Urinary incontinence is characterised by the unintentional passing of urine, and can be due to a variety of causes. In women, it is more common among older women and women who have given birth before.
Pregnancy and childbirth—particularly vaginal birth—places great strain on women’s pelvic floor muscles by stretching and weakening them. In serious cases, it can even tear the supports of the bladder and uterus.
While in most cases the woman’s body can recover back to its pre-pregnancy state within a few months after delivery, it is understandable why some cannot, causing the woman to live with weakened pelvic floor muscles and its common resultant problem—urinary incontinence.
Not only does pregnancy and childbirth weaken the pelvic floor muscles, they can also cause urinary incontinence due to damage of the nerves that supply the pelvic floor muscles, including the bladder.
Urinary incontinence can be a very distressing condition. Beyond the physical inconvenience of constantly having to rush to the bathroom and wetting one’s pants, it can also result in significant embarrassment and social withdrawal.
It is a common misconception that urinary incontinence is a necessary effect of pregnancy—it can definitely be treated and one’s quality of life can be greatly improved.
Minimally Invasive Treatment & Prevention Tips
Depending on the type and severity of urinary incontinence, treatment options vary and can involve a combination of laparoscopic surgery, medication, lifestyle and dietary changes, as well as pelvic floor exercise.
Various types of medicines are available that serve different purposes—speak to your doctor to find out which may be suitable for you:
Should the problem persist in spite of conservative treatment methods, surgery may now have to be considered.
It is worth thinking if you plan to have future pregnancies, as some women may wish to wait until they are done having children before opting for surgery; because the strain of pregnancy and childbirth can sometimes affect the results of otherwise successful surgical treatments.
Of all the surgical procedures available for treating stress urinary incontinence in women, the Tension-Free Vaginal Tape (TVT) is the most well-researched and preferred method in most cases. Designed to provide support for a sagging and weakened urethra, the cure rate (depending on patient profile) stands between 80% and 90% even after 10 years.
In TVT, a mesh tape will be placed under the urethra like a sling to keep it in its normal position, keeping the urethra and bladder neck closed.
Why “tension-free”? Because the doctor will carefully adjust the tightness (tension) of the tape such that it is just enough to support the urethra—not too much, and not too little. For instance, if the patient is not under general anaesthesia, she may be asked to cough so that the doctor can check and adjust the tension of the tape.
The tape will be inserted through tiny incisions in the abdomen and vaginal wall, with no sutures required and is held permanently in place. This is typically performed as a day procedure under anaesthesia with just a one night’s hospital stay and full recovery takes one to four weeks.
Talk to a gynaecologist if you still have bladder problems six weeks after delivery. Accidental leaking of urine may mean that you have another medical condition. The loss of bladder control should be treated or it can become a worse or long-term problem.
More specifically, should you notice that you involuntarily pass urine when you laugh, sneeze, cough, or exercise, constantly wake up at night to go to the bathroom or feel a strong urge to pass urine even when your bladder is not actually full, you should pay a visit to a gynaecologist for an evaluation and diagnosis.
Rest assured that regardless of cause or severity, a range of treatment for urinary incontinence is available for women in Singapore.