Urinary Incontinence Treatment

Urinary incontinence, a common and often distressing problem, is the involuntary leakage of urine. It can significantly impact a person’s quality of life, affecting their social, psychological, and physical well-being.

Are your symptoms affecting your qualify of life? Consult with our UK Trained Urologist for an accurage diagnosis and personalised treatment plan.

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Understanding Urinary Incontinence

Urinary incontinence is not a disease in itself but a symptom of underlying medical conditions, lifestyle habits, or physical problems. It can be categorised into four main types:

  • Stress Incontinence: This occurs when urine leaks due to pressure exerted on the bladder by coughing, sneezing, laughing, exercising, or lifting something heavy. It’s often linked to physical changes resulting from pregnancy, childbirth, or menopause.
  • Urge Incontinence: Characterised by a sudden, intense urge to urinate followed by an involuntary loss of urine. This can be associated with conditions like diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
  • Overflow Incontinence: This happens when the bladder doesn’t empty completely, leading to frequent or constant dribbling of urine. Often a result of an obstruction in the urinary tract or nerve damage.
  • Functional Incontinence: This incontinence is associated with a physical or mental impairment that prevents a person from reaching the toilet in time, despite normal bladder control.

Causes of Urinary Incontinence

  • Age: As people get older, their bladder capacity decreases, and incontinence becomes more likely.
  • Pregnancy and Childbirth: Hormonal changes during pregnancy and the stress of childbirth can weaken the pelvic floor muscles, leading to incontinence.
  • Menopause: The drop in oestrogen production can weaken the urethra’s lining, increasing the chances of incontinence.
  • Prostate Problems: In men, incontinence can be related to an enlarged prostate or prostate cancer.
  • Neurological Disorders: Conditions like multiple sclerosis, Parkinson’s disease, stroke, and spinal injury can interfere with nerve signals involved in bladder control, leading to incontinence.

Diagnosis of Urinary Incontinence

Diagnosing urinary incontinence involves a thorough evaluation of symptoms, medical history, and physical examination. The types of tests and examinations involved include:

  • Urinalysis: A test of your urine for signs of infection, traces of blood, or other abnormalities.
  • Bladder Diary: A detailed record of your fluid intake, episodes of urination, and instances of urine leakage.
  • Postvoid Residual Measurement: A test to measure the amount of urine left in the bladder after urination.
  • Pelvic Ultrasound: An imaging test to view the bladder and other parts of the urinary tract.
  • Urodynamic Testing: Tests to measure pressure and volume inside the bladder.

Non-surgical Treatment Options

Bladder training: This technique involves delaying urination after the urge to go is felt. Bladder training can help increase the amount of urine your bladder can hold and improve your control over the timing of urination.

Double voiding: This technique helps ensure the bladder is completely empty to prevent overflow incontinence. Double voiding can be particularly helpful for people who have enlarged prostates that may obstruct the flow of urine, or for those who have conditions that affect bladder muscle contraction.

Scheduled toilet trips: This technique involves scheduling bathroom visits at regular intervals, typically every two to four hours, rather than waiting for the need to go.

Fluid and diet management: Certain foods and drinks can irritate the bladder and increase the urge to urinate. These can include alcohol, caffeine, and acidic foods. Managing your intake of these can help reduce symptoms.

Pelvic Floor Muscle Exercises: Also known as Kegel exercises, these strengthen the muscles that help control urination. To do Kegel exercises, follow these steps:

  • Tighten (contract) your pelvic floor muscles as though you were trying to hold in urine or gas. It should feel like a “lift and squeeze” sensation.
  • Hold the contraction for five seconds, then relax for five seconds. If this is too difficult, start by holding for two seconds and relaxing for three seconds.
  • Work up to holding the contraction for 10 seconds at a time.
  • Aim to do at least three sets of 10 repetitions each day.

Anticholinergics: Medications like oxybutynin and tolterodine. These block a chemical messenger to calm an overactive bladder and reduce the urge to urinate.
Mirabegron: This medication relaxes the bladder muscle, increasing its capacity and reducing the urgency to urinate.

Alpha blockers: Examples of these medications include tamsulosin and alfuzosin. Used primarily in men, these relax the muscles in the bladder neck and prostate, making urination easier.

Topical oestrogen: Applied directly to the urethra and vaginal areas, this can help tone and rejuvenate these tissues, reducing incontinence symptoms in postmenopausal women.

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Surgical Treatments

When non-surgical treatments do not provide sufficient relief, surgical options may be considered. Here’s a brief overview of these procedures:

  • Sling Procedures: In this surgery, a sling made of synthetic material or the patient’s own tissue is used to lift and support the urethra and bladder neck. This is commonly used to treat stress incontinence.
  • Bladder Neck Suspension: This procedure is designed to provide support to the urethra and bladder neck, an area of thickened muscle where the bladder connects to the urethra. It involves an abdominal incision and is often used to treat stress incontinence.
  • Prolapse Surgery: In some cases, incontinence is caused by a prolapse of the bladder, rectum, or uterus. Surgery can be performed to correct the prolapse and improve incontinence symptoms.
  • Artificial Urinary Sphincter: This is a small, fluid-filled ring implanted around the bladder neck to keep the urinary sphincter shut until you’re ready to urinate. To urinate, you would press a valve implanted under your skin that causes the ring to deflate and allow urine from your bladder to be released.

Each of these procedures has its own risks and benefits, and the choice of procedure depends on the individual’s specific symptoms, overall health, and personal preference. Always consult with a healthcare provider to discuss the best treatment options for you.


Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

Our Clinic Locations

Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

3 Mount Elizabeth, #11-16 Medical Centre, Singapore 228510

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

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    Frequently Asked Questions

    What are the risk factors for developing urinary incontinence?

    Risk factors for urinary incontinence include age, being overweight, smoking, family history, and other medical conditions such as diabetes or neurological disorders.

    Are there any specific exercises or physical activities that should be avoided to prevent worsening urinary incontinence?

    High-impact exercises, such as running or jumping, can put pressure on the bladder and potentially worsen symptoms of stress incontinence. Maintain overall physical fitness by considering low-impact activities like swimming or cycling.

    How does urinary incontinence affect men differently than women?

    Men are less likely to experience stress incontinence but may experience incontinence related to prostate issues. Overflow incontinence, where the bladder doesn’t empty properly, is also more common in men.

    How can urinary incontinence impact mental health?

    Urinary incontinence can lead to embarrassment, social isolation, and stress. It can also disrupt sleep, leading to fatigue and mood changes.

    Are there any home remedies or over-the-counter products that can help manage urinary incontinence?

    Over-the-counter products like absorbent pads and adult diapers can manage leaks. Certain dietary changes, such as reducing caffeine and alcohol, can also help. These should be used in conjunction with medical treatments.

    How long does it typically take for non-surgical treatments to show results?

    The time frame varies depending on the treatment and the individual. Behavioural techniques and pelvic floor exercises often show improvement within a few weeks, while medications may take a few days to a few weeks to take effect.

    What are the potential side effects or complications of the surgical treatments mentioned?

    Surgical treatments for urinary incontinence can have side effects such as infection, bleeding, difficulty urinating, and, in rare cases, damage to nearby organs. Discuss these risks with your urologist.

    Are there any new or emerging treatments for urinary incontinence?

    Emerging treatments for urinary incontinence include stem cell therapy and regenerative medicine techniques, but these are still in the experimental stages.