What Is Urinary Incontinence, What Causes it, And How Do You Treat it?
Are you experiencing urine leaks, or do you have the urge to urinate every few minutes?
If so, you may be suffering from urinary incontinence, a condition that affects over 13 million Americans. It can be embarrassing and even limit your freedom to go out, but the good news is that it can be treated, despite what is commonly believed.
We’ll look into it in detail, but first—
What Is Urinary Incontinence?
Urinary incontinence is a condition where you lose control of your bladder and unintentionally leak urine. Symptoms of urinary incontinence tend to range in severity. It can involve problems passing urine, occasional leaks when you cough or sneeze, stopping and starting as you pass urine, or having an uncontrollable and rather strong urge to visit the restroom but not reaching it in time.
As a result, living with urinary incontinence can impair your quality of life.
Causes Of Urinary Incontinence
You may be experiencing loss of bladder control for many reasons, such as:
- Benign prostatic hyperplasia: When the prostate becomes enlarged, it may push against the urethra and bladder, causing problems with urination.
- Beverages: Carbonated drinks, caffeinated drinks like coffee and tea, and alcoholic beverages can all lead to more bathroom visits.
- Constipation: With this condition, an overfull bowel (of hard and dry stool) presses over the bladder, so it may cause you to visit the loo frequently.
- Diabetes: It can affect the nerve and muscles that control bladder function, leading to excess urination.
- Medications: Certain medications like antipsychotics and antidepressants can play a role in the onset or exacerbation of urinary incontinence.
- Multiple Sclerosis (MS): Bladder control issues are common in nearly 90% of MS patients.
- Menopause: The loss of estrogen brought on by menopause can weaken your pelvic floor muscles, causing loss of bladder control.
- Pregnancy: Over one-third of women experience this problem in their second or third trimester. It happens when the baby in the uterus places a lot of pressure on the bladder, leading to involuntary leakage of urine.
- Urinary Tract Infections (UTI): UTIs are a common infection involving any part of your urinary system. It causes pain and increases your need to pee more often.
- Pelvic floor disorders: By weakening the pelvic muscles, pelvic floor disorders can lead to tiny leaks with motions like coughing and sneezing, which stress the bladder. It can cause an urge to go to the restroom, followed by an involuntary leak.
- Stroke: About 50% of people who experience stroke develop incontinence.
Age, a family history of incontinence, smoking, gender (women experience it more than men), and obesity can also play a role in causing urinary incontinence.
Types Of Urinary Incontinence
Take a look at the most common types of urinary incontinence:
Stress Incontinence
This is the most common form of urinary incontinence, presenting itself when you cough, exercise, laugh, sneeze, or do heavy lifting exercises. These movements and activities place pressure on your bladder, causing a small amount of urine to leak.
Urge Incontinence
It causes an involuntary contraction of the muscular wall of the bladder, giving you a sudden urge to pee right away. The feeling is intense, so you often have little time to rush to the bathroom. Usually, an overactive bladder (OAB) is to be blamed.
Total Incontinence
This is the most severe form of incontinence. It happens when your bladder cannot store any urine. So, you’re either passing large amounts of urine occasionally or are experiencing uncontrollable leaking at all times, even at night.
Overflow Incontinence
Also called chronic urinary retention, it happens when you’re unable to completely empty your bladder when urinating. Since your bladder does not empty as it should, you constantly have the urge to urinate, passing small dribbles of urine from the urethra frequently.
Mixed Incontinence
In this instance, you often deal with different types of incontinence, the most common being stress and urge incontinence. So, you not only leak urine with movements or activities involving exertion but also feel the sudden, uncontrollable urge to pee immediately.
How Is Urinary Incontinence Diagnosed?
Your doctor will ask you for your medical history—and information on medications you’re currently on—to find the root cause of your bladder control issues.
To solidify their findings, they might also:
- Conduct a pelvic exam. Or, examine a man’s rectum to check the size of his prostate.
- Take urine samples to rule out infections and abnormalities.
- Conduct a blood test to assess kidney function.
