What is Urinary Incontinence?

Urinary incontinence, urine leaking, losing bladder control, is a common and often embarrassing problem. The severity ranges from the occasional loss of urine when coughing or sneezing to the urge to urinate that is so sudden and strong that you don't make it to the bathroom in time.

Urinary incontinence is the involuntary loss of urine. It means that a person urinates when he does not want to. Control over the urinary sphincter is lost or weakened. Urinary incontinence is a common problem that affects many people. 

As you age, the muscles that support your bladder weaken, which can lead to urinary incontinence. Many health problems can also cause the condition. Symptoms can range from mild to severe and can be a sign of cancer, kidney stones, infection, or an enlarged prostate.

Urinary incontinence occurs more often in women than in men. It is believed that 30 percent of women between the ages of 30 and 60 have it, compared to 1.5-5 percent of men.

Pregnancy, childbirth, and menopause can contribute to urinary incontinence in women. Weak bladder muscles, overactive bladder muscles, and nerve damage can also cause urinary incontinence in women.

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Causes or Types 

The causes of incontinence are closely related:

Stress Incontinence

The factors include:

  • pregnancy and childbirth
  • menopause, as the drop in estrogen, can weaken muscles
  • hysterectomy and some other surgical procedures
  • years
  • obesity
  • urge incontinence

The following causes of urge incontinence have been identified:

  • cystitis, an inflammation of the lining of the bladder
  • neurological conditions, such as multiple sclerosis (MS), stroke, and Parkinson's disease
  • an enlarged prostate, which can cause the bladder to fall out and the urethra to become irritated

Overflow Incontinence

This happens when there is an obstruction or blockage of the bladder. The following can cause a blockage:

  • an enlarged prostate
  • a tumor pressing against the bladder
  • urinary stones
  • constipation
  • urinary incontinence surgery that went too far

Total Incontinence

This can result from:

  • an anatomical defect present from birth
  • a spinal cord injury that affects nerve signals between the brain and the bladder
  • a fistula, when a tube or channel develops between the bladder and a nearby area, usually the vagina

Other Causes

These include:

  • some medications, especially some diuretics, antihypertensives, sleeping pills, sedatives, and muscle relaxants
  • alcohol
  • urinary tract infections (UTI)

Diagnosis

During your appointment, your healthcare provider will ask you questions about your symptoms. They will probably want to know how long you have been incontinent, what types of incontinence you have experienced, and other details. They may also ask you about your daily habits, including your typical diet and any medications or supplements you take.

Based on your symptoms and medical history, your healthcare provider may order additional tests, including:

Physical Exam

The doctor may examine the vagina and check the strength of the pelvic floor muscles. They can examine the rectum of a male patient to determine if the prostate gland is enlarged

Urinalysis

  • Tests for signs of infection and abnormalities.

Blood Test

  • Assesses kidney function.

Post-Void Residual Measurement (PVR)

  • Measures urine left in the bladder after urination.

Pelvic Ultrasound

  • Provides images to detect abnormalities.

Stress Test

  • Patient applies sudden pressure while doctor checks for urine leakage.

Urodynamic Test

  • Determines bladder and urinary sphincter pressure tolerance.

Cystogram

  • X-ray procedure that provides a picture of the bladder.

Cystoscopy

  • Thin tube with a lens is inserted into the urethra to see urinary tract abnormalities.

Urinary Incontinence Treatments

There are many treatment options available. Your healthcare provider can discuss the approaches that may work for you and your lifestyle.

Behavior Modification Therapy

Your provider can suggest techniques for you to adopt. These may include limiting the amount of fluid you drink, eliminating caffeine (which can irritate your bladder), or learning to hold your urine longer.

Physical Therapy or Exercises

  • Strengthens the pelvic floor muscles to help control urine flow.

Vaginal Insert (Pessary)

  • Removable inserts support the urethra to prevent stress incontinence.

Medications

  • Block nerve signals around the bladder, relaxing muscles to increase bladder capacity.

Medication Injections

  • Thicken the urethra wall to seal it tightly and prevent urine leakage.

Botox

  • Relaxes overactive bladder muscles for several months; injections may need repeating.

InterStim Therapy

  • Implanted device sends electrical impulses to bladder-controlling nerves.

Sling Procedures

  • Minimally invasive surgery places a sling around the urethra to support and prevent stress incontinence.

When to See a Doctor?

Incontinence can be a major disorder in your life. It is important to get an accurate diagnosis and discuss treatment options with your healthcare provider.

In certain circumstances, incontinence is a symptom of a medical emergency, When you lose control of your bladder and have any of the following symptoms, you may get urgent medical attention:

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Prevention

Urinary incontinence cannot always be prevented. However, to help lower your risk:

  • Maintain a healthy weight
  • Practice pelvic floor exercises
  • Avoid bladder irritants such as caffeine, alcohol, and acidic foods
  • Get more fibre, which can prevent constipation, a cause of urinary incontinence
  • Do not smoke or seek help to quit smoking
  • Do exercises
  • Eat a balanced diet
  • Use a washcloth to clean yourself
  • Allow your skin to air dry
  • Keep a bedside dresser in your bedroom
  • Install a raised toilet seat
  • Expand an existing bathroom door

Citations

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Frequently Asked Questions

1.What is bladder leakage a sign of?

Urinary incontinence is usually caused by problems with the muscles and nerves that help the bladder hold or urinate.

2. Can urine leakage be cured?

Urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled.

3. What drinks are good for incontinence?

Look for flavored water or try coconut water. Decaf tea and coffee can be taken in small doses. Also, even a non-citrus drink, like apple juice, can be enjoyed.

4. Which Vitamin Helps With Bladder Control?

Vitamin D deficiency is associated with increased urination. Therefore, getting enough vitamin D can be protective.

5. How to deal with Urinary Incontinence?

To manage urinary incontinence, regularly perform Kegel exercises to strengthen pelvic muscles and make lifestyle changes like reducing caffeine and alcohol intake. Consult a healthcare provider for personalized treatment options, including medications or surgical procedures if needed.

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