Urinary incontinence is represented by the loss of bladder control. Severity ranges from occasionally leaking urine when sneezing/coughing to suffering a sudden and uncontrollable urge that leaves insufficient time for reaching a bathroom. It can affect daily activities and cause embarrassing situations.

 

Types of urinary incontinence:

Stress incontinence: leaks that occur when you put pressure on your bladder by coughing, sneezing, exercising or lifting heavy things

Urge incontinence: intense, unexpected urge to urinate followed by loss of urine

Overflow incontinence: bladder does not empty completely

Functional incontinence: physical or mental impairment keeps you from getting to the bathroom in time

Mixed incontinence: experiencing more than one type of urinary incontinence

Causes

The causes of this symptom can range from day-to-day habits, physical problems or underlying medical conditions

 

Certain medication, drinks or food can have a diuretic effect that cause this symptom: alcohol, caffeine, carbonated drinks, artificial sweeteners, corn syrup, spicy foods, citrus fruits, excessive doses of vitamins (B and C), sedatives, heart and blood pressure medication, muscle relaxants

 

Urinary tract infections (UTIs) can cause bladder irritation, burning sensation and an almost uncontrollable urge to urinate

Constipation

 

Persistent urinary incontinence can be caused by:

 

Pregnancy – due to hormonal changes, pressure from the weight of the uterus

 

Childbirth – vaginal deliveries weaken muscles that are involved in bladder control; they can also lead to a prolapsed (dropped) pelvic floor that can cause incontinence

 

Aging – muscle weakening

 

Menopause – shortage in estrogen (the hormone keeps the lining of the bladder and urethra healthy)

 

Hysterectomy – any surgery of a woman’s reproductive system can affect pelvic floor muscles

 

Enlarged prostate (occurs especially in the case of older men)

 

Prostate cancer – incontinence due to untreated prostate cancer; but in most cases incontinence is a side effect of the cancer treatment

 

Obstruction – anywhere along the urinary tract – tumors or stones (form in the bladder)

 

Neurological disorders – brain tumors, stroke, spinal injuries, multiple sclerosis, Parkinson’s disease can cause urinary incontinence

Symptoms and signs

 

Involuntarily releasing urine when coughing, sneezing or laughing (small or moderate amount)

Frequent and sudden need to urinate

Uncontrollable urge to urinate

Advice

 

The doctor will have to establish what type of urinary incontinence you are suffering from in order to offer the appropriate course of treatment

 

Tests and recommendations: urinalysis (the urine is checked for signs of infection, blood, etc), post-void residual measurement (you will be asked to void your bladder, afterwards the doctor will measure the amount of urine left in your bladder using a catheter or ultrasound), bladder diary (you will be asked to write down liquids intake, when you urinate, amount, urges and incontinence episodes)

 

Special testing may be required if your doctor needs further information about your situation: urodynamic testing (the bladder is filled with water through a catheter; the aim is to measure bladder and urinary sphincter strength and health), cystoscopy (a thin tube with a lens is inserted in your urethra), cystogram (a special dye is injected in the urethra and bladder, x-rays then reveal possible problems), pelvic ultrasound

 

The simplest and most non-invasive course of treatment is first recommended (if the problem does not require immediate medical treatment or surgery)

 

Lifestyle changes are effective: reducing or eliminating alcohol/caffeine, weight loss, avoiding to lift heavy objects, regular exercise, Kegel exercises (help strengthen the pelvic floor muscles)

 

Bladder training – voluntarily delaying urination

 

Double voiding – going to the toilet and trying to urinate again after 5 minutes

 

Electrical stimulation (of the pelvic muscles and bladder nerves)

 

Medication: alpha blockers (for men, relax bladder and prostate muscles to make it easier to urinate), topical estrogen (to rejuvenate vaginal and urethral tissue), medication that help in treating urge incontinence (Mirabegron), anticholinergics (medication for calming overactive bladders: oxybutynin, fesoterodine, tolterodine)

 

Medical devices: urethral insert (tampon-like disposable device), pessary (a stiff ring device that is inserted in the vagina to hold up the bladder and prevent leakage)

 

Interventions and surgery: nerve stimulator (in treating urge incontinence a device like a pacemaker is inserted under the skin), botox injections, bulking material injections (in the tissue surrounding the urethra to keep it closed and reduce sudden leaking), prolapse surgery (for women with mixed incontinence), artificial urinary sphincter (for men, a fluid-filled ring is implanted around the bladder neck), bladder neck suspension (procedure designed to support the urethra and bladder neck), sling procedures (strips of body tissue or synthetic materials are used to help keep the urethra closed)

 

Absorbent pads and protective garments can be used to reduce inconveniences

 

Catheters can be recommended to properly void the bladder

 

Your doctor will give instructions on how to use and keep catheters clean for reuse

 

MISCONCEPTIONS
  •  

    Urinary incontinence only affects older persons.

     

    It is uncommon and shameful. You should not talk about such a problem.

     

    It is permanent and inevitable after childbirth.

     

    You should drink as little liquids as you can.

     

    Urinary incontinence does not affect men.

Statistics

 

More than 24 million people in the US suffer from a form of urinary incontinence

 

Urinary incontinence affects more than 200 million people worldwide

 

More than 70% of the people that suffer any form of urinary leakage do not seek specialized help

Did you know?

 

Being overweight can cause urinary incontinence because of the extra pressure on your bladder and surrounding muscles.

 

Women are more prone to urinary incontinence due to pregnancy, childbirth and menopause.

 

Older people are more prone to suffer falls when rushing to the bathroom. Besides the obvious discomfort, this is another reason why urinary incontinence should be treated and kept under control.

 

Cranberry juice helps in preventing urinary tract infections that lead to incontinence.