Dr. Justin Vass - Urological Surgeon Locations ( Rooms & Hospitals )Your Practice Online
Language Options
Dr. Justin Vass: (02) 9439 3899
Patient Info

Urinary Incontinence

Urinary Tract Infection :: Haematuria :: Erectile dysfunction :: Urinary Incontinence
Urinary stones :: Vescico ureteral reflux :: Benign Prostatic Hyperplasia :: Cancer

Urinary incontinence is the inability to control the flow of urine and is a common side effect of a number of Uro-oncology treatments, including surgery on the prostate and bladder as well as radiation therapy.

Physiology of Normal Bladder Filling

Normal bladder filling depends on unique elastic properties of the bladder wall that allow it to increase in volume at a pressure lower than that of the bladder neck and urethra (otherwise incontinence would occur). Despite provocative maneuvers such as coughing, voluntary bladder contractions do not occur. Emptying is dependent on the integrity of a complex neuromuscular network that causes relaxation of the urethral sphincter a few milliseconds before the onset of the detrusor (bladder muscle) contraction. With normal, sustained detrusor contraction, the bladder empties completely.

The Types of Urinary Incontinence

  • Stress
    Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising)

  • Urge
    Leakage of large amounts of urine at unexpected times, including during sleep. Functional untimely urination because of physical disability, external obstacles, problems in thinking or communicating that prevent a person from reaching a toilet

  • Overflow
    Unexpected leakage of small amounts of urine because of a full bladder

  • Mixed
    Usually the occurrence of stress and urge incontinence together. Transient leakage that occurs temporarily because of a condition that will pass (infection or medication)

A person can also become incontinent due to neurologic injury, birth defects, strokes, multiple sclerosis, or physical problems associated with aging.

The level of incontinence differs for each person and depends upon the treatments that they have had, however for some people the phenomena may be short lived while for a few it may be permanent.

There has however been a lot of progress in dealing with continence issues and there are a wide variety of aids and equipment for collecting urine, preventing infection and protecting the skin and surrounding area. There are also a number of exercises that can be done to strengthen the urinary sphincter muscle that controls the opening and closing of the bladder.


Non-Surgical :: Surgical

Non-Surgical (Conservative)

Exercising the Pelvic Floor

Pelvic floor exercises are an important and relatively easy way to improve your bladder control. When done correctly they can build up and strengthen the muscles that help you hold urine. The pelvic floor is made up of muscles stretched like a hammock from the pubic bone in the front through to the bottom of the backbone. These firm supportive muscles help to hold the bladder and bowel in place and also function to close the bladder outlet and the back passage. Pelvic floor exercises strengthen the muscles that support the pelvic contents and prevent the escape of wind, faeces or urine. Stronger muscles can also enhance sexual satisfaction.

Bladder Retraining

The aim of bladder retraining is to overcome urgency and stretch out the intervals between trips to the toilet.

Surgical Treatment

Today surgery for stress incontinence has become quite minimally invasive and can often be performed either as a day stay or overnight procedure. Of all the methods there are two that have become very popular;

  1. Sub-Urethral Sling (TVT)
  2. Laparoscopic Burch

Technically they both achieve the same result but they are done differently.

Below are charts, instructions, forms related to Incontinence care. All of them are PDF documents which will open in a new window. Click on the desired handouts to open them in a new browser window.

Bristol Stool Chart Bristol Stool Chart (PDF 41KB)
Care of Your Supra Pubic Catheter Care of Your Supra Pubic Catheter (PDF 56 KB)
Catheter Policy & Guidelines for Indwelling Catheters Catheter Policy & Guidelines for Indwelling Catheters (PDF 71 KB)
Catheter Residual Record Catheter Residual Record (PDF 45 KB)
Instruction Trial of Void Instruction Trial of Void (PDF 71KB)
Instruction Trial of Void Time and Volume Chart Instruction Trial of Void Time and Volume Chart (PDF 49 KB)
Residual Check Residual Check (PDF 33.3 KB)
Time and Volume Record Time and Volume Record (PDF 33KB)
Trail of Void Trail of Void (PDF 43KB)
Trail of Void at Home Trail of Void at Home (PDF 44KB)
Trail of Void with a Suprapubic Catheter Trail of Void with a Suprapubic Catheter (PDF 54KB)

Talk to the incontinence nurse at your local hospital or to your medical team for advice about the options management of your continence and the options available to you.

You will need the Adobe Reader to view and print these documents.Get Adobe Reader

About Dr.Justin Vass, MBBS, FRACS
Keyhole Surgery & Laser Surgery
Best Doctors
Patient Forms
Pre & Post Operative Instructions
Multimedia Patient Education
Facebook Twitter LinkedIn
Bookmark and Share
© Dr. Justin Vass Urologist Urological Surgery Sydney Australia