Urinary incontinence

This is where one or more of the organs in the pelvis slip down from their normal position and bulge into the vagina. The front wall, back wall and uterus can prolapse. Treatments for a vaginal prolapse include pelvic floor exercises, vaginal pessaries and surgery to repair the weakness in the vaginal walls or a hysterectomy to remove a prolapsed uterus. Women who are overweight, have had children, have had a hysterectomy and regularly increase their intra-abdominal muscles through straining (constipation) are at an increased risk of developing a vaginal prolapse. Women may also notice that they develop a prolapse around the time of the menopause.

Stress urinary incontinence: leakage with coughing, sneezing, exercising

Stress urinary incontinence happens when there is a rise in intra-abdominal pressure and the pelvic floor isn’t strong enough to combat it. Treatments include pelvic floor exercises (or strengthening the pelvic floor with the use of electrical stimulation) and surgery.

Overactive bladder: urgency, frequency, urge incontinence and nocturia

Treatments for an overactive bladder include fluid advice, bladder retraining and pelvic floor exercises. Drugs, such as (solifenacin and mirabegron) may also improve symptoms. If these don’t improve things then Botulinum toxin injections into the bladder or tibial nerve stimulation may be considered following urodynamic investigations. Women can also suffer with voiding difficulties. These occur when the bladder isn’t able to empty properly. Constipation, fibroids, vaginal prolapse, surgery, urinary tract infections are all causes. Intermittent self-catheterisation is used to allow the patient to empty their bladder fully.