by Dr. Rodolfo Milani – Gynecologist – Columbus Clinic Center

Urinary incontinence in women is defined as the involuntary leakage of urine through the urethra, to such an extent that it causes a serious psychophysical discomfort that alters the subject’s quality of life.

Initial symptoms can be modest and easily tolerated; their worsening over time can generate a sense of social inadequacy and isolation. Women tend to avoid social life and experience great embarrassment even in the family and with their partner.

An estimated 20% of women who have given birth naturally at least once are affected by incontinence, 50% of these have a serious disorder that requires specific treatment.

A woman may leak urine for two reasons: a strong urge to urinate that is difficult to delay or the inability to hold back urine under stress or when performing a physical activity.

In the first case, the woman complains of an “urge for urination”, that is, the urgent and uncontrollable need to urinate followed by the involuntary loss of urine with no chance of stopping the leakage, thus leading to copious discharge.

This form of incontinence is known as “urge incontinence”.

In other cases, the woman has a regular control of the urge to urinate but leaks urine, in variable amounts, when performing physical effort, physical work activities, sport or when simply coughing, sneezing, or laughing. Occasionally, the phenomenon also occurs during sexual activity.

This form of incontinence is called “stress urinary incontinence”.

Both of these forms of incontinence can be treated; urge incontinence is treated with medical or physical rehabilitation therapies; stress incontinence, instead, is treated surgically or through pelvic floor muscle training.

The estimated chances of recovery range from 65% for urge incontinence to about 90% for stress incontinence.

Before starting any therapy, it is advisable for a woman suffering from urinary incontinence to undergo a urodynamic assessment, in order to have a correct diagnosis of the type of incontinence and set the most appropriate treatment.

The diagnostic process includes a first visit to a urogynecologist, who will give the instructions on how to prepare for the urodynamic examination, then will share with the patient the appropriate therapy for the specific case.