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Urinary Incontinence
Wellness

Urinary Incontinence: Causes & Treatments

Urinary incontinence can be an embarrassing problem many people face. It involves loss of bladder control that can range from occasionally leakages when force is applied such as by coughing or sneezing, to sudden strong urges that cause you to be unable to reach the bathroom in time. Unfortunately having urinary incontinence can affect your daily activities and make you uncomfortable going out for fear of having an accident.

There is no reason to be embarrassed. Many people suffer from urinary incontinence due to some reasons including aging, and with available treatments, it is still possible to engage in your favorite activities without fear.

Types of Urinary Incontinence

Woman with Bladder ProblemThe symptoms of incontinence include occasional minor urine leaks or losing small to moderate amounts of urine leaking on a more regular basis. How much and how the leakage occurs will determine what type of incontinence you may suffer from. You may experience:

  • Urge Incontinence This usually involves a sudden urge to urinate, directly followed by loss of bladder control. This type is often accompanied by a frequent need to urinate as well as the need to urinate often throughout the night.
  • Stress Incontinence This type will cause leakage when there is stress on the body such as laughing, exercising, coughing, or sneezing.
  • Functional Incontinence This type of urinary incontinence occurs when someone has a physical or mental impairment that prevents them from being able to reach the bathroom in time.
  • Overflow Incontinence Overflow incontinence involves frequent or consistent dribbling because your bladder does not completely empty when you go to the bathroom.

What Can Cause Urinary Incontinence?

While most people believe that age is what causes incontinence, it is only one possible reason. The cause will largely have to do with what type of incontinence you are experiencing. Some symptoms of temporary incontinence include:

  • Food or drink Food and beverages that act as stimulants or diuretics can lead to incontinence, or exacerbate the symptoms, such as alcohol, caffeine, chocolate, artificial sweeteners, chili peppers, and other spicy foods.
  • Medications Large does of vitamin C, some heart and blood pressure medications, sedatives, and muscle relaxers can lead to incontinence.
  • Infections Urinary tract infections can create a strong need to urinate, and, if left untreated, can lead to incontinence.
  • Severe constipation Since your rectum shares some nerves with your bladder, when you have hard and compacted stool, the nerves can overact, leading to leakage.

If you are experiencing persistent or more frequent incontinence, the cause of it could be an underlying condition such as:

  • Pregnancy Weight gain and hormonal changes can lead to persistent stress incontinence.
  • Childbirth When you have a vaginal delivery, your vaginal muscles can become weakened, and you can suffer damage to the bladder nerves as well as the supportive tissue. This can lead to a pelvic floor prolapse and incontinence.
  • Aging As you get older, your bladder’s capacity to hold urine may decrease. You also may have more bladder contractions as you age which can lead to high rates of incontinence.
  • Menopause Due to decreased estrogen levels occurs with menopause, the tissues that line the bladder and the urethra can deteriorate and cause incontinence.
  • Hysterectomy The uterus and the bladder are supported by some of the same muscles and ligaments. Removing the uterus can possibly damage the pelvic floor, causing leakage.
  • An obstruction Any types of blockage in your urinary tract can block the urine flow and result in overflow incontinence. Common blockages include tumors and stones.
  • Neurological conditions  Conditions that affect the nervous system, such as multiple sclerosis, Parkinson’s, strokes, and spinal injuries can damage the nerve signals that control the bladder.

While any of the above causes may be linked to your urinary incontinence, there are also risk factors that can increase your chances of developing it. Women tend to experience it more than men, and as you get older, you are more likely to experience it. Other risk factors include being overweight, smoking, diabetes, and a family history of incontinence.

Urinary Incontinence Treatment

UrologistThe treatment that will be used to treat your urinary incontinence will largely depend on the type of incontinence you have and the severity of the symptoms. Some types may also require a combination of treatments to get it best under control. Some of the most common treatments used for urinary incontinence include:

Behavioral Treatments

Behavioral treatments may be the first treatment your doctor recommends for many types of incontinence. It can include bladder training, where you delay urination after feeling the urge to go, planning scheduled bathroom breaks, and managing your fluid intake and diet. For cases such as overflow incontinence, they may recommend double voiding.

Pelvic Muscle Exercises

If the cause of your incontinence is linked to poor pelvic muscles, such as cases caused by pregnancy, childbirth, and menopause, pelvic floor muscle exercises may be recommended. These exercises involve tightening the muscles as you would to stop the flow of urine and holding it for five seconds before relaxing for five seconds. You will need to perform three sets of ten a day and work up to holding each time for 10 seconds.

Electrical Stimulation

Electrical stimulation involves electrodes being inserted into the vaginal area or rectum where a gentle stimulation will be applied to strengthen the pelvic floor muscles. This is often used for stress or urge incontinence and can require multiple treatments for at least several months.

Medications

Your doctor may also prescribe medications to help control your urinary incontinence. Medications used to treat urge incontinence include anticholinergics, Mirabegron, and alpha blockers which can be used for both urge and overflow incontinence. Women who have incontinence due to weakened tissues in the urethra and vagina may be prescribed a topical estrogen.

Medical Devices

Medical devices can be used to help reduce the symptoms and prevent them from interfering with your daily activities. Your doctor may prescribe a urethral insert, which is a disposable tampon-like device that can be inserted before you are performing an activity that can trigger your incontinence. This can prevent leakage during the activity and is removed before you urinate. A pessary is a stiff ring that is inserted into the vagina where it works all day and is usually prescribed for those for are suffering from incontinence due to prolapse.

Interventional Therapies

Other interventional therapies can also help prevent leakage and improve the muscles to reduce symptoms. Some doctors may use nerve stimulators which are implanted under the skin and deliver gentle impulses to the nerves of the bladder to control urge incontinence. This is usually ordered if other therapies have failed. Bulking material injections are also used and are an injection of a synthetic material which can help to keep your urethra closed to reduce leaking. Botox has also been used for overactive bladders. It is injected into the bladder muscles to strengthen them.

Surgical Treatments

Surgical procedures are usually one of the last options after other treatments have failed. Some of the treatments available include:

  • Sling procedures The surgeon will use pieces of tissue, or mesh to create a pelvic sling that will wrap around the urethra and where the muscle connects the bladder to the urethra. The sling will keep your urethra closed and help treat stress incontinence.
  • Prolapse surgery Typically used for pelvic organ prolapse or mixed incontinence, the surgeon may use prolapse surgery to fix a fallen pelvic floor. Sometimes this is combined with the sling procedure.
  • Bladder neck suspension This procedure is done to create support for the neck of your bladder and your urethra. The procedure will be done under general anesthesia or with a spinal block.

Catheters and Absorbent Pads

In cases where urinary treatments cannot rectify your incontinence, you should stock up on products that can help eliminate the inconvenience and discomfort of urinary incontinence. These products can allow you to feel confident when performing your daily activities. Products include catheters which involve inserting a soft tube catheter into your urethra several times a day to drain your bladder. You can also purchase pads and protective undergarments worn daily to absorb leakage and keep you dry.

Don’t let urinary incontinence prevent you from performing the daily activities that you enjoy. If you are experiencing leaking, and suspect you have incontinence, contact your doctor to find out what treatment will work best for you.

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