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&#8220;Urinary incontinence&#8221; is a condition that occurs in women 2-4 times more often than in men, and its prevalence increases with age. The approximate statistics are as follows :
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<li style="font-weight: 400;" aria-level="1">In the under-40 age group, 3-5% of women are affected, compared to 1% or less of men.</li>
<li style="font-weight: 400;" aria-level="1">In the 40-49 age group, 7.5% of women are affected, compared to 1.7% of men.</li>
<li style="font-weight: 400;" aria-level="1">In the 50-59 age group, 12% of women are affected, compared to 2.5% of men.</li>
<li style="font-weight: 400;" aria-level="1">In the 60-70 age group, 15.8% of women are affected, compared to 3.6% of men.</li>
<li style="font-weight: 400;" aria-level="1">In those aged 70 and older, up to 30% of women are affected, while up to 10% of men may experience the condition.</li>
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The higher likelihood of women experiencing urinary incontinence compared to men is due to several factors. These include having a shorter urethra, lower estrogen levels that decrease with age or during menopause, which leads to reduced muscle elasticity in the pelvic area. This affects the ability to control the bladder and urethral sphincter. Women who have been pregnant or given birth are also more likely to experience pelvic muscle laxity. In addition to urinary incontinence, the inability to control urination, or urinary retention, is also more common in women than in men.
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Urinary incontinence can be caused by various factors and is a common health issue among women worldwide. The condition can be categorized into three main types:
<ol>
<li style="font-weight: 400;" aria-level="1">Overflow Incontinence: This type is often seen in individuals with neurological or brain disorders, where urine constantly leaks (overflow). This can occur even with regular or quick walking, and the person may need to use absorbent pads.</li>
<li style="font-weight: 400;" aria-level="1">Stress Incontinence: This occurs when urine leaks during physical exertion, such as coughing, sneezing, playing sports, or lifting heavy objects. Around half of all patients experience this type.</li>
<li style="font-weight: 400;" aria-level="1">Overactive Bladder: In this case, individuals experience sudden urges to urinate and may leak urine before reaching the bathroom. It is also accompanied by frequent urination.</li>
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Each of these types has different underlying causes and requires specific management.
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The cause of stress urinary incontinence, or urinary leakage during physical exertion, is due to prolonged pressure accumulation in the abdominal cavity. This pressure causes the muscles in the vaginal walls to weaken, and the bladder and urinary tract shift position. Activities that increase intra-abdominal pressure, such as lifting heavy objects or engaging in sports, can cause urine leakage. Vaginal wall weakening can occur for several reasons, including being overweight, chronic constipation, or consistent abdominal pressure, which increases the likelihood of urinary leakage.
In addition, stress urinary incontinence is also common in individuals who engage in intense physical exercise or heavy lifting over prolonged periods. Pregnancy and childbirth, especially in cases of difficult delivery, can also contribute to weakened and injured vaginal tissues, known as pelvic organ prolapse. This can lead to urinary leakage during exertion, particularly in women who do not engage in proper postpartum exercises.
Another condition that can lead to urinary leakage is an overactive bladder, where the bladder contracts too quickly. In this case, when the person feels the urge to urinate, they may not make it to the bathroom in time, resulting in urine leakage. Individuals with this issue often experience frequent urination as well.
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<h2>Overactive bladder (OAB) is one of the causes of urinary leakage. </h2>
This condition may arise from neurological disorders, abnormal contractions of the bladder muscles, inflammation or irritation of the bladder, which is often caused by infections or chronic cystitis, as well as bladder stones or other diseases like diabetes. In women, a decrease in estrogen levels during menopause can weaken the pelvic muscles, bladder, and urethra, leading to urinary incontinence.
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Diagnosis can involve several approaches, such as urine tests to check for infections, measuring bladder pressure, and performing ultrasounds. Treatment may begin with lifestyle modifications, such as reducing caffeine or alcohol intake, losing weight, and strengthening the pelvic muscles through exercises. Managing underlying conditions, using medications to relax bladder muscles, or more specialized treatments like Botox injections or nerve stimulation (using electrical currents to control bladder muscle contractions) can help reduce abnormal muscle contractions and improve bladder control. Doctors will provide treatment based on the underlying causes and severity of the symptoms.
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For early-stage urinary incontinence, doctors often recommend pelvic floor exercises, such as Kegel exercises, where the pelvic muscles are tightened and released. If done correctly and consistently—at least 30 repetitions three times a day (morning, afternoon, and evening)—this can help prevent pelvic organ prolapse and urinary leakage.
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However, in cases where patients struggle to focus on pelvic exercises throughout the day, medical devices may be used for assistance. One popular technology currently available is vaginal laser therapy, which helps tighten and rejuvenate the vaginal tissues, providing support to prevent further incontinence.
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Laser treatment for urinary incontinence works by destroying old cells and stimulating the production of collagen in the vaginal tissue. Normally, the elasticity of the tissue comes from the collagen beneath the skin. However, as people age and enter menopause, the tissue deteriorates. Other factors like being overweight, pregnancy, or difficult childbirth can also contribute to collagen loss. The laser helps by removing surface cells and encouraging the regeneration of collagen.
Before undergoing laser treatment for urinary incontinence, patients need to undergo a physical examination to assess the severity of the condition. Laser therapy is most effective for mild cases, such as those where incontinence occurs only during intense physical activities like heavy sports or fitness classes, or if the patient feels the vaginal area is not as tight as it should be and experiences vaginal air leakage. However, if left untreated and the condition worsens, surgery may be required instead.
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Surgical treatment for urinary incontinence involves either an abdominal surgery to lift the corner of the bladder or using a sling tape to elevate the bladder corner. This helps adjust the angle of the urethra back to its normal position, but it does not address vaginal tightening. In contrast, laser treatment can resolve both issues simultaneously. Additionally, in cases where women may feel dissatisfaction with sexual intercourse, even without urinary incontinence, laser treatment can be performed to tighten the vagina for enhanced comfort.
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Vaginal tightening with laser treatment for mild urinary incontinence or to improve vaginal firmness requires three sessions, with one visit to the doctor per month. Each session takes about 10-15 minutes, and there is no need for hospitalization, anesthesia injections, or any pain. After the treatment, patients can resume normal activities immediately. The cost is lower than surgery, and there are minimal side effects, almost none at all. The only possible side effect is an increase in vaginal discharge during the first week. This makes it an appealing new treatment option.
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For women experiencing urinary incontinence or inability to control urination, medical care can be sought at both the Urology Center and the Women&#8217;s Health Center (Obstetrics and Gynecology) at Phyathai 2 Hospital. The doctor will take a detailed medical history and examine potential causes, such as checking for neurological issues related to the bladder, urinary tract infections, bladder inflammation, kidney stones, tumors, or cancer in the urinary tract. It could also be related to pelvic floor issues due to hormonal changes after menopause or previous pregnancies and childbirth. Other potential causes will also be explored to determine the most suitable medical specialty for treatment.
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In cases where multiple factors complicate the condition, a holistic approach involving both the urology and women’s health specialists may be required for optimal treatment outcomes. Patients also play an essential role in choosing the most appropriate course of diagnosis and treatment according to their needs at each step.

Urinary incontinence" is a condition that occurs in women 2-4 times more often than in men, and its prevalence increases with age.

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Urinary incontinence, or the inability to control urination, is not a small issue for women.

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