Urinary incontinence
What is it?
Urinary incontinence is defined as the inappropriate involuntary passage of urine resulting in wetting.
What are the symptoms?
Symptoms of stress incontinence involve the involuntary release of urine, especially when coughing, sneezing, or laughing. It is the most common type of urinary incontinence in women. It usually results in a small to moderate amount of urine leaked.
Symptoms of urge incontinence include the need to urinate frequently and a sudden, urgent, and uncontrollable need to urinate. It can result in a moderate to large amount of urine leaked, although it often occurs when the bladder contains only a small amount of urine.
It is common for a woman to have mixed incontinence , usually a combination of stress and urge incontinence.
Symptoms of overflow incontinence may include:
- A urine stream that starts and stops during urination
- An accidental release of a small amount of urine
- A weak urine stream
- A need to strain while urinating and a sense that the bladder is not empty
- An urgent need to urinate, often at night
- Loss of urine while asleep
Overflow incontinence is rare in women.
What causes urinary incontinence?
Urinary incontinence can be caused by many factors including:
- Physical disabilities preventing the patient from getting to the toilet in time
- Side effects of medications
- Having surgery in the pelvic area
Stress incontinence can also be caused by pregnancy, being overweight and the weakening of muscles with age.
Urge incontinence can be brought on by infections of the bladder, blockages caused by bladder stones and an irritable or unstable bladder. Patients may also suffer from incontinence as a result of loss of nerve control in neurological disorders such as multiple sclerosis.
Overflow incontinence is caused by an obstruction to complete emptying of the bladder e.g. due to enlarged prostate. Once full the bladder overflows and leaks a small amount of urine.
Treatment for urinary incontinence
Specific treatment for urinary incontinence will be determined by your doctor based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may include:
- diet modifications (e.g., eliminating caffeine in coffee, fizzy drinks, and tea, and/or eliminating alcohol)
- behavioral therapies (to help people regain control of their bladder)
- pelvic muscle rehabilitation (to improve pelvic muscle tone and prevent leakage)
- medication
- surgery
If you think you have an incontinence problem you can do something about it. It can be treated. The first step to feeling better is talking about your bladder problems. You might feel awkward at first. But you can trust your doctor or nurse. He or she is trained to help you with these types of issues.
If your doctor diagnoses you as suffering from urge incontinence, it would help in the diagnosis if you can record the frequency of symptoms.
One medical option for doctors is to prescribe an antimuscarinic drug. These medicine are all very effective; in fact NICE (National Institute of Clinical Excellence) suggests that they are all equally effective.
When talking to your doctor, make sure you ask about adverse events (side effects of the medications). All options have side effects but some are less likely to cause side effects than others.