By Medicover Hospitals / 03 Mar 2021
Urinary incontinence, urine leaking, losing bladder control, is a common and often embarrassing problem. The severity ranges from the occasional loss of urine when coughing or sneezing to the urge to urinate that is so sudden and strong that you don't make it to the bathroom in time.
- What is Urinary incontinence?
- When to visit a Doctor?
What is Urinary incontinence?
Urinary incontinence is the involuntary loss of urine. It means that a person urinates when he does not want to. Control over the urinary sphincter is lost or weakened. Urinary incontinence is a common problem that affects many people. As you age, the muscles that support your bladder weaken, which can lead to urinary incontinence. Many health problems can also cause the condition. Symptoms can range from mild to severe and can be a sign of cancer, kidney stones, infection, or an enlarged prostate.
Urinary incontinence occurs more often in women than in men. It is believed that 30 percent of women between the ages of 30 and 60 have it, compared to 1.5-5 percent of men.
Pregnancy, childbirth, and menopause can contribute to urinary incontinence in women. Weak bladder muscles, overactive bladder muscles, and nerve damage can also cause urinary incontinence in women.
The causes of incontinence are closely related:
The factors include:
The following causes of urge incontinence have been identified:
- pregnancy and childbirth
- menopause, as the drop in estrogen, can weaken muscles
- hysterectomy and some other surgical procedures
- urge incontinence
- cystitis, an inflammation of the lining of the bladder
- neurological conditions, such as multiple sclerosis (MS), stroke, and Parkinson's disease
- an enlarged prostate which can cause the bladder to fall out and the urethra to become irritated
This happens when there is an obstruction or blockage of the bladder. The following can cause a blockage:
- an enlarged prostate
- a tumor pressing against the bladder
- urinary stones
- urinary incontinence surgery that went too far
This can result from:
- an anatomical defect present from birth
- a spinal cord injury that affects nerve signals between the brain and the bladder
- a fistula, when a tube or channel develops between the bladder and a nearby area, usually the vagina
- some medications, especially some diuretics, antihypertensives, sleeping pills, sedatives, and muscle relaxants
- urinary tract infections (UTI)
During your appointment, your healthcare provider will probably ask you questions about your symptoms. They will probably want to know how long you have been incontinent, what types of incontinence you have experienced, and other details. They may also ask you about your daily habits, including your typical diet and any medications or supplements you take.
Based on your symptoms and medical history, your healthcare provider may order additional tests, including:
- Physical Exam: The doctor may examine the vagina and check the strength of the pelvic floor muscles. They can examine the rectum of a male patient to determine if the prostate gland is enlarged
- Urinalysis: Tests are done to look for signs of infection and abnormalities.
- A blood test can assess kidney function.
- Post-void residual measurement (PVR): assesses the amount of urine left in the bladder after urinating.
- Pelvic Ultrasound: Provides an image and can help detect any abnormalities.
- Stress Test: The patient will be asked to apply sudden pressure while the doctor checks for urine leakage.
- Urodynamic Test: determines how much pressure the bladder and urinary sphincter can withstand.
- Cystogram: An x-ray procedure provides a picture of the bladder.
- Cystoscopy: A thin tube with a lens on the end is inserted into the urethra. The doctor can see any abnormalities in the urinary tract.
There are many treatment options available. Your healthcare provider can discuss the approaches that may work for you and your lifestyle.
- Behavior Modification Therapy: Your provider can suggest techniques for you to adopt. These may include limiting the amount of fluid you drink, eliminating caffeine (which can irritate your bladder), or learning to hold your urine longer.
- Physical Therapy or Exercises: Strengthen the pelvic floor, which is the group of muscles that help control the flow of urine.
- Vaginal Insert (pessary): These removable vaginal inserts, intended to support the urethra, can help prevent stress incontinence.
- Medications: Some block chemical messages in the nerves around the bladder which relax the bladder muscles to increase the capacity of the bladder.
- Medication Injections: Certain substances can thicken the wall of the urethra to make it seal more tightly to prevent urine from leaking.
- Botox: For women who have not received help with other injections, Botox injections can relax overactive bladder muscles. The benefits can last for several months. The injections may need to be repeated once or twice a year.
- InterStim Therapy: A small device, the size of a stopwatch, is implanted under the skin of the hip. It sends mild electrical impulses to the nerve that controls the muscles of the bladder.
- Sling Procedures: During this minimally invasive surgery, your provider places a sling made of synthetic or natural material around the urethra to support it, which helps prevent stress incontinence.
When to visit a Doctor?
Incontinence can be a major disorder in your life. It is important to get an accurate diagnosis and discuss treatment options with your healthcare provider.
In certain circumstances, incontinence is a symptom of a medical emergency, When you lose control of your bladder and have any of the following symptoms, you may get urgent medical attention:
- trouble talking or walking
- weakness or tingling anywhere in your body
- vision loss
- loss of consciousness
- loss of bowel control
Urinary incontinence cannot always be prevented. However, to help lower your risk:
- Maintain a healthy weight
- Practice pelvic floor exercises
- Avoid bladder irritants such as caffeine, alcohol, and acidic foods
- Get more fiber, which can prevent constipation, a cause of urinary incontinence
- Do not smoke or seek help to quit smoking
- Do exercises
- Eat a balanced diet
- Use a washcloth to clean yourself
- Allow your skin to air dry
- Keep a bedside dresser in your bedroom
- Install a raised toilet seat
- Expand an existing bathroom door
Frequently Asked Questions:
Urinary incontinence is usually caused by problems with the muscles and nerves that help the bladder hold or urinate.
Urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled.
Look for flavored water or try coconut water. Decaf tea and coffee can be taken in small doses. Also, even a non-citrus drink, like apple juice, can be enjoyed.
Vitamin D deficiency is associated with increased urination. Therefore, getting enough vitamin D can be protective.
Science Direct - https://www.sciencedirect.com/science/article/abs/pii/S000293780501135X
Nature Reviews Disease Primers - https://www.nature.com/articles/nrdp201742
Nature Reviews Disease Primers - https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1520-6777(2000)19:3%3C259::AID-NAU7%3E3.0.CO;2-U