The prevalence of urinary incontinence in Asia has been reported to be around 14.6% in females and 6.8% in males. There is an increased risk of incontinence in old age, among females, multiparity, history of pelvic surgery, lower urinary tract surgery, obesity and neurological disease.

(L to R): Dr. Syed Raziuddin Biyabani, Assistant Professor and Consultant Urologist, AKU; Dr. Nasir Sulaiman, Consultant Urologist and Lecturer, AKU; Dr. Khurram Siddiqui, Consultant Urologist and Senior Instructor, AKU and Dr. Zafar Nazir, Consultant Paediatric Surgeon, Associate Professor and Head of Paediatric Section of Surgery, AKU.

Urinary incontinence is involuntary loss of urine that is severe enough to cause a social or hygienic problem. It is a distressing, potentially debilitating condition and is, frequently under-reported because of the social embarrassment associated with it.

This was disclosed by Dr. Syed Raziuddin Biyabani, Assistant Professor and Consultant Urologist, who was the keynote speaker at Aga Khan University Hospital's 'Signs Symptoms and Care' programme for public health awareness on September 4, 2004.

Explaining the common types of incontinence, Dr. Biybani said, "The incontinence of urine include over active bladder that causes unwanted contractions of the urinary bladder and makes the patient rush to the toilet; stress urinary incontinence leading to leakage of urine on exertion due to muscle weakness; overflow incontinence due to weakness of the muscles of the urinary bladder in diabetes or neurological diseases and total incontinence causing leakage of urine all the time." The temporary causes of incontinence are urinary infection, severe constipation, uncontrolled diabetes, immobility, psychological problems and certain medications.

Audience at the Signs, Symptom and Care' programme for public health awareness.

Dr. Biyabani explained the procedure for evaluating the disease, and gave examples of tests such as uroflowmetry study that checks for obstructions in the passage of urine and urodynamic studies which tests the function of the bladder by measuring its pressure and capacity. For viewing the urinary bladder, cystoscopy may be recommended.

"Depending on the cause," Dr. Biyabani continued, "various treatments options are available, including special exercises, medications to treat unwanted urinary bladder contractions, devices in females to stop urine leakage, bulking injections or surgery to strengthen the weak muscles and surgery in cases of obstruction to the bladder outflow in males." Patients with weak urinary bladder are trained to pass a catheter, which enables them to empty their bladder 4-6 times a day.

"With proper evaluation of the disease, most patients can be cured, treated or adequately managed, which results in improved quality of life," Dr. Biyabani concluded.