Urinary incontinence is the involuntary leakage of urine — a common condition that can affect both men and women and range from occasional dribbles to complete loss of bladder control. It can significantly impact quality of life but is often treatable and manageable.
There are several types of urinary incontinence:
Stress incontinence – leakage when coughing, sneezing, laughing, or lifting due to weak pelvic floor muscles or pressure on the bladder.
Urge incontinence – a sudden, strong need to urinate with little warning, often linked to overactive bladder (OAB).
Overflow incontinence – when the bladder doesn't empty properly, leading to frequent or constant dribbling.
Functional incontinence – difficulty reaching the toilet in time due to physical or cognitive limitations.
Mixed incontinence – a combination of stress and urge symptoms.
Overactive bladder (OAB) is a common cause of urge incontinence, involving frequent urination, urgency, and sometimes leakage — even when the bladder isn’t full.
Neurogenic bladder occurs when nerve damage (from conditions like spinal cord injury, Parkinson’s disease, or multiple sclerosis) interferes with bladder control, leading to problems with emptying or storage.
Incontinence
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Urinary incontinence can develop when the normal control of bladder function is disrupted — often due to problems with the bladder muscles, pelvic floor, nerves, or urinary tract.
Weak pelvic floor muscles – Often due to aging, childbirth, surgery, or obesity, weakened muscles can make it harder to hold in urine, leading to stress incontinence.
Overactive bladder muscles – When bladder muscles contract too often or without warning, it causes urge incontinence with a strong need to urinate frequently or suddenly.
Bladder outlet obstruction – Conditions like an enlarged prostate can block urine flow, leading to overflow incontinence when the bladder overfills and leaks.
Nerve damage – Injury, diabetes, stroke, or neurological disorders (like multiple sclerosis or Parkinson’s disease) can interrupt signals between the bladder and brain, resulting in neurogenic bladder, where the bladder doesn’t fill or empty properly.
Hormonal changes – Especially in women after menopause, reduced oestrogen can affect bladder and urethral tissues, contributing to incontinence.
Lifestyle and health factors – Smoking, chronic coughing, constipation, or certain medications can also play a role.
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Diagnosing urinary incontinence begins with a comprehensive assessment to understand the type, cause, and impact of your symptoms. Dr.Matthew will take a detailed medical history and may ask about:
When and how often leakage occurs
Fluid intake and urination habits
Associated symptoms like urgency, frequency, or pain
A physical examination will check for signs of pelvic floor weakness, prostate issues, or neurological problems.
Further Testing May Include:
Urine Tests
To check for infection, blood, or other abnormalities.
Bladder Diary
You may be asked to record how much you drink, how often you urinate, and any leakage episodes over a few days.
Post-Void Residual Test
Measures how much urine remains in your bladder after urinating, usually done via ultrasound.
Urodynamic Studies
A series of tests that measure bladder pressure, capacity, and how well the bladder and urethra are working. Useful for complex or unclear cases.
Cystoscopy
A small camera is inserted into the bladder through the urethra to look for structural issues, blockages, or signs of inflammation.
Imaging (Ultrasound or MRI)
Sometimes used to assess the bladder, kidneys, or pelvic structures.
These tests help determine the specific type of incontinence and guide the most effective treatment plan.
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Treatment for urinary incontinence depends on the type, severity, and underlying cause. Many people experience significant improvement — or complete resolution — with the right approach. Dr. Matthew offers a range of tailored treatment options, including:
1. Lifestyle Modifications
Reducing caffeine, alcohol, and fluid intake
Weight loss if overweight
Managing constipation
Bladder training (timed voiding to retrain the bladder)
2. Pelvic Floor Physiotherapy
Targeted exercises (like Kegels) to strengthen pelvic muscles and improve bladder control
Often first-line treatment for stress incontinence
3. Medications
Anticholinergics or beta-3 agonists for overactive bladder (urge incontinence)
Topical estrogen for postmenopausal women with vaginal atrophy
Medications to manage underlying conditions like an enlarged prostate
4. Bladder Botox Injections
Used for overactive bladder that doesn’t respond to medication
Helps relax bladder muscles and reduce urgency and frequency
5. Nerve Stimulation (Neuromodulation)
Techniques like sacral nerve stimulation or posterior tibial nerve stimulation (PTNS) to regulate bladder signals, especially in neurogenic bladder
6. Surgical Options
Sling procedures to support the urethra (often used in women with stress incontinence)
Artificial urinary sphincter – for men with severe incontinence, especially after prostate surgery
Bladder augmentation or diversion in complex or neurogenic cases
With a personalised treatment plan, most patients experience meaningful improvement in symptoms and quality of life. If you're dealing with bladder control issues, Dr. Matthew can help you explore the best path forward.
If you are experiencing symptoms of urinary incontinence or bladder dysfunction, book a consultation with Dr. Matthew Farag to explore personalised and effective treatment options tailored to you.
Any urgent referral will be reviewed within 24 hours.