Urinary Incontinence

Overview

Urinary incontinence is a condition where the affected individual loses control over their bladder, causing urine to leak without notice. It usually affects older people and women who have just given birth or gone through menopause. The severity of this condition may vary from person to person.

In some people, urine may only occasionally leak out as they cough aggressively or sneeze. The urge to urinate may sometimes be so strong and uncontrollable that one may not be able to get to the washroom in time.

While minor tweaks in daily lifestyle can help control the condition, they may cause inevitable problems in the lives of some people, intervening in their daily activities. If the latter is the case, one must visit the doctor to have the symptoms of urinary incontinence treated.

What is Urinary Incontinence?

Urinary incontinence is a condition that results from bladder control issues leading to the unintentional leakage of urine. This may severely impact one’s social life as the urge to urinate is almost impossible to suppress. The ureters are connected to the bladder. This is where the urine is collected until ready to be released from the body.

The bladder acts as a storage tank and once it is full, the brain signals the body, reminding it that it’s time to urinate. Urine leaves the bladder as the sphincter opens up. Thus, the urine flows out of the body through the urethra. This is the usual urination process, with the bladder, kidneys, ureters, and urethra all functioning in accordance.

One also has just the right amount of time to contain the urge to urinate, find a bathroom and then head there in time. Urinary incontinence, on the other hand, causes the different parts to not work in order due to various triggers.

Types of Urinary Incontinence

People experience different types of urinary incontinence, triggered by various reasons. Here are the urinary incontinence types listed below:

Urge Incontinence

Urge incontinence refers to the condition where one needs to urinate right away. The urge is so strong that they are unable to find a toilet in time and end up leaking urine. It is triggered by a condition known as overactive bladder (OAB), caused by weak pelvic muscles, infections, nerve damage, low oestrogen levels postmenopausal or even obesity.

Stress Incontinence

If one leaks urine while being involved in daily activities or running strenuous errands, it can be caused by stress incontinence. In this situation, a person’s pelvic floor muscles become weak and cannot support the pelvic organs. This type of muscle weakness causes one to accidentally leak urine when they move about.

Overflow Incontinence

If one's bladder does not empty every time they urinate, they possibly have overflow incontinence. Due to urine not being fully drained out, there may be unintentional urine leakage as one moves about.

Mixed Incontinence

Mixed incontinence may result from the combined effects of more than one of the above-mentioned types. For example, one may be dealing with both, urge incontinence and stress incontinence.

Symptoms of Urinary incontinence

Symptoms may differ based on the type of urinary incontinence one has. The table below specifies the symptoms associated with the respective urinary incontinence categories:

Type of Urinary Incontinence	Symptoms
Urge Incontinence	Sudden and intense urge to urinate, leaking urine, urge to urinate often throughout the night
Stress Incontinence	Urine leakage upon pressure exertion on the bladder is induced by laughing, coughing, sneezing, exercising, lifting stuff, etc.
Overflow Incontinence	Frequent dribbling of urine resulting from the bladder not being completely emptied out
Functional Incontinence	Leaking of urine owing to one not being able to make it to the bathroom in time, like in the case of functional impairments triggered by arthritis
Mixed Incontinence	Refer to symptoms associated with urge incontinence and stress incontinence.

Causes of Urinary Incontinence

Urinary incontinence can be triggered by several different causes. One may have temporary or persistent urinary incontinence. Temporary urinary continence can be caused by alcohol, caffeine, chocolate, chilli peppers, sparkling water, carbonated drinks, food items high in sugar or acid, spice, citrus fruits, muscle relaxants, etc. It can also be caused by constipation or a urinary tract infection.

On the other hand, persistent urinary incontinence may be triggered by pregnancy, childbirth, menopause, the enlarged state of the prostate, increasing age, prostate cancer, an obstruction along the urinary tract, or certain neurological disorders (like a brain tumour, multiple sclerosis, Parkinson’s disease or a stroke), etc.

Urinary Incontinence Diagnosis and Tests

One should not hesitate to visit a healthcare professional if they are facing issues with bladder control. No matter how embarrassed they may feel, it’s best to consult a professional within the field. The doctor will ask the concerned person certain questions to be able to pinpoint the type of urinary incontinence they have.

Such questions will help determine whether or not the urine leak happens when one coughs or laughs, and whether one needs to use the bathroom frequently. Also, doctors can know if they face difficulty in passing urine, how much fluid, caffeine or alcohol they drink, etc.

The doctors may also suggest keeping a bladder diary, where the concerned individuals will note down how often they pass urine and drink water among other records. Tests and examinations may be necessary including a physical examination, a dipstick test, a residual urine test, a cystoscopy and urodynamic tests.

Urinary Incontinence Management and Treatment

At first, healthcare professionals shall recommend the incorporation of behavioural techniques, including bladder training and double voiding. They will then ask the concerned individuals to schedule their trips to the toilet to maintain a pattern and reduce/control the urge. Diet and fluid management will also be necessary.

Pelvic floor muscle exercises or kegel exercises should help the affected individuals have better control of the muscles controlling urination. Further, medication including anticholinergics, mirabegron, topical estrogen and alpha-blockers may be prescribed. In the case of medication failing, electrical stimulation, interventional therapies or surgeries may be required.

Preventive Measures for Urinary incontinence

Certain lifestyle tweaks can help prevent urinary incontinence. Such positive changes include switching to a healthy diet, daily exercising and maintenance of overall weight. If detected, make sure to treat UTIs and reduce risks of urinary incontinence. Finally, avoid smoking and alcoholic drinks as much as possible.

Myths and Facts Related to Urinary Incontinence

Here are some popular myths associated with urinary incontinence and the truths to prove them wrong:

Myth 1: Urinary Incontinence is a Usual Result of Aging
Fact: Even though urinary incontinence is more common in older people, it does not normally accompany old age. It may affect a person with underlying issues, including an irritable bladder system or a weak pelvic floor that may be an aftermath of childbirth or some types of pelvic surgeries.

Myth 2: Drinking Less Fluids Shall Help Get Rid of Urinary Incontinence
Fact: Drinking water can never prove to be bad for anybody, but one can try and spread out their intake of other fluids (caffeine, sugary drinks, carbonated beverages, etc.) throughout the day. For people who are affected by the constant urge to pee in the nighttime, we recommend cutting down on fluids at least 4 hours before bedtime. Large volumes of water at once also, preferably, should not be consumed.

Myth 3: Some People Leak Out on Purpose for Attention
Fact: Urinary incontinence causes people to involuntarily leak out urine. It’s not in their control. Therefore, it is not a cry for attention. Instead, they must be referred to the respective healthcare professionals to avoid future accidents of the same sort.

Myth 4: Urinary Incontinence Can Only Be Cured with Surgery
Fact: Mindful lifestyle changes can help the affected person feel better and it is the first-line intervention usually offered. If they do not seem to have the expected impact, medication may be prescribed or certain procedures may be required to be conducted. Surgery is usually the final resort if all else seems to fail.

Myth 5: Urinary Incontinence is Not a Major Issue
Urinary incontinence may greatly affect a person’s mood, making them feel ashamed about the “accidents” they cannot control. Several patients have shown signs of depression and anxiety. Their inability to participate in usual social activities also makes them feel like outcasts. So, it is, indeed, a major issue that needs to be attended to by professionals.