Types of Urinary Incontinence
Urinary incontinence is not a single condition — it is a symptom with several distinct causes and presentations. Accurate diagnosis of the type is critical to selecting the right treatment. THE FIT CLINIC's urogynecologists assess each patient comprehensively to identify the precise form of incontinence present.
Stress Incontinence
Leakage triggered by physical pressure — coughing, sneezing, laughing, jumping, or lifting. The most common type in women of reproductive and perimenopausal age. Caused by weakened pelvic floor muscles or urethral sphincter insufficiency.
Urge Incontinence
A sudden, intense urge to urinate followed by involuntary leakage before reaching the toilet. Often associated with overactive bladder (OAB). Can be triggered by the sound of running water, cold temperatures, or habitual "just in case" voiding behaviour.
Mixed Incontinence
The most prevalent type overall in women — a combination of both stress and urge incontinence. Requires a treatment approach that addresses both the structural weakness and the bladder overactivity components simultaneously.
Overflow Incontinence
Continuous dribbling due to inability to fully empty the bladder — less common in women but can occur with neurological conditions, severe prolapse, or following certain pelvic surgeries. Requires specialist urodynamic evaluation.
Causes and Risk Factors
Understanding the underlying causes of urinary incontinence is the first step toward effective treatment. The most common risk factors in women include:
- Pregnancy and vaginal delivery: The growing uterus and the mechanical stress of labour stretch and can damage the pelvic floor muscles, fascia, and pudendal nerve. Forceps or ventouse deliveries and large baby birth weight further increase risk.
- Menopause: Declining oestrogen levels lead to thinning of urethral and bladder wall tissues, reducing closure pressure and increasing urinary urgency and frequency.
- Aging: Gradual reduction in muscle mass and connective tissue elasticity progressively weakens pelvic floor support structures.
- Obesity: Elevated intra-abdominal pressure places constant mechanical stress on the pelvic floor, accelerating structural weakness.
- Chronic straining: Long-term constipation, chronic cough (from smoking or respiratory disease), and heavy manual labour all contribute to pelvic floor fatigue and prolapse.
- Previous pelvic surgery: Hysterectomy and other pelvic procedures can alter anatomical support structures and contribute to both stress and urge incontinence.
Non-Surgical Treatments
THE FIT CLINIC follows a non-surgical-first approach. Non-surgical management is usually tried before any operative intervention is considered. Response varies between individuals.
Pelvic Floor Physiotherapy
Supervised pelvic floor physiotherapy remains the first-line evidence-based treatment for stress urinary incontinence and mixed incontinence. Our specialist physiotherapists perform a detailed internal and external assessment of pelvic floor muscle function, identifying weakness, overactivity, or coordination impairment. A personalised home exercise programme is developed alongside in-clinic supervised sessions. Biofeedback and electrical stimulation may be incorporated to optimise engagement of the correct muscle groups. How many sessions are useful, and over what period, is decided after assessment rather than set in advance, and how much anyone gains from it varies.
Deka Magnetic Chair
The Deka Magnetic Chair is a non-invasive pelvic floor stimulation device. Using pulsed electromagnetic field (PEMF) technology, it generates powerful, involuntary contractions of the pelvic floor musculature during a 28-minute session. Patients remain fully clothed and seated in the chair throughout treatment; there is no discomfort, no undressing, and no invasive contact.
Each Deka Magnetic Chair session lasts 28 minutes, with no physical effort required from the patient.
The electromagnetic pulses stimulate the pudendal nerve and directly activate the levator ani muscle group, which forms the primary structural support of the bladder and urethra. Clinical evidence demonstrates statistically significant improvements in both stress and urge incontinence symptoms following 6–8 sessions administered twice weekly. The Deka Magnetic Chair is particularly suitable for patients who are unable to perform correct Kegel contractions independently, have very weak baseline pelvic floor function, or have not responded adequately to home exercise alone.
