This article has been compiled by Athira Krishnan who is a content writer at Proactive For Her.
What is urinary incontinence?
Urinary incontinence is the involuntary leakage of urine. It is a common problem that affects most people, usually common in old age.
What are the different types of urinary incontinence?
- Stress: Urine loss that occurs during common activities like coughing, sneezing, laughing, jumping or lifting.
- Urge: An occasional sudden need to urinate with a large volume of urine loss and can also exist without incontinence.
- Overflow: A frequent dribble of urine due to insufficient bladder emptying.
- Functional: Urine loss that occurs without any pathology or problem in the urinary system. This is associated with physical or cognitive impairment such as immobility, Alzheimer’s disease or head injury.
Symptoms and Causes of Urinary Incontinence
Most people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine frequently.
The most common symptoms being:
- Involuntary passing of urine when coughing, laughing, sneezing or exercising
- Feeling sudden, uncontrollable urges to urinate
- Frequent urination
- Waking up several times while sleeping at night to urinate
- Urinating while sleeping
When to see a doctor?
You may feel uncomfortable discussing incontinence with your doctor. But if it is frequent and affects your quality of life, it is important to seek medical advice because urinary incontinence may -
- Indicate a more serious underlying problem
- Cause you to restrict your usual activities and hinder your social life
- Increase the risk of falling in older adults as they rush to the toilet.
Causes
What one needs to understand about urinary incontinence is, it is not a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine the exact cause behind this problem.
- Temporary urinary incontinence - Common drinks, foods and medications may act as diuretics (any substance that promotes diuresis which is the increased production of urine). They include :
- Alcohol
- Caffeine
- Carbonated drinks/Sparkling water
- Artificial sweeteners
- Chocolate
- Chilli peppers
- Foods that are high in spice, sugar or acid
- Heart and blood pressure medications, sedatives and muscle relaxants
2. Medical Conditions:
- Urinary tract infection - These infections can irritate your bladder, causing you to have strong urges to urinate.
- Constipation - The rectum is located near the bladder and shares many of the same nerves. Hard stool in the rectum causes these nerves to be overactive and hence increases the frequency of urination
3. Persistent Urinary Incontinence - This can also be a persistent condition caused by underlying physical problems, including :
- Pregnancy
- Changes with age/Menopause
- Menopause
- Hysterectomy - Any surgery that involves a woman's reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
- Obstruction - A tumour or urinary stones in the urinary tract
- Neurological disorders - Multiple sclerosis (A disease in which the immune system eats away at the protective covering of nerves), Parkison’s disease, Stroke, Brain tumour or a spinal injury can interfere with nerve signals involved in bladder control.
Some factors may put you at a higher risk of incontinence
- Gender - Women are more likely to develop this condition due to pregnancy, childbirth and menopause. However, men with prostate gland problems are at increased risk of urge and overflow incontinence.
- Age - As you get older, the muscles in the bladder and urethra will lose some of their strength. Changes with age reduce how much urine your bladder can hold and increases the chance of involuntary urine release.
- Being overweight - The extra weight increases pressure on your bladder and its surrounding muscles, which weakens them and hence, allows urine to leak out when you cough or sneeze.
- Smoking - The use of tobacco may increase your risks
- Family history - If a close family member has urinary incontinence, your risk is subsequently higher
Why should you be taking care of it?
Complications of chronic urinary incontinence include :
- Skin problems - Rashes, infections and sores can develop due to constantly wet skin
- Urinary tract infections - Incontinence increases the risk of repeated infections
- Impacts on personal life - It can affect your social, work and personal relationships.
Diagnosis
Your doctor is likely to start with a thorough history and physical exam. You may then be asked to cough to demonstrate incontinence. After that, the doctor will likely recommend :
- Urinalysis - Your urine sample is checked for signs of infection, blood or other abnormalities.
- Bladder diary - You are asked to record how much you drink, when you urinate, the amount of urine produced, how often the urge to urinate is and the number of incontinence episodes in a diary.
- Post-void residual measurement - PVR (Postvoid residual) is the amount of urine that remains in your bladder after you urinate. Having urine in the bladder could be caused by a narrowing in the urethra, a blockage in the urinary tract, bladder damage, neurological problems and side effects of certain medications like antidepressants, anticholinergics and/or decongestants.
What are the treatment options?
Your doctor is likely to suggest the least invasive treatments first and then move on to other options if these techniques fail. A few ideas to start training patients include modifying behaviours to improve bladder muscle tone and work on improving the total capacity of your bladder such as -
- Bladder training - Try to hold off for 10 minutes every time you feel the urge to urinate. The goal is to lengthen the time between trips to the toilet.
- Double voiding - After urinating, wait for a few minutes and try again to make sure your bladder is completely void.
- Scheduled toilet trips - Urinate every 2-4 hours rather than waiting for the urge to go.
- Fluid and diet management - You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity can also ease the problem.
- Pelvic floor muscle exercises - Also known as Kegel exercises, these exercises are especially effective for incontinence and to strengthen the pelvic floor muscles. To do these exercises, imagine that you’re trying to stop your urine flow. Then, :
- Tighten the muscles that you would use to stop urinating and hold for 5 seconds and then relax for 5 seconds. (If this is too difficult, try tightening and relaxing for 2 or 3 seconds each)
- Work up to holding the contractions for 10 seconds at a time
- Aim for at least 3 sets of 10 repetitions each day.
Devices designed to treat women with incontinence include :
- Urethral insert
- Pessary
Surgery - If other treatments aren't working, several surgical procedures can treat the problems that cause urinary incontinence:
- Sling procedure
- Bladder neck suspension
- Prolapse surgery
- Artificial urinary sphincter
Absorbent pads and catheters - If medical treatments aren't helping to completely eliminate incontinence, you can try products that help ease the discomfort and inconvenience of leaking urine.
- Pads and protective garments - Most of these products are no more bulky than normal underwear and can easily be worn under everyday clothing. Men can use a drip collector - a small absorbent padding worn over the penis.
- Catheter - If your bladder doesn't empty properly, your doctor may recommend that you learn how to insert a soft tube (catheter) into your urethra several times a day to drain your bladder. You will be instructed on how to clean these catheters for safe reuse.
Lifestyle and home remedies
Problems with urine leakage may require you to take extra care to prevent skin irritation.
- Use a washcloth to clean yourself
- Allow your skin to air-dry
- Avoid frequent washing and douching
- Ask your doctor about special cleansers made to remove urine.
Disclaimer - This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.
Proactive is a digital clinic for women, offering accessible, personalized, and confidential healthcare solutions. We offer products and services for out-patient health concerns of Indian women, across their lifetime - from puberty to pregnancy to menopause. To know more on the sexual and reproductive health of women, visit https://www.proactiveforher.com/