Urinary incontinence, or the inability to control the bladder, is a common problem causing embarrassment and discomfort. It ranges from leaking a few drops when coughing or sneezing to a sudden, strong urge to urinate that might not allow reaching the bathroom in time.
Women are more likely to get urinary incontinence than men because of:
- The anatomical differences in the urinary tract between women and men.
- Hormonal changes before menopause andmenopause for women.
- Pregnancy and childbirth cases.
Also, urinary incontinence is a problem that comes with aging, and people need to know how to deal with it as they get older.
Urinary incontinence can seriously affect a person's life at home, work, and outside, and many feel embarrassed to talk about it with their doctor.
This article will cover the causes of urinary incontinence, its symptoms, how it’s diagnosed, and possible treatments.
What is urinary incontinence?
Urinary incontinence basically means losing urine involuntarily. The bladder stores urine, and the sphincter muscles that surround the urethra hold it in.
Plus, the pelvic floor muscles support the urethra, bladder, and other pelvic organs, and if any part of this system doesn’t work well, it can lead to urinary incontinence.
Symptoms of urinary incontinence
The main symptom is unexpected urine leakage. This can show up differently for people , some might just get a few drops during activity, others might lose urine fully after feeling a strong urge to pee.
Types of urinary incontinence include:-
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Stress urinary incontinence:- It happens when urine leaks as the bladder is pressured by coughing, sneezing, laughing, lifting heavy things, or exercising.
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Urgency urinary incontinence:- This happens when a person suddenly feels a strong urge to pee followed by involuntary urine loss. It could be caused by something simple like an infection or something more serious, like diabetes or a neurological disorder.
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Overflow urinary incontinence:- It happens when a person leaks urine frequently or continuously because they don't empty their bladder fully.
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Functional Urinary Incontinence: Sometimes physical or mental disability stops a person from reaching the bathroom in time, like severe arthritis that makes it hard to unbutton clothes quickly.
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Mixed Urinary Incontinence: This happens when a person has more than one type of the previous urinary incontinence types, often a mix of stress and urge incontinence.
Causes of Urinary Incontinence
There are many causes and risk factors for urinary incontinence, including these:
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Getting older.
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Pregnancy and childbirth.
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Family history.
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Abdominal or pelvic surgeries.
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Weight gain.
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Taking some medications.
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Having pelvic floor disorders.
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Frequent urinary tract infections.
How to diagnose urinary incontinence
It's important to figure out the type of urinary incontinence a person has. Usually, the doctor will identify the type based on the info and symptoms the person shares. This info will guide treatment decisions.
The doctor will likely start with a full history and a physical exam. They may ask for a simple test that can show incontinence, like coughing.After that, the doctor will probably recommend the following:-
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Urine test:- A urine sample is checked for signs of infection, blood, or other abnormalities.
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Bladder diaryFor several days, you record how much liquid you drink, when you pee, how much urine comes out, if you feel the need to pee, and how many accident episodes you have.
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Measuring leftover urine after peeingThe person is asked to urinate or empty into a container that measures the amount of urine. Then the doctor checks the leftover urine in the bladder with ultrasound. Leftover urine in the bladder might mean a blockage in the urinary tract or a problem with the bladder's nerves or muscles.
If more info is needed, the doctor might suggest more invasive tests like urodynamic testing and pelvic ultrasound. These are usually done if surgery is being considered.
Treatment for Urinary Incontinence
Treatment depends on the type and severity of incontinence, and the cause. Sometimes several treatments are needed. If there is an underlying condition causing symptoms, the doctor treats that first.
The doctor may suggest less invasive treatments to start and move to others if those don’t help. These include:
1. Behavioral techniques
The doctor might recommend:
- Bladder training to delay urination after feeling the urge.You can start by trying to hold it for 10 minutes each time you feel the need to pee. The goal is to stretch out the time between bathroom trips to every 2.5 to 3.5 hours.
- Double voiding, helps learn how to fully empty the bladder to avoid overflow incontinence. It means peeing, then waiting a few minutes and trying to pee again.
- Bathroom schedulingmeans peeing every 2 to 4 hours without waiting for the urge.
- Managing diet and weight, to control the bladder, you might need to cut back on caffeine, alcohol, and acidic foods, lose extra weight, and be more active.
2. Pelvic floor exercises
The doctor might also suggest doing pelvic floor exercises regularly. These exercises help strengthen the muscles that control urination. They are also known as Kegel exercises, which are especially effective to treat stress urinary incontinence and might help with urge incontinence too.
To do Kegel exercises, imagine you’re trying to stop the flow of urine. Follow these steps:-
1. Tighten the muscles you use to control urine and hold for 5 seconds.
2. Relax the muscles back and hold for another 5 seconds.
3. If that’s hard, squeeze the muscles for 2 seconds, then relax for 3 seconds.
4. Aim for 10 reps in 3 sets.
3. Using Medications
Medications used to treat urinary incontinence may include:-
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Anticholinergics:- Used to calm bladder overactivity, they can help treat urge incontinence.
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Mirabegron:- Used for urge incontinence, it relaxes bladder muscles and can increase how much urine the bladder holds. It may also increase how much urine can be passed at once.
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Alpha blockers:- Used for men with urge or overflow incontinence. These drugs relax the bladder neck muscles and prostate muscle fibers, making it easier to empty the bladder.
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Topical Estrogen:- Applying a low dose of topical estrogen as a vaginal cream might help renew tissues in the urethra and inflamed areas.
4. Electrical Stimulation
This is done by inserting temporary electrodes in the rectum or vagina to stimulate and strengthen pelvic floor muscles. It works well for stress and urge urinary incontinence.
5. Surgery
If other treatments fail, several surgical procedures can fix issues causing urinary leakage., which include:-
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Urinary incontinence sling procedures.
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Bladder neck suspension.
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Vaginal prolapse surgery.
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Artificial urinary sphincter.
6. Absorbers and leak guards
If medical treatments can’t stop urine leakage, people can use products that ease the discomfort from leaks, like pads, protective underwear, and catheters.
