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Urinary Incontinence

Urinary Incontinence in Singapore: Causes, Symptoms & Treatments

Urinary incontinence is a condition that affects many women in Singapore. While it occurs more commonly in older adults and in women, it is not a normal physiological process and should not be ignored.

The good news is that effective urinary incontinence treatments are available in Singapore, ranging from pelvic floor therapy to non-surgical technologies and surgical procedures.

One such option is Electromagnetic Incontinence Therapy (EMIT), a conservative treatment approach that uses magnetic stimulation to help improve pelvic floor muscle function.

Early evaluation allows for more treatment options and better outcomes.

What Is Urinary Incontinence?

Urinary incontinence occurs when the bladder muscles contract suddenly or when the urethral sphincter muscles are not strong enough to hold urine, resulting in involuntary urine leakage. The condition can affect daily activities and overall quality of life.

The severity can range from:

Occasional leaks during coughing or exercise
Sudden urges that result in leakage before reaching the toilet
Frequent small leaks due to incomplete bladder emptying

Understanding the type of urinary incontinence is essential because treatment depends on the underlying cause.

Types of Urinary Incontinence

1) Stress Urinary Incontinence (SUI)

Stress urinary incontinence is the most common type in women.

It occurs when urine leaks during activities that increase abdominal pressure, such as:

Coughing
Sneezing
Laughing
Jumping
Running
Exercising

This happens when weakened pelvic floor muscles fail to provide adequate support to the bladder and urethra.

Common Causes of SUI

Pregnancy
Vaginal childbirth
Menopause
Chronic coughing
Obesity
Pelvic surgery

2) Urgency Urinary Incontinence (UUI)

Urge urinary incontinence involves:

A sudden, strong urge to urinate
Difficulty delaying urination
Leakage before reaching the toilet

It is often associated with overactive bladder (OAB), where bladder muscles contract prematurely.

Possible Causes of UUI

Ageing
Long-standing diabetes
Stroke
Neurological disorders
Urinary tract infections
Excess caffeine or alcohol

3) Mixed Urinary Incontinence

A combination of stress urinary incontinence and urge urinary incontinence. One type usually predominates.

4) Overflow Incontinence

Characterised by:

Frequent small leaks
Incomplete bladder emptying
Reduced bladder sensation

More common in men due to prostate-related obstruction.

Causes of Urinary Incontinence

Urinary incontinence may result from:

Pelvic floor muscle weakness
Hormonal changes during menopause
Nerve damage
Pelvic surgery
Neurological conditions
Infections
Certain medications

Accurate diagnosis is essential because treatment varies depending on the cause and type.

Urinary Incontinence Treatment in Singapore

Treatment for urinary incontinence depends on the type and severity of symptoms. Management is individualised after assessment by a specialist.

Below are evidence-based treatments available in Singapore.

Treatment for Stress Urinary Incontinence (SUI)

1) Pelvic Floor Exercises (Kegel Exercises)

Pelvic floor exercises strengthen the muscles that support the bladder and urethra.

When performed consistently, they can:

Improve bladder control
Reduce urine leakage
Enhance pelvic support

Guidance from a women’s health physiotherapist can improve effectiveness.

2) Lifestyle Modifications

Maintaining a healthy body weight and optimising medical conditions such as chronic cough or asthma can reduce strain on the pelvic floor.

A person sitting on a chair, removing an adult diaper, with a puddle of liquid on the floor.

3) EMIT: Electromagnetic Incontinence Therapy for Stress Urinary Incontinence

EMIT is a non-invasive urinary incontinence treatment that uses high-intensity focused electromagnetic (HIFEM) energy to stimulate and strengthen pelvic floor muscles involved in bladder control.

Studies evaluating electromagnetic pelvic floor stimulation have shown that strengthening these muscles may improve symptoms in women with stress urinary incontinence, particularly in mild to moderate cases. It may be considered by women who prefer a non-surgical treatment approach.

How EMIT Works
EMIT delivers targeted electromagnetic pulses that stimulate deep pelvic floor muscles, producing supramaximal muscle contractions that are difficult to achieve through voluntary exercises alone.

These repeated contractions help strengthen the pelvic floor muscles that support the bladder and urethra. Improved pelvic floor muscle function may reduce urine leakage that occurs during activities such as coughing, sneezing, running, or exercise.

What to Expect During EMIT Treatment

20–30 minute sessions
Performed while fully clothed
No incisions or anaesthesia
No downtime
Typically 6–8 sessions recommended

Patients can resume normal activities immediately after each session.

Who Is Suitable for EMIT?
Magnetic stimulation may be considered as a conservative treatment option for women with urinary incontinence, particularly those seeking a non-invasive approach.

4) Mid-Urethral Sling Surgery (TVT / TOT)

A highly effective surgical treatment for stress urinary incontinence involving placing a supportive tape under the urethra to improve bladder support. While effective, it requires surgery and recovery time.

5) Bulking Agents

Bulking agent treatment involves performing a cystoscopy (bladder scope) to guide the injection of bulking material into the wall of the urethra. The injected material narrows (constricts) the urethral diameter, improving closure during increases in abdominal pressure such as coughing or exercise.

This is considered the least invasive surgical option for stress urinary incontinence. However, compared to sling procedures, bulking agents generally have lower long-term efficacy and often require repeat injections to maintain results.

For patients seeking minimally invasive intervention but who are not suitable for sling surgery, bulking agents may be considered after careful assessment by a urogynaecologist.

Treatment for Urge Urinary Incontinence (UUI)

Surgery is generally not effective for UUI. Management focuses on bladder control strategies.

Management of UUI typically includes:

Lifestyle Modifications

Reduce caffeine and alcohol
Avoid bladder irritants (high sugar, salt, preservatives)
Quit smoking
Maintain healthy body weight
Optimise control of medical conditions such as diabetes

Keeping a bladder diary can help identify patterns and triggers.

Bladder Training

Bladder training aims to:

Increase the time between toilet visits
Improve bladder capacity
Reduce urgency episodes

A normal bladder capacity is approximately 300–400ml. If frequent small voids are noted, gradual delay techniques combined with pelvic floor contraction exercises can help retrain bladder control.

Consistency over weeks to months is key.

Medications

Oral medications help relax bladder muscles and reduce urgency.
Side effects may include dry mouth or constipation.

Choosing the Right Treatment for Urinary Incontinence

The most appropriate treatment depends on the type and severity of incontinence.

In general:

Mild stress urinary incontinence → Pelvic floor exercises or EMIT
Moderate stress urinary incontinence → EMIT or surgical options
Severe stress urinary incontinence → Mid-urethral sling surgery
Urge urinary incontinence → Bladder training and medications

Many women prefer to begin with non-invasive treatment options before considering surgery. A consultation with a specialist helps determine the most suitable approach.

When Should You Seek Treatment?

Consult a specialist if:

Urine leakage affects daily activities
New or worsening symptoms like painful urination or blood in the urine
Unexplained weight loss or discomfort

Early diagnosis allows for less invasive treatment options and better outcomes.

If you suspect urinary incontinence, seek professional evaluation to determine the most appropriate treatment plan for you.