What is urinary incontinence?
Urinary incontinence is the accidental release of urine. It can happen when a person coughs, laughs, sneezes or jogs. Bladder control problems are very common, especially among older adults. They usually do not cause major health problems, but they can be embarrassing. Incontinence can be a short-term problem caused by a urinary tract infection, a medicine, or constipation. It gets better when you treat the problem that is causing it.
There are two main kinds of chronic incontinence. Some have both:
Stress incontinence occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on the bladder. It is the most common type of bladder control problem in women.
Urge incontinence happens when you have a strong need to urinate but can't reach the toilet in time. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water.
Mixed incontinence is a combination of different types of bladder control problems, usually stress and urge incontinence. These problems often occur together in older women.
What causes urinary incontinence?
Chronic bladder control problems may be caused by weak muscles in the lower urinary tract, problems or damage either in the urinary tract or in the nerves that control urination.
Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles cannot support your bladder properly, the bladder drops down and pushes against the vagina. You cannot tighten the muscles that close off the urethra. So urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.
Urge incontinence is caused by an overactive bladder muscle that pushes urine out of the bladder. It may be caused by irritation of the bladder, emotional stress, or brain conditions such as Parkinson’s disease or stroke. Many times doctors don't know what causes it.
What are the symptoms?
The main symptom of urinary incontinence is the accidental release of urine. In stress incontinence, one may leak a small to medium amount of urine while coughing, sneezing, laughing, or exercising.If there is urge incontinence, one may feel a sudden urge to urinate and the need to urinate often. With this type of bladder control problem, one may leak a larger amount of urine that can soak clothes or run down the legs.
How is it treated?
Most bladder control problems can be improved or cured. Treatment for stress incontinence includes:
- Doing Kegel exercises (consist of contracting and relaxing the muscles which form part of the pelvic floor) to strengthen the pelvic floor muscles. It is one of the best ways to improve stress incontinence.
- Using a removable device called a pessary (which is placed inside the vagina). It can help reduce stress incontinence by putting pressure on the urethra.
- Medicines can be used but these may have side effects.
- Surgery to support the bladder or move it back to a normal position.
For urge incontinence, the doctor may suggest behaviour changes to fix the problem. For example, bladder training can help increase how long one can wait before urinating. Medicines can also be used to treat this. The doctor may also suggest things you can do at home, such as going to the bathroom at set times and completely emptying your bladder when you urinate. It may also help to cut back on caffeine drinks, such as coffee, tea, or sodas.
What is the prevention?
Strengthening the pelvic muscles with Kegel exercises may lower the risk for incontinence. If you smoke, quitting may help as it may make you cough less, which may help with incontinence.