Welcome to this afternoon's webchat. We are joined in the studio by Dr Rosemary Leonard who will be discussing Stress Urinary Incontinence.

Belinda wants to know:

Are there different types of urinary incontinence? If so, what causes the differences?

Dr Rosemary Leonard said:

There are two main types of urinary incontinence, stress incontinence and urge incontinence. Stress incontinence is accidental leakage of urine when you cough, laugh or sneeze and it's generally caused by weak pelvic floor muscles. Urge incontinence is when you suddenly need to pee and can't hold on. Sometimes you may just leak a little bit of urine or sometimes you might accidentally completely empty your bladder. Urge incontinence is often caused by weakness of the bladder muscles. These two different types of incontinence are treated in completely different ways. However some women have 'mixed incontinence' which means they have both stress and urge incontinence and so need two sets of treatment.

Rita wants to know:

I've always considered urinary incontinence as an "elderly" problem, but one of my closest friends has just revealed that she suffers from it. We're both just 26. She hasn't had a child either so what could be the cause?

Dr Rosemary Leonard said:

It's unusual to have incontinence at a young age, especially if you haven't had children. Quite a lot of younger women do get incontinence after childbirth due to weakening of the pelvic floor muscles but obviously, this is not the case for your friend. Urinary incontinence can be caused by a urine infection and this is the first thing that she should have checked out. This can be done by a simple test by her GP. If she doesn't have an infection then I would recommend that she has further investigations, which would probably need to be done by a specialist. The big message really for her is she needs to get it sorted out. She shouldn't just have to suffer this.

Kate wants to know:

My mother suffers from a weak bladder and is always having accidents. Does this mean it will happen to me?

Dr Rosemary Leonard said:

Generally, urine incontinence does not run in families so just because your mother has a problem does not mean that you are more at risk. I think it's very sad that your mother is frequently having accidents and with the right treatment these could probably be prevented. I bet she hasn't wanted to admit to her doctor that she's got a problem because she's too embarrassed by it. Why not try and encourage her to go and see her GP?

Nigel wants to know:

My wife suffers from this problem but she is afraid to do anything about it. Is the treatment/surgery for this painful?

Dr Rosemary Leonard said:

You haven't specified what type of incontinence that she has but most types can be treated without the need for surgery. Sometimes pelvic floor exercises are all that is needed; other women benefit from taking tablets and there are an increasing number of newer options such as injection treatments, which are not painful, so try and encourage her to see her GP.

Sabina wants to know:

Is stress urinary incontinence a permanent problem? Does treatment just lessen the regularity of the occurrence of the symptoms or is there a way to get rid of it permanently?

Dr Rosemary Leonard said:

Many women find they accidentally leak urine in the first few weeks after having a baby. Sometimes this gets better on its own but doing regular pelvic floor exercises really can help and in some women cure the problem for good. Some women require other treatments and in most cases these too can give a permanent cure.

Jane wants to know:

I have suffered from SUI during intercourse and I have a new partner and I am dreading our first sexual experience incase this happens. Is there anything I can do to prevent this happening?

Dr Rosemary Leonard said:

Sometimes this type of problem can be due to weak pelvic floor muscles. The first thing to do is to make sure you empty your bladder before you have sex - that way even if you do have a leak it will only be very small but for a more long term cure you need to do pelvic floor exercises, these can improve your sex life in another way as they will tighten up the entrance around the vagina so your partner will feel the benefit too. If you have a good relationship your partner should understand after all many older men have worries about their performance in bed as well and sharing your concerns could well improve intimate relations between you.

Helen wants to know:

Do men suffer with bladder problems as much as women do?

Dr Rosemary Leonard said:

Men do get bladder problems especially after the age of fifty as the prostate gland naturally enlarges at this time. This can lead to dribbling and a need to frequently pass urine at night. Many men also don't realise that they have pelvic floor muscles too, which can become weaker as in women. Like women, any man with a bladder problem should pluck up courage and see his doctor and get it sorted out.