Bladder Training
For urge incontinence and overactive bladder, bladder training is a highly effective behavioural intervention. The programme involves progressively extending the interval between urinations, resisting urgency using urge suppression techniques, regulating fluid intake, and reducing bladder irritants (caffeine, alcohol, carbonated drinks). Combined with pelvic floor physiotherapy, bladder training produces better outcomes than either intervention alone. Our specialists provide a structured written programme and monitor progress across follow-up appointments.
Surgical Options
For patients with significant stress urinary incontinence who have not achieved adequate improvement with non-surgical treatment, surgical options offer durable long-term correction. THE FIT CLINIC's urogynecologists are trained in minimally invasive sling procedures — the gold standard for surgical stress urinary incontinence treatment.
TVT (Tension-Free Vaginal Tape) and TOT (Trans-Obturator Tape)
TVT and TOT are minimally invasive mid-urethral sling procedures performed under light general or spinal anaesthesia as day surgery or with one overnight stay. A thin synthetic mesh tape is placed beneath the mid-urethra to provide structural support during increases in intra-abdominal pressure. Published five-year outcomes in appropriately selected patients are good; your surgeon will discuss what the evidence means for your own case. Recovery involves 1–2 weeks of restricted activity, with return to normal life within 3–4 weeks. Patients undergo thorough urodynamic evaluation before any surgical option is recommended, ensuring that the correct diagnosis and procedure are matched precisely.
Why Choose THE FIT CLINIC for Urinary Incontinence?
Many women in Bangkok receive urinary incontinence care from general obstetricians and gynaecologists who manage a broad range of conditions. THE FIT CLINIC operates differently. Our team consists of dedicated urogynecologists — specialists whose practice is focused specifically on female pelvic floor dysfunction, urinary incontinence, and pelvic organ prolapse. This subspecialty focus means greater diagnostic precision, familiarity with the full range of treatment options, and experience with complex or treatment-resistant cases.
We invest in an advanced non-surgical technologies, including the Deka Magnetic Chair, and maintain a clear non-surgical-first protocol that reflects current international guidelines. When surgery is needed, our surgeons have the subspecialty experience to deliver optimal outcomes. Consultations are conducted in English or Thai, and an interpreter can be arranged if you request one when booking.
Book Your Urogynecology Assessment
See a specialist urogynecologist at THE FIT CLINIC Bangkok — not a generalist. Open daily, EM Tower Sukhumvit.
Book Now · Line / WhatsAppFrequently Asked Questions
What causes urinary incontinence in women?
The most significant causes include pregnancy and vaginal delivery (which can stretch and weaken pelvic floor muscles and the urethral sphincter), menopause (declining oestrogen thins urethral and bladder tissues), aging, obesity, chronic straining, and previous pelvic surgery. A specialist assessment identifies the type and cause so the treatment that suits you can be recommended.
Can urinary incontinence be treated without surgery?
Yes. The majority of urinary incontinence cases can be effectively managed without surgery, especially when addressed early. Non-surgical treatments at THE FIT CLINIC include pelvic floor physiotherapy, Deka Magnetic Chair neuromuscular stimulation, bladder retraining, and lifestyle modifications. Response varies between individuals.
How does the Deka Magnetic Chair help with urinary incontinence?
The Deka Magnetic Chair uses pulsed electromagnetic field (PEMF) technology to generate powerful, involuntary pelvic floor contractions in a 28-minute session. Patients remain fully clothed and seated throughout. It is sometimes used for patients who struggle to perform Kegel exercises correctly on their own. Suitability is decided individually after assessment.
How many treatment sessions are needed for urinary incontinence?
How many sessions of either, and how far apart, is decided after assessment rather than sold as a set programme, and how soon anything changes differs from person to person. Your specialist will outline a personalised timeline at your initial assessment.
Is urinary incontinence normal after childbirth?
Urinary leakage is common after vaginal delivery — affecting up to 1 in 3 women — but should not be accepted as permanent. Many cases resolve spontaneously within the first few months. If symptoms persist beyond 3–6 months or significantly impact daily life, a specialist urogynecology assessment is recommended. Early treatment produces the best long-term outcomes.