Urinary incontinence refers to the involuntary leakage of urine, meaning that a person urinates even when they don’t want to. This loss of bladder control happens when a person loses control over their urinary sphincters, which are two muscles that control the exit of urine in the bladder. Urinary incontinence is more common among women than in men. News reveals that between the ages of 30-60, about 30 percent of women experience incontinence compared to 1, 1.5 percent in men. This condition, however common, is considered embarrassing which is one of the main reasons people choose living with it and do not share it with a urinary doctor or visit a clinic to get treatment for Urinary Incontinence.
Urinary Incontinence Types and Causes
The types and causes of urinary incontinence are consistent with each other.
#1 Stress incontinence
When urine leaks when pressure is exerted over your bladder. This may happen when you’re coughing, sneezing, laughing, lifting something, etc. Its causes include age, obesity, pregnancy, menopause, and surgical procedures.
#2 Overflow Incontinence
This is when you experience a constant or frequent leakage of urine when your bladder hasn’t emptied after urinating because of a blockage. Some of its causes are urinary stones, tumor passing through, enlarged prostate gland, or constipation.
#3 Urge Incontinence
This refers to the sudden urge to relieve yourself followed by an involuntary loss of urine. It may be caused by a minor infection but may also be serious due to neurological conditions such as a stroke or multiple sclerosis.
#4 Functional Incontinence
When a physical or mental disability hinders you from making it to the toilet in time, it is referred to as functional incontinence. A person with arthritis may not be able to unzip his pants in time to relieve themself.
#5 Mixed Incontinence
When a person’s health gets affected by more than one type of incontinence at the same time.
Urinary Incontinence – Risk Factors
There are several factors that may increase your chance of having urinary incontinence:
As a person grows older, with declining health, the muscles in their urethra lose their strength. These changes allow them to have lesser control over the bladder, thus leading to the involuntary release of urine.
The risk of urinary incontinence is always higher in women, which can be either due to pregnancy, childbirth, menopause, or even normal body anatomy. Whereas men with enlarged prostate glands are at higher risk of an involuntary leak.
#3 Weight gain/ Obesity
Heavier weight increases the pressure on a person’s bladder thus creating a higher risk of urine leakage.
#4 Family History
If a close member of a person’s family suffers from incontinence, it is more likely that they may share the condition too. This is common for urge incontinence.
#5 Other diseases
People with a history of diabetes or any neurological conditions are always at higher risk of getting urinary incontinence.
Urinary Incontinence Diagnosis
A consultation with a clinic, urologist, or a urinary doctor entails:
#1 A bladder diary
This requires a person to keep track of a page of their water intake, the number of times they had the urge to urinate, and the times they experienced episodes of involuntary leakage.
#2 Physical exam
In females, the doctor examines the vagina to assess the health of the pelvic muscles and floor. In males, the doctor carries out a rectal exam to check for symptoms of enlarged prostate glands.
Urine tests are carried out to check for any infections or abnormalities.
#4 Post Void Residual (PVR) measurement
This procedure assesses how much urine is left in the bladder after urinating.
#5 Pelvic ultrasound
Provides an image and may help detect any abnormalities.
#6 Stress test
The patient is asked to apply sudden pressure on their bladder while the doctor keeps track of the loss of urine.
#7 Urodynamic testing
This determines how much pressure the bladder and urinary sphincter muscle can withstand.
A thin tube with a lens at the end is inserted into the urethra so that the doctor can view any abnormalities in the urinary tract.
Urinary Incontinence Treatment
Urinary Incontinence Treatment is dependent upon the severity, type, and causes of the incontinence, and for the same, a combination of treatments may be recommended by the doctor after diagnosis.
#1 Bladder training
The goal of this technique is to strengthen your bladder control. Therefore, every time you feel the urge to go, you try to delay it by 10 minutes, doing so until you’re only urinating at 2.5 to 3 hours.
#2 Double voiding
This helps in emptying your bladder in one go to avoid leakage. With every trip to the bathroom, you urinate and wait 5 minutes before trying to urinate again.
#3 Scheduled toilet trips
Scheduling trips to the bathroom every two to four hours rather than going every time you have the urge.
#4 Fluid and diet management
Managing your diet is highly necessary in order to control your bladder. For the same, you need to cut back on alcohol consumption, caffeine, and food items that are acidic in nature. You may also need to control your fluid intake and lose weight as well.
Pelvic floor muscle exercises
Also known as Kegel exercises, these exercises are especially effective for stress incontinence but may also help urge incontinence.
- Tighten the muscles you would use to stop urinating and hold for five seconds, and then relax or ease for five seconds.
