What is Urinary Incontinence?
Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to as their control over the urinary sphincter is either lost or weakened. The loss of bladder control is a common problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you are not able to reach to thre washroom on time. Incontinence most commonly seen in women, elderly people, and those with brain or spinal cord damage.
Symptoms:
Many people sometimes experience minor leakage of urine. Others may lose small to medium amounts of urine more frequently.
Types of urinary incontinence include:
Stress incontinence :- Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
Urge incontinence :- You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as a neurological disorder or diabetes.
Overflow incontinence :- You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
Functional incontinence :- A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
Mixed incontinence :- You experience more than one type of urinary incontinence — most often this refers to a combination of stress incontinence and urge incontinence. Many people sometimes experience minor leakage of urine. Others may lose small to medium amounts of urine more frequently.
These are the signs that you should consult a doctor:
Leaking urine during normal activities like lifting, bending, coughing, or exercising
Sudden, strong urges to urinate; feeling like you might not make it to the toilet in time
Leaking urine without feeling any warning sign or urge
Bed-wetting
Diagnosis:
A bladder diary: The person records how much they drink, when urination occurs, how much urine is produced, and the number of episodes of incontinence.
Physical exam: The doctor may examine the vagina and check the strength of the pelvic floor muscles. They may examine the rectum of a male patient, to determine whether the prostate gland is enlarged.
Urinalysis: Tests are carried out for signs of infection and abnormalities.
Blood test: This can assess kidney function.
Postvoid residual (PVR) measurement: This assesses how much urine is left in the bladder after urinating.
Pelvic ultrasound: Provides an image and may help detect any abnormalities.
Stress test: The patient will be asked to apply sudden pressure while the doctor looks out for loss of urine.
Urodynamic testing: This determines how much pressure the bladder and urinary sphincter muscle can withstand.
Cystogram: An X-ray procedure provide an image of the bladder.
Cystoscopy: A thin tube with a lens at the end is inserted into the urethra. The doctor can view any abnormalities in the urinary tract.
Causes:
Incontinence may be a temporary problem caused by a vaginal or urinary tract infection (UTI), constipation, or certain medications, or it can be a chronic condition.
The most common causes of chronic incontinence include:
Overactive bladder muscles
Weakened pelvic floor muscles
Nerve damage that affects bladder control
Interstitial cystitis (chronic bladder inflammation) or other bladder conditions
A disability or limitation that makes it difficult to get to the toilet quickly
Side effects from surgery
Obstruction
Neurological disorders such as multiple sclerosis, stroke, or Parkinson’s disease
Men: an enlarged prostate, or benign prostatic hyperplasia (BPH), prostate cancer
Women: Pregnancy, childbirth, menopause, hysterectomy
Risk Factors:
The following factors may put you at higher risk for developing Urinary incomtinence:
Being female: Women experience stress incontinence twice as often as men. Men, on the other hand, are at greater risk for urge and overflow incontinence.
Advancing age: As we get older, our bladder and urinary sphincter muscles often weaken, which may result in frequent and unexpected urges to urinate. Even though incontinence is more common in older people, it is not considered a normal part of aging.
Excess body fat: Extra body fat increases the pressure on the bladder and can lead to urine leakage during exercise or when coughing or sneezing.
Other chronic diseases: Vascular disease, kidney disease, diabetes, prostate cancer, Alzheimer's disease, multiple sclerosis, Parkinson's disease, and other conditions may increase the risk of urinary incontinence
Smoking: A chronic smoker's cough can trigger or aggravate stress incontinence by putting pressure on the urinary sphincter.
High-impact sports: While sports don't cause incontinence, running, jumping, and other activities that create sudden pressure on the bladder can lead to occasional episodes of incontinence during sports activities.
Prevention:
Urinary incontinence isn't always preventable.
However, to help decrease your risk by taking some measures like:
Maintain a healthy weight.
Practice pelvic floor exercises.
Avoid bladder irritants, such as caffeine, alcohol and acidic foods.
Eat more fiber, which can prevent constipation, a cause of urinary incontinence.
Don't smoke, or seek help to quit if you're a smoker.
Complications:
The inability to retain urine can sometimes lead to discomfort, embarrassment, and sometimes other physical problems, these include:
Skin problems: A person with urinary incontinence is more likely to have skin sores, rashes, and infections because the skin is wet or damp most of the time. This is bad for wound healing and also promotes fungal infections.
Urinary tract infections: Long-term use of a urinary catheter significantly increases the risk of infection.
Prolapse: Part of the vagina, bladder, and sometimes the urethra can fall into the entrance of the vagina. This is usually caused by weakened pelvic floor muscles.
Note: Embarrassment can cause people to withdraw socially, and this can lead to depression. Anyone who is concerned about urinary incontinence should see a doctor, as help may be available.
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