Incontinence is basically the involuntary loss of urine that can occur when you cough or strain (stress incontinence) or if you need to pass urine urgently and you are unable to hold on until you reach the toilet (urge incontinence).
Stress leakage often occurs in women after pregnancy and is associated with weak pelvic floor ligaments. It is also often associated with pelvic floor prolapse.
In cases of mild leakage, women may improve with exercises to strengthen the pelvic floor but often a simple surgical procedure can be performed with a sling is placed under the urethra for support. This is usually extremely effective in controlling the leakage.
Urge incontinence is related to having a strong urge to pass urine and not being able to hold on. There are many conditions that can cause uncontrolled bladder contractions including infection, bladder cancers and inflammatory conditions but in many cases no specific abnormality is identified. If a problem is discovered, treatment will be directed to that issue. Where no problem is identified, treatment is largely aimed at bladder retraining techniques as well as medications that can help to make the bladder less active. In some refractory cases, Botox can be injected into the bladder directly to partially paralyze the bladder muscle.
In some women, the frequency and urgency they experience is also associated with pelvic floor ligament weakness and sometimes strengthening these ligaments helps with symptom relief.