Urinary Leakage and Incontinence

Urinary incontinence involves involuntary urine leakage, presenting both social or hygienic challenges.

In Singapore, urinary incontinence affects 10–20% of women, with incidence increasing with age.

Urinary incontinence often results from multiple factors, these include:

• Urinary tract infections
• Side effects of certain medications
• Congenital ligament weakness or collagen deficiency
• Pregnancy and natural childbirth, leading to pelvic floor damage (muscles, ligaments, fascia and nerves)
• Pelvic organ prolapse
• Menopausal changes
• Ageing
• Stroke, dementia
• Spinal cord diseases or injuries
• Post-surgical complications
• Restricted physical mobility
• Obesity, heavy lifting, constipation, chronic cough

There are four primary types of urinary incontinence:

• Stress incontinence: Involuntary urine leakage physical activities such as coughing, sneezing, laughing, exercising or lifting. Common causes include pregnancy, childbirth, obesity and pelvic organ prolapse.
  
  
• Urge incontinence: Characterised by involuntary leakage accompanied by a sudden, intense urge to urinate. This type is often linked with overactive bladder conditions. For more information, please visit our Frequent Urination and Overactive Bladder page.
  
  
• Mixed incontinence: A combination of both stress and urge incontinence symptoms.
  
  
• Overflow incontinence: Involuntary leakage not related to physical exertion or urgency. This type can result from conditions like stroke, dementia, spinal cord injury, diabetes mellitus, significant pelvic organ prolapse, or complications following childbirth or surgery.
  
  
• True incontinence: Continuous leakage due to congenital urinary tract abnormalities or a fistula. This is a rare complication following vaginal delivery, Caesarean section or gynaecological surgery.

Treatment depends on the type of incontinence. For urge incontinence, please refer to our Frequent urination and overactive bladder page.

Women experiencing stress incontinence may benefit from pelvic floor (Kegel) exercises. If these are ineffective, urodynamic investigations are conducted to confirm the diagnosis and rule out detrusor overactivity before considering surgical options.