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URINARY INCONTINENCE

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URINARY INCONTINENCE

Urinary incontinence is an uncontrolled involuntary leakage of urine.

  • It can also be referred to as a loss of bladder control.
  • The condition is common and distressing and may have a large impact on the quality of life.
  • This is because many people with the condition are afraid to do normal activity as they usually do not want to be far from a toilet.
  • Urinary incontinence is thought to affect millions of people, and the chance of having it increases with age.
  • There are different types of incontinence and they include:

STRESS INCONTINENCE

With this type, a weakened pelvic muscle floor and tissue cause urine to leak, this may be due to extra pressure placed on the bladder and the muscle involved in urine control.

This is the most common type of urinary incontinence. It is common in women especially older women who have gone through menopause or women who have given birth.

Stress incontinence may be triggered by:

  • Coughing, laughing or sneezing
  • Exercises
  • Heavy lifting

URGE INCONTINENCE

This is also called overactive bladder and is the second most common type of urinary incontinence. With this type, a sudden, involuntary contraction of the muscular wall of the bladder causes an intense urge to urinate.

Urge incontinence may be triggered by:

  • A sudden change in position
  • Sex, especially during orgasm

OVERFLOW INCONTINENCE

With this type, the bladder cannot hold as much urine as the body is making, or the bladder doesn’t completely empty, causing a small amount of leakage.

This is more common in men with prostate cancer problems, a blocked urethra, or a damaged bladder.

FUNCTIONAL INCONTINENCE

With this type, a person recognizes the need to urinate but cannot make it in time due to physical or mental impairment such as dementia or arthritis.

MIXED INCONTINENCE

With this type, you are experiencing more than one type of urinary incontinence. Many women have both stress and urge incontinence.

CAUSES

Urinary incontinence is not a disease but rather a symptom. It can be caused by underlying medical conditions or everyday habits.

Certain foods, drinks, or medications may stimulate the bladder and increase the volume of urine. Such as:

  • Alcohol
  • Caffeine
  • Chocolate
  • Chili peppers
  • A large dose of vitamin C
  • Artificial sweeteners
  • Heart and blood pressure medications

Other causes of urinary incontinence may be due to underlying physical problems or changes, including:

  • Pregnancy
  • Menopause
  • Enlarged prostate
  • Prostate cancer
  • Hysterectomy or other surgical procedures
  • Obesity
  • Cystitis
  • Neurological conditions such as stroke, multiple sclerosis, and Parkinson disease.
  • Urinary stones
  • An anatomical defect present from birth
  • Spinal cord injury
  • Childbirth
  • Urinary infections
  • Constipation
  • Uncontrolled diabetes mellitus
  • Bladder cancer

SYMPTOMS

The main symptoms of urinary incontinence are the involuntary leakage of urine. How and when this happens depends on the type of urinary incontinence.

DIAGNOSIS AND TREATMENT

To make diagnosis, the doctor will review your medical history and carry out a physical examination.

During the physical examination, the doctor will examine your vagina and check the strength of the pelvic floor muscles. For a male patient, the rectum is examined to determine if the prostate cancer is enlarged.

The doctor may recommend:

  • Urinalysis where your urine is checked for signs of infections, traces of blood or other abnormalities.
  • Bladder diary to keep track of how much fluid you drink when urination occurs, the amount of urine, and the number of incontinence episodes.
  • Post-void residual measurement to assess the amount of urine left in your bladder.
  • Urodynamic testing to determine the amount of pressure the bladder and urinary sphincter can hold.
  • Pelvic ultrasound.

TREATMENT

Treatment for urinary incontinence depends on the type, the severity, and the underlying cause.

Treatment option may include:

  • Behavioral techniques including bladder training, fluid and diet management, or toilet trips schedule.
  • Pelvic floor muscle exercises to help strengthen the muscle that helps control urination.
  • Medications including alpha blockers, topical estrogen, anticholinergic, and mirabegron.
  • Medical devices designed for females including urethral inserts, pessary.
  • Interventional therapies including bulking agents, nerve stimulator, botox injections.
  • Surgery including artificial urinary sphincter, sling procedures, bladder neck suspension, or prolapse surgery.

 

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