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About Urinary Incontinence

Urinary incontinence is a condition wherein a person is unable to control urine, thus urine leaks. Sudden urinary incontinence can be due to aging, weak pelvic floor muscles and urethral sphincters, physical and neurologic issues. Its occurrence is more to females than in males. Suffering urinary incontinence is difficult because as much as possible a person would want to stay near the restrooms especially when outdoors. This hinders a person to perform day-to-day activities without worrying that he might get embarrassed if unable to control urine.

Symptoms

Here are common symptoms of sudden urinary incontinence but appearance would depend on the type of the incontinence:

  • Urine leaks when coughing ,sneezing, jumping, and laughing
  • Intense urge to urinate even bladder is not full
  • Urine dribbling due to incomplete bladder emptying
  • Unable to reach the restroom due to physical or neurologic impairment

Types of Urinary Incontinence

Types of sudden urinary incontinence and how it affects an individual:

  • Stress Incontinence – urine leaks because of weak urethral sphincters and pelvic floor muscles. Whenever pressure is laid on the bladder such as sneezing, laughing, coughing, or bringing up bulky objects, the urine leaks.
  • Urge Incontinence – known as overactive bladder (OAB), a strong urge to urinate even the bladder is not full because the bladder contracts even though it shouldn’t. This causes a urine leak passing through the urethral sphincter that closes the bladder. Does urge incontinence go away? No, you have to speak with your urologist for proper treatment.
  • Mixed Incontinence – urge vs stress incontinence, the person suffers both urinary incontinence types at the same time.
  • Overflow Incontinence – a person cannot feel any urge to urinate even the bladder is full. Urine leak or dribbling of urine happens because the bladder is unable to empty. This usually happens to a male who has prostate enlargement that causes obstruction to the urethra.
  • Functional Incontinence – physical or neurologic impairment hinders a person to get to the comfort room in time even the bladder is functioning perfectly. Physical impairment includes arthritis, and neurologic impairment includes dementia, multiple sclerosis, and Parkinson’s disease.

Causes

  • Weak pelvic floor muscles – due to multiple vaginal deliveries, previous hysterectomy
  • Weak bladder and urethral sphincters – due to menopause, production of less estrogen; aging, a natural phenomenon wherein muscles and organs begin to deteriorate and lose its functioning.
  • Obstruction in the urethra – urinary stones, enlargement of prostate, tumors
  • Loss of bladder control – Neurological disorders such as multiple sclerosis, Parkinson’s disease, stroke, brain, and spinal cord injury

Treatment for Urinary Incontinence

  • Kegel’s exercise – strengthens pelvic floor muscles and urinary sphincter. To do this, try to contract your muscles as if you’re holding urine for 5 seconds, and relax for another 5 seconds. Do these until you can manage to contract and relax for 10 seconds each. Perform this cycle at least 3 sets of 10 repetitions.
  • Bladder training – postpone urination whenever you feel any urge; double voiding: urinate, wait for 2 minutes, then urinate again to completely empty the bladder; try to urinate on scheduled times like every 2 hours or 3 hours. All these techniques will help the person get in control of your bladder.
  • Medications
    • Anticholinergics – treats overactive bladder and has effects for urge continence
    • Mirabegron (Myrbetriq) – treats urge incontinence
    • Alpha-blockers – works for urge or overflow incontinence
    • Topical estrogen – helps restores and strengthens tissues in the urethra and vaginal areas.
  • Medical devices
    • Urethral inserts – a small device that acts as a plug to prevent urine leaks during activities.
    • Pessary – firm ring inserted into the vagina that holds up the bladder to prevent urine leaks. This is used to females who have prolapse that causes the incontinence.
  • Surgery
    • Sling procedures – use strips of body tissues or mesh that is used as a pelvic sling to the bladder neck and the urethra, keeping the urethra closed to treat stress incontinence.
    • Colposuspension – this procedure is done to prevent urine leaks by preventing pressure and compression of the bladder neck. This treats stress incontinence.
    • Artificial urinary sphincter – an artificial sphincter is implanted on the bladder neck, and when you urinate, you have to press the valve to open the artificial sphincter so urine can flow out of the bladder.
  • Absorbent pads – used to absorb urine dribbling, and are secured with undergarments.
  • Catheters – catheter inserted to the bladder and attached to a urine bag to drain urine.

Risk Factors & Complications

Risks

  • Gender – stress incontinence is more prevalent in women, females post-vaginal deliveries, post- hysterectomy females, menopause
  • Age – muscles, and organs weaken as a person ages
  • Obesity – excess fats on the body put more pressure on the bladder
  • Smoking – causing chronic cough, can result in periods of incontinence
  • Injury – brain and spinal cord injury can lose bladder control
  • Diseases – stroke, diabetes, kidney problems, neurologic problems: Parkinson’s disease and multiple sclerosis.

Complications

  • Urinary tract infections – frequent and prolonged use of catheters
  • Skin breakdown – high risk to develop rashes, sores, and infection due to wetness on the skin.
  • Prolapse – weak pelvic floor muscles can cause prolapse of vagina, bladder, and urethra.

Prevention

  • Keep a healthy weight.
  • Perform pelvic floor exercises.
  • Control consumption of alcohol and caffeinated beverages
  • Eat a healthy diet and add more fiber to meals.
  • Quit smoking

FAQs

What is Urinary Incontinence?

Urinary incontinence is the inability to control bladder resulting in urine dribbling or urine leaks.

What is The Treatment for Urinary Incontinence?

Various treatments for urinary incontinence include:
• Kegel’s exercise
• Bladder training
• anticholinergics
• Alpha-blockers
• topical estrogen
• Urethral inserts
• Pessary
• Sling procedures
• Colposuspension
• Artificial urinary sphincter
• Catheters
• Absorbent pads

When to see a doctor For Urinary Incontinence?

Consult a doctor when the incontinence becomes frequent and is already affecting your daily activities.

Is Urinary Incontinence Treatment Successful?

Yes, there is high rate of effectiveness in urinary incontinence treatment.

What are the Complications in Surgery?

• Bleeding
• Infection
• Bladder spasms
• Injury to bladder, urethra and other urinary tract organs
• Blood clots
• Vaginal prolapse
• Reactions to anesthetics

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