Helen wants to know:

Hi Rosemary, I am only 25 and I am already experiencing bladder problems. My problem is that as soon as I need to urinate I must do so within about 10 minutes otherwise I actually do wet myself. This is really difficult if I am out and cannot find a toilet and I have had lots of accidents. I am worried this is going to get worse with age and also I find myself not wanting to drink so I know I won't wet myself

Dr Rosemary Leonard said:

It could be that you have a urine infection and a simple course of antibiotics could solve your problem. However, it may be that you have an irritable bladder but restricting your fluid intake is not the answer and will put you at risk of more bladder problems. Not only that but the more frequently you go to the loo, the less urine your bladder will be able to hold. You may need to do specific bladder exercises, which can help to expand your bladder and retrain it to hold more urine. You probably need to see a specialist about this but your GP should be able to refer you.

Sarah wants to know:

I am 40 years old and experience a slight problem when I laugh. Will this get much worse as I get older and would it be better to have surgery now?

Dr Rosemary Leonard said:

Yes, the problem could get worse as you get older and the longer you leave it and the worse it gets the more likely you are to need surgery. If you have only mild to moderate stress incontinence there are lots of other options - pelvic floor exercises, drug treatment and filling or bulking agents. Don't let it carry on - see your GP.

Donna wants to know:

Is it true that having a hysterectomy can increase your likelihood of suffering from SUI?

Dr Rosemary Leonard said:

No. Having a hysterectomy should not increase your likelihood of getting SUI - if anything, it should decrease the risk as the bladder can sometimes be 'hitched up' at the same time as the womb is removed.

Emma wants to know:

I used to live in Africa and was told that Western women suffered more from this condition because we use toilets, which you sit down on. Whereas African women, use the standing/squatting toilet which supposedly exercises different muscles. Do you know if this is true and if so would it help changing the toilets that we use?

Dr Rosemary Leonard said:

I don't think this is anything to do with the way African or Western women actually go to the loo but it may be related to the difference in diet. African women generally eat a lot of fibre and this means for them constipation is pretty rare. On the other hand European women often eat very low fibre diets, which means they have to strain to open their bowels. This can stretch and weaken the pelvic floor muscles and so increase the risk of Stress Incontinence.

Patricia wants to know:

How is this weakness caused, is it our lifestyles or what we eat, or lack of exercise?

Dr Rosemary Leonard said:

Your lifestyle can certainly affect your pelvic floor. Smoking, coughing and being overweight along with a tendency to constipation can all contribute to incontinence problems? Exercise generally helps to keep the body toned as well as keeping weight down. So there's another reason to stop smoking, eat those five portions a day of fruit and veg and get active!

Anon wants to know:

A colleague sometimes smells a little urinary - how do you go about advising them to get treatment?

Dr Rosemary Leonard said:

Tackling personal hygiene in a colleague is always tricky and I really don't know the best way to go about it. However, I don't think it's fair that other people should have to live with unpleasant smells, wherever they're coming from. However, one thing to note is that ketones in the breath can smell strange and a bit like urine and this has nothing to do with incontinence. It can be linked to dieting or to diabetes so maybe her general health needs to be checked.

Philippa wants to know:

Sometimes when I'm really busy at work and I need to go to the bathroom I hold it in. Can this do any long term damage?

Dr Rosemary Leonard said:

No, there's no harm in holding on. In fact, many women could do themselves a favour if they learnt to hold on a little bit longer. Going to the loo too often can shrink your bladder.

Polly wants to know:

Where can I get more information about bladder problems?

Dr Rosemary Leonard said:

There are lots of sources of information. Obviously, your GP or practice nurse should be your first port of call if you have a problem. However, if you feel too embarrassed there is information available on-line for example www.incontact.org has information about both bladder and bowel problems. They also have an information telephone line - 0870 7703246. The real message here is that help is at hand. I know a lot of people find the idea of admitting they have incontinence really embarrassing but it is such a common problem you really should not feel worried about going to see a health professional about it.