I Had Surgery for Stress Incontinence and Now I Have Urge Incontinence! What Happened?

There are multiple types of incontinence, and I have discussed them on my SharePost blog previously. What happens when you have been diagnosed with stress incontinence and have undergone surgery and you are still wet? Stress incontinence is traditionally the type of incontinence where one loses bladder control with a cough, sneeze, laugh, or activity.

For the most part, surgical correction is the best way to treat it. I am not going to go into the details of surgeries for stress incontinence. But, I do want to discuss what happens when after surgery you end up with urge incontinence.

Urge incontinence is what is often referred to as overactive bladder (watch a video about overactive bladder). It is where the bladder muscles squeeze without a signal from the brain. It may just cause frequency of urination, but some people have leakage of urine.

So, here you are, having had surgery for your stress incontinence, and now you find that you have increased frequency of urine and even loss of urine unexpectedly, not related to activity like is was before. This is very frustrating, but it has a name - De Novo Urge incontinence. De Novo is Latin for "new." This means that you have acquired a new type of incontinence after getting a different type fixed.

I recently read a journal article that reports about 27% of people (mostly women) have urge incontinence after surgery for stress incontinence. This is a remarkably high number in my opinion, but I do find it is often true. No one knows how to predict who is at risk to have urge incontinence after surgery.

There is good news, however. Post-operative urge incontinence is easily treated with medications. There are at least five different medications on the market for overactive bladder. I truly don't believe that one works better than the other for this situation, and not every medication works well on every person, so it may take some trial and error before you find one that works well for you. Even better news, most people don't need to be on the medications forever either. Sometimes you just need to retrain your bladder for three to six months with the medications.

So why does this happen? There are many theories for this. I think it is because of the bladder's personality. Imagine that your bladder has not had to hold very much urine over the years and was able to leak whenever it felt like it. Now, after surgery, it has to do its job even better and hold more. You probably lost capacity over time, but by taking medications for a few months, you can train the bladder to hold more.

If you find that after surgery, you are having these problems, please go back and see your surgeon. There are some other situations that can cause these symptoms that are more serious, and would need to be evaluated. The important thing to remember is to not get discouraged, and there is an easy solution!

Facts and Figures about Stress Urinary Incontinence

Stress urinary incontinence is by far the most common type of incontinence there is. In our previous article “NHS approves new pelvic muscles’ toner”, we talked about a revolutionary new treatment to this condition and now we decide to bring you some facts and figures about the stress urinary incontinence.

1.    Stress incontinence occurs as a result of reduced support for the bladder.
2.    It affects both men and women.
3.    It is the most common form of incontinence for both genders
4.    In men, stress incontinence is common following a prostatectomy.
5.    In women, physical changes resulting from pregnancy, childbirth, and menopause often contribute to stress incontinence.
6.    IT IS TREATABLE
7.    Pelvic floor exercises are the most effective treatment.
8.    Obesity can increase stress urinary incontinence episodes in patients already experiencing the symptoms.
9.    One in ten women in the workplace experience it, as do a third of all new mothers.
10.    It accounts for 65 % of female urinary incontinence.
11.    It is estimated that 4 million women in the UK are affect by stress incontinence.
12.    Surgery is only suggested after other treatments have not shown any positive results.

Got any more questions about stress urinary incontinence? Don’t hesitate to contact us or our nurse specialist Shona.

Menopause transition associated with stress urinary incontinence

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A study exploring the effects of age and menopause on urinary incontinence (UI) in midlife has identified a relationship between menopausal transition and stress UI.

The study included 1211 women followed up since their birth in 1946 and looked at their menopausal transition status and symptoms of stress, urge, and severe UI over 7 years from ages 48-54.

Women who were peri-menopausal were more likely to have symptoms of stress UI than post-menopausal women. Menopausal transition status was not associated with urge or severe UI. These relationships were not explained by age, childhood enuresis, reproductive factors, previous health status, body mass index and educational qualifications.

Source: Nursing Times

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