- Ask you to maintain a bladder diary to see the number of “accidents”.
- Conduct a stress test, asking you to put pressure on the bladder through movements and exercises to demonstrate incontinence.
- Use a Post Void Residual Measurement test to measure urine output and the amount of urine left in your bladder after urinating.
If more information is required, the healthcare provider may also conduct an ultrasound or cystogram of your bladder or a cystoscopy to get a close look at the internal structure of your bladder and examine its function.
Treatment For Urinary Incontinence
The treatment options available will vary based on factors like the type of urinary incontinence, age, medical condition, and so on. They typically include:
Lifestyle Changes
Your doctor may recommend the following:
- Timed voiding and bladder training: Going to the restroom based on the clock instead of waiting to get the urge to pee.
- Emptying your bladder and avoiding drinking alcohol, caffeine, or other fluids before physical activities to avoid leakage.
- Doing pelvic floor exercises to strengthen the muscles around your pelvis.
- Maintaining a healthy body weight, as obesity is a strong risk factor for the loss of bladder control.
Medications
The following medications help treat urinalysis incontinence:
- Anticholinergics: They inhibit involuntary muscle movements and calm an overactive bladder, making them a useful ally against bladder issues.
- Imipramine: This tricyclic antidepressant can be used as part of the treatment for enuresis.
- Mirabegron: This class of medication works by relaxing the bladder muscles, which may treat urgent and uncontrolled leakage.
Alpha-blockers and topical estrogen may also be used to improve symptoms of incontinence.
Absorbent Products And Protective Garments
Women may use a wide range of absorbent products—think adult diapers, pads, panty liners, and reusable underwear to absorb moisture in cases of mild incontinence.
Men, on the other hand, will benefit from a drip collector. Worn over the penis and held close with snug underwear, it is designed to wick moisture away.
Electrical Stimulation
Despite what the name suggests, electrical stimulation is a safe, non-invasive treatment for incontinence. It strengthens weak pelvic floor muscles with the help of electrodes, though it can also be effective for calming an overactive detrusor muscle.
Medical Devices And Procedures
The following medical devices may prove helpful in treating incontinence:
- Urethral inserts: It’s a small tampon-like, reusable device inserted before doing activities to prevent leakage and removed when one needs to pee.
- Catheter: It is a partially flexible silicone tube that collects urine from the bladder into a drainage bag, which collects urine.
- Pessary: It’s a removable prosthetic ring that goes into the vagina to support the vaginal tissues and the area of prolapse to keep leaks at bay.
- Botox: It is injected into your bladder to treat an overactive bladder and can lead to a 60-80% decrease in episodes.
- Bulking agents: They are injected into the walls of the urethra to improve urethral mucosal coaptation and limit stress-induced leakage.
Surgical Treatments
When everything fails to work, your doctor may recommend surgery. Options include:
- Sling procedures: The surgeon inserts a synthetic mesh around the urethral bulb to strengthen the muscles that control urination and reduce episodes of urinary incontinence.
- Colposuspension: This procedure calls for lifting the tissues near the bladder neck to treat incontinence. It has a success rate between 50-70%.
- Artificial sphincter: It is an implanted device that controls the flow of urine, preventing it from leaking. It comes with a hand pump, allowing you to pass urine when you want to.
When To See A Doctor
Urinary incontinence is one of those conditions you feel embarrassed or uncomfortable discussing—even with your doctor. But if it restricts your day-to-day life, it’s important to disregard the stigma around it and seek treatment at the earliest, as most of the time it can be corrected with medical intervention.
Resources:
- https://medlineplus.gov/urinaryincontinence.html
- https://my.clevelandclinic.org/health/diseases/17596-urinary-incontinence
- https://www.everydayhealth.com/urinary-incontinence/guide/
- https://www.healthline.com/health/urinary-incontinence
- https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808
- https://www.medicalnewstoday.com/articles/165408#_noHeaderPrefixedContent
- https://www.nhs.uk/conditions/urinary-incontinence/
- https://www.urologyhealth.org/urology-a-z/u/urinary-incontinence