Have you noticed what seems to be an increase in the number of advertisements for products to manage urinary incontinence lately? Well, if you have, it's not your imagination. The facts are that urinary incontinence is a common condition in Canada, affecting 1.5 million people of all ages, and that number is rising. It can affect your sex life, social life, career, and recreational pursuits, not to mention your psychological well-being. But it can be successfully managed, if not eliminated - hence all the ads. And there are many more options than simply wearing a pad or taking a pill.

The most important factor in determining treatment for incontinence is determining the cause. While an overactive bladder is perhaps the most obvious culprit, a weak bladder, urinary tract infections, pregnancy, vaginal infection or irritation, and constipation can also play a role. Neurological damage or illness is also a cause of incontinence. In men, a blocked urethra, often resulting from prostate enlargement or surgery, can cause urinary incontinence.

Perhaps the most common type of incontinence is what's known as stress incontinence and it is often seen in women who have had their pelvic muscles weakened as a result of childbirth. With this type of incontinence, any activity that temporarily increases the pressure within the abdomen (and consequently the bladder), such as coughing, sneezing, or laughing, may cause urine to escape - even if the bladder isn't full.

Pelvic muscle exercises (PMEs), also known as Kegel exercises, are a popular treatment for stress incontinence. Essentially, they involve tightening the pelvic floor muscles as if you're trying to control urination or defecation.

Another option to tone and tighten the pelvic muscles involves electrical stimulation via a small rectal or vaginal probe. These devices passively exercise the pelvic floor muscles using electrical pulses. The electrical pulses should not feel painful.

A new device for stress incontinence in women has become available in Canada: the FemSoft plug.

The FemSoft plug is a single-use, flexible device that is placed in the urethra (the tube that passes from the bladder to the outside of the body) with an applicator. It works by plugging the urethra so that urine is less likely to leak out. When the woman wants to urinate, she removes the insert, urinates, and then puts in a fresh insert.

Then there's urge incontinence, which is the involuntary loss of urine associated with a strong desire to urinate. In other words, you may not be able to get to a toilet in time, due to strong and involuntary contractions of the bladder muscles.

Medications used to treat urge incontinence generally work by relaxing the bladder muscles to stop the abnormal contractions. They include anticholinergics, such as oxybutynin and tolterodine, and muscle relaxants such as flavoxate.

As far as surgery goes, it is typically used to correct anatomical problems that are causing incontinence. It can also be used to remove blockages. But surgery can also be performed to add rather than remove a blockage. The procedure, called urethral bulking, involves injecting collagen or synthetic materials around the urethra, effectively narrowing the urethra, which in turn increases resistance to the flow of urine.

If you think you may have overactive bladder, keep a diary or a record of some kind for a week or so, to see how often you go to the toilet. And, talk to your doctor. After all, there is no reason to suffer in silence - there's a lot that can be done to help.

Written and reviewed by the MediResource Clinical Team