Urinary incontinence & overactive bladder
Stress incontinence, urge urinary incontinence, overactive bladder, prolapse and pelvic floor assessment for women of every age.
What it is
Leaking urine is extremely common and almost never discussed. Many women are told it is a normal consequence of childbirth or age and simply live with it for decades. It is common, but that is not the same as untreatable.
Treatment depends on the type. Leaking on coughing, laughing or exercise is stress incontinence, a support problem. A sudden desperate urge with leakage before reaching the toilet is an overactive bladder, a nerve and muscle problem. The two are treated very differently, and many women have both.
Symptoms you may notice
- Leaking on coughing, sneezing, laughing or exercise
- A sudden urge that is difficult to defer
- Leaking on the way to the toilet
- Passing urine more than eight times a day
- Getting up at night more than once
- A dragging sensation or a bulge in the vagina
- Needing to change pads through the day
Get seen promptly if
- Leakage that began after pelvic or gynaecological surgery
- Continuous leakage day and night — this may be a fistula
- Blood in the urine alongside urgency
- Recurrent infections with incomplete emptying
How it is assessed
- A three-day bladder diary — more informative than most tests
- Examination including a cough stress test
- Post-void residual measurement
- Urodynamics where the picture is mixed or previous treatment has failed
- Cystoscopy if there is blood or suspicion of a fistula
What the options actually involve
Other conditions
Urethral stricture & genitourinary fistula
Urethroplasty and fistula repair, including redo cases referred after a previous repair has failed.
Symptoms and treatmentUrinary infection & recurrent UTI
A single infection is usually simple. Infections that keep coming back are a different question, and the answer is rarely another course of antibiotics.
Symptoms and treatmentKidney failure & transplant assessment
When kidney function falls far enough to need dialysis or a transplant, the decision is about timing as much as technique.
Symptoms and treatmentHave a scan or report about this already?
Send it before your appointment. The consultation then starts from your findings rather than from scratch.