Urinary Incontinence
Aug 13, 2019
Not all bladder leaks are a long term issue, but if they are…here are a few simple steps you can take, along with options available from the physicians and care team at Pelican Family Medicine.
Urinary Incontinence is more common among women than men, with an estimated 30 percent of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men.
Urinary incontinence is a common problem that affects many people, far more than you might think. According to the American Urological Association, one-quarter to one-third of men and women in the United States experience urinary incontinence.
Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened during and after pregnancy, as the results of the aging process or a health-related matter and is more common with conditions such as obesity and for those who smoke. It can also be due to stress factors, such as coughing.
While both men and women can be affected by urinary incontinence (UI), women are twice as likely to have it. This is due to reproductive health events unique to women such as pregnancy, childbirth, and menopause which can affect the bladder, urethra, and other muscles that support these organs. Age is another factor, likely due to hormonal changes during menopause. More than 40% of women 65 and older have urinary incontinence.
Also, the female urethra is shorter than the male urethra. With less muscle keeping the urine in until you are ready to urinate any weakness or damage to the organ is more likely to cause urinary incontinence.
Weak or overactive bladder muscles
Weakened pelvic floor muscles
Damage to nerves that control the bladder
Limited mobility
Pelvic organ prolapse
There are four types of incontinence.
Stress Incontinence occurs when urine leaks occur as pressure is put on the bladder during exercise, coughing, sneezing, laughing, or lifting heavy objects.
Urge Incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. This is common for those who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
Overflow Incontinence happens when small amounts of urine leak from a bladder that is always full. Diabetes and spinal cord injuries can also cause this type of incontinence.
Functional Incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet.
There are many options for treating for urinary incontinence. Choosing a specific treatment depends on the type of bladder control problem you have, how serious it is, and what best suits your lifestyle. As a general rule, begin with simple and safe treatments. This includes bladder control training to help you get better control of your bladder—including Kegel exercises, biofeedback, and timed voiding. Making lifestyle changes can also have a positive impact.
Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating. Making these muscles stronger helps you hold urine in your bladder longer. Learn more about pelvic floor exercises and how to do them.
Biofeedback uses sensors to make you aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra. Biofeedback can also be helpful when learning pelvic muscle exercises.
In timed voiding, you urinate on a set schedule, for example, every hour. You can slowly extend the time between bathroom trips. When timed voiding is combined with biofeedback and pelvic muscle exercises, you may find it easier to control urge and overflow incontinence.
Losing weight, quitting smoking, saying “no” to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation and avoiding lifting heavy objects may help with incontinence. Choosing water instead of other drinks and limiting drinks before bedtime may also help.
Besides bladder control training, there are other ways to help manage incontinence. After treatment, some people may still leak urine from time to time. For this reason, there are bladder control products and other solutions available, including adult diapers, furniture pads, urine deodorizing pills, and special skin cleansers that may make leaking urine less bothersome.
Medicines can help the bladder empty more fully during urination and other drugs can tighten muscles, lessening leakage.
Some women find that using an estrogen vaginal cream may help relieve stress or urge incontinence. A low dose of estrogen cream is applied directly to the vaginal walls and urethral tissue.
Using bulking agents can augment the urethral wall and increase urethral resistance to urinary flow. It is a minimally invasive method of correcting urinary incontinence, but is being performed less frequently in current practice.
Some women may be able to use a medical device, such as a urethral insert, a small disposable device inserted into the urethra. A pessary, a stiff ring inserted into the vagina, may help prevent leaking if you have a prolapsed bladder or vagina.
Nerve stimulation, which sends mild electric current to the nerves around the bladder that help control urination, may be another option.
Surgery can sometimes improve or cure incontinence if it’s caused by a change in the position of the bladder or blockage due to an enlarged prostate.