- Work up to holding the contractions for 10 seconds at a time.
- Set a goal for at least three sets of 10 contractions each day.
Electrodes are temporarily inserted into your rectum or vagina to strengthen your pelvic floor muscles. Gentle electrical stimulation can be effective for stress incontinence and urge incontinence, but you may need multiple treatments over several months, depending upon the severity of your case.
Modern medicine network has several medication to treat incontinence including:
These medications can calm an overactive bladder and are helpful for urge incontinence.
It is used to treat urge incontinence. This medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold.
#3 Alpha blockers
In men with urge or overflow incontinence, these medications relax bladder muscles and muscle fibers in the prostate and make it easier for the patient to empty the bladder.
#4 Topical estrogen
For women, topical estrogen in the form of a vaginal cream, ring, or patch may help tone and rejuvenate tissues in the urethra and vaginal areas.
Clinical devices designed to treat women with incontinence include:
#1 Urethral insert
A small, tampon-like disposable device inserted into the urethra before any strenuous activity that can trigger incontinence. The insert acts as a plug to prevent leakage and is removed before urination.
It is a stiff medical ring that you insert into your vagina and wears all day. The pessary helps hold up your bladder, which lies near the vagina, to prevent urine leaks.
If other medical treatments aren’t working, it is best to visit a clinic and consult a doctor to opt for a surgical procedure:
#1 Sling procedures
A network of body tissues, synthetic material or mesh is used to create a pelvic sling around your urethra and the area of thickened muscle where the bladder connects to the urethra. The sling helps keep the urethra closed, especially when you cough or sneeze. This procedure is used to treat stress incontinence.
#2 Bladder neck suspension
This procedure is designed to provide support to your urethra and bladder neck — an area of thickened muscle where the bladder connects to the urethra. It involves an abdominal incision, so it’s done during general or spinal anesthesia.
#3 Artificial urinary sphincter
In men, a small, fluid-filled ring is implanted around the bladder neck to keep the urinary sphincter shut until you’re ready to urinate. To urinate, you press a valve implanted under your skin that causes the ring to deflate and allows urine from your bladder to flow.
Absorbent pads and catheters
#1 Pads and protective garments
Men who have problems with urine leakage can use a drip collector — a small pocket of absorbent padding that’s worn over the penis and held in place by close-fitting underwear.
If you’re incontinent because your bladder doesn’t empty properly, your doctor may recommend that you learn to insert a soft tube (catheter) into your urethra several times a day to drain your bladder.
Change in diet and lifestyle is how one can easily manage urinary incontinence:
#1 Dietary Restrictions
There are certain foods and items that trigger incontinence therefore general advice is to avoid or stop eating them. These include foods that are spicy, honey, caffeine, alcohol, sodas, vinegar, chocolate, tomatoes, fizzy drinks, artificial sweeteners, dairy, and citrus juices.
#2 Weight Management
Excess or extra weight or belly fat puts immense pressure on your bladder leading to exertion over your bladder and consequent loss of control. Therefore, regular physical exercise is recommended as one of the best remedies.
#3 Vitamin D and Magnesium
Low levels of Vitamin D can also lead to urinary incontinence. You can get enough vitamin D in your diet from natural foods like egg yolks, mushrooms, fatty fish, soya milk, cheese, cereals, and other dairy products. Magnesium plays a role in improving incontinence by reducing bladder muscle spasms and enabling the bladder to fully empty. Therefore, you should ensure the intake of green leafy vegetables, legumes, nuts and seeds, and seafood.
Urinary Incontinence is a very common condition, which increases with a person’s age and life. With early diagnosis news, it is treatable with non-surgical methods with slight changes in lifestyle but severe cases require urology surgery. One of the most common issues with this condition is the embarrassing stigma surrounding it, which is one of the main reasons why people do not seek help by visiting a doctor or a clinic, or even confide or share with family or friends.
Frequently Asked Questions
– leaking urine during everyday activities, such as lifting, bending, coughing, or exercising
– feeling a sudden, strong urge to urinate right away
– leaking urine without any warning or urge
– being unable to reach a toilet in time
– wetting your bed during sleep
To diagnose the cause of your urinary incontinence, a physical examination of the doctor is needed and asks about your past health. Your doctor will ask about what and how much you drink. You will also be asked how much and how often you urinate and leak urine.
Nonsurgical options for treating stress urinary incontinence include lifestyle changes, physical therapy, the use of devices called peccaries that are placed in the vagina, and special injections.
Certainly, not all pregnant patients have incontinence following delivery. But pregnancy can predispose to urinary incontinence, especially in the case of a vaginal delivery.