 45, with nearly 40% of women and 30% of men experiencing some form of the condition.

Doctors say many women, especially homemakers, silently suffer due to social stigma and hesitation to discuss urinary leakage even with family members. This delay in seeking medical help often worsens the condition, though timely diagnosis and treatment can completely restore normalcy.

Urinary incontinence is usually a symptom of an underlying issue rather than a disease in itself. Common causes include urinary tract infections, constipation, pregnancy, childbirth, weakened pelvic muscles and hormonal changes during menopause. In women, childbirth, obesity, smoking, caffeine intake, diabetes and pelvic surgeries increase the risk. In men, prostate enlargement, previous surgeries, radiation therapy and neurological disorders like stroke or Parkinson’s disease are contributing factors.

Urge incontinence or overactive bladder is common among the elderly and sometimes in children with neurological issues. It occurs due to involuntary bladder contractions triggered by infections, cystitis or kidney stones. Patients experience a sudden urge to urinate and often cannot reach the restroom in time. Diagnosis includes urine tests, ultrasound and uroflowmetry. Treatment begins with medication, while resistant cases may require Botox injections or sacral neuromodulation therapy.

Stress incontinence, seen mostly in middle-aged and elderly women, causes urine leakage during coughing, sneezing or physical activity. It results from increased abdominal pressure on a weakened bladder. Mild cases improve with Kegel exercises, moderate cases may require medication and severe ones can be corrected surgically using sling procedures or minimally invasive laparoscopic or robotic techniques.

Mixed incontinence combines both urge and stress symptoms. Evaluation through urodynamic studies helps determine which component is dominant and treatment is customized accordingly. Continuous incontinence, in which urine leaks constantly, usually results from structural problems such as a fistula between the bladder and vagina and requires surgical repair.

Conservative treatment options include pelvic floor exercises, weight reduction, treatment of urinary infections and electrical stimulation therapy to activate pelvic muscles. Medications such as estrogen and anticholinergics may be prescribed under medical supervision. Behavioral modifications such as adjusting fluid intake, scheduling urination and maintaining pelvic floor exercises are also effective.

For cases of overactive bladder unresponsive to medication, Botox injections or sacral nerve stimulation may be advised. Surgical options like TVT-O sling procedures, laparoscopic repair or pelvic reconstructive surgeries offer lasting relief for stress or continuous incontinence.

Doctors emphasize that urinary incontinence, though distressing, is highly treatable. Early consultation with a urologist or gynecologist can make a significant difference. With timely intervention through exercises, lifestyle changes, medications or surgery, patients can regain control and confidence in their lives.