Non-surgical Aesthetic treatments For Urinary Incontinence

Urinary incontinence is when urine leaks involuntarily from the bladder ^{1, 2}. The severity ranges from occasionally leaking to having the urge to urinate that’s so sudden and a strong leak before reaching the toilet in time.

Urinary incontinence has a negative impact on the woman’s quality of life which could severely restrict her daily activities. Many women are unable to play sports, run, jump, sneeze or cough without the embarrassment of being incontinent and are obliged to use panty liners all the time.

Urinary incontinence is a problem in up to 40% of women, that happens commonly after childbirth and menopause but may affect women of all ages during life situations.

What are the types of urinary incontinence?

(A) Stress Urinary Incontinence (SUI): Urine leaks on straining (i.e Valsalva’s Maneuver that is the sudden rise of intraabdominal pressure) or exertion of pressure on the bladder, like in coughing, sneezing, laughing, or exercising typically leads to urine leakage involuntarily.

it is usually caused by weakness in the support of the bladder neck or urethral sphincter (weak pelvic floor muscles with prolapse/sagging of the pelvic organs. The pelvic floor muscles are controlling urine outflow and become weak after childbirth (mechanical or due to direct birth injuries) or at menopause (with atrophy of the supporting tissues as a result of ageing process and declining levels of Oestrogen/Feminine hormone).

(B) Urge incontinence (UI): urine leakage after a sudden urge/desire to pass urine but you leak on your way to the toilet. This is could be caused by a lower urinary tract infection or bladder stone or due to dysfunction in the bladder control mechanism so the bladder wall contracts overpowering your voluntary control and overcoming the urethral closing pressure (formed by the urine tube/bladder neck angle /sphincter muscle resting tone) causing some urine to leak through the urine tube opening (the urethra) against the will and without being able to stop it (called Overactive Bladder OAB, Detrusor Instability). OAB causes might be nerve damage from injury or pelvic surgery, bladder stones, diabetes, kidney disease, side effects of some drugs, and neurologic disorders like Parkinson's disease, stroke, or multiple sclerosis. But often, the cause of OAB is a mystery!

(C) Total incontinence: (Interstitial Cystitis), when the bladder fails to store urine because the walls are not able to expand to accommodate the normal capacity of urine storage volume (~250 ml), which causes you to pass urine constantly or have frequent leaking. This is usually due to chronic inflammatory conditions affecting the bladder wall called Interstitial Cystitis which has a controversial aetiology.

(D) Urinary incontinence that happens due to chronic irritation of the base of the bladder as caused by Atrophic changes in the bladder wall at menopause (Senile Trigonitis) or due to constant mechanical pressure on the bladder base by an enlarged fibroid uterus limiting the storage capacity or by the presence of a pocket of residual urine. (In Pregnancy, the growing uterus constantly exerts pressure on the bladder, therefore there is a tendency to frequent urination or even urine leakage during pregnancy).

(E) Overflow incontinence is the involuntary release of urine due to a weak bladder muscle or blockage, thence the bladder becomes overly full, and leaks even though the person feels no urge to urinate. overflow incontinence is more common in men than women. The most common cause in men is an enlarged prostate, which impedes the flow of urine out of the bladder. Other possible causes of overflow incontinence include:

• Blockages of the urethra (the tube that carries urine from the bladder to outside the body) from tumours, urinary stones, scar tissue, swelling from infection, or kinks caused by dropping of the bladder within the abdomen

• Weak bladder muscles, which are unable to squeeze the bladder empty

• Injury of nerves that affect the bladder

• Nerve damage from diseases such as diabetes, alcoholism, Parkinson's disease, multiple sclerosis, back problems/back surgery, or spina bifida

• Medications, including some anticonvulsants and antidepressants, affect nerve signals to the bladder.