What is Urinary Incontinence?
Urinary incontinence is the involuntary passing of urine, ranging from mild or severe. Although increasingly common, many sufferers of urinary incontinence feel embarrassed and uncomfortable when they experience an episode. About a third of people over age 60 are estimated to be incontinent, and it is not uncommon at earlier stages of development. Primarily due to physiological differences, urinary incontinence occurs roughly twice as often in women than in men.
There are four primary forms of urinary incontinence:
- Urge incontinence (also called reflex incontinence or overactive bladder) is when your bladder muscles suddenly contract and you feel a sudden need to urinate. You might not get to the bathroom in time, and you get up often during the night to urinate.
- Stress incontinence is when you leak when laughing, sneezing, exercising, or coughing; it is more common in women.
- Overflow incontinence is when you have a constant trickle of urine because your bladder does not empty itself completely; it is more common in men.
- Functional incontinence, when something else like a health issue or physical disability prevents you from getting to the restroom in time. There can be more than one cause behind your incontinence.
Can Anything Be Done?
There are a variety of treatments available; they vary depending on the cause of your incontinence, the severity of the symptoms, and your overall health. Often some simple changes in behavior can decrease incontinence. About 80% of people who are living with urinary incontinence have symptoms improve, or may even be cured.
Talk to Your Doctor
You should go to see a doctor if you suffer from incontinence. It may be treatable, and it could also be a symptom of another serious health issue. When you see your doctor, they will look over your medical history, exploring symptoms and looking for things that may be related to your issue. This will likely lead to a physical examination, which will focus on finding medical conditions that may be related to your incontinence. Your doctor may order tests like a measurement of bladder capacity, a stress test, blood tests or urinalysis, or even an ultrasound or cystoscopy of the bladder. Additionally, you may also be asked to keep a journal recording incidences. From here your doctor will guide you through treatments and interventions.
To start, there are many different skills and habits you can learn which will assist with your bladder control. Bladder training – practicing holding your urine for progressively longer periods of time – is used to aid those with urge incontinence. You may also choose to keep a written record of your bathroom trips to help recognize patterns, and then use that to plan ahead. Some doctors may suggest you urinate following a schedule; instead of waiting for an urge, simply go at intervals of 2-4 hours. Double voiding can help overflow incontinence. To help empty your bladder more completely, double voiding involves waiting a few minutes after urinating before trying again. Biofeedback may help you notice what is occurring with your pelvic muscles, and can teach you how to to control them.
You might be told to try to modify diet or fluid intake; some foods and drinks can cause bladder irritation. Nicotine, for example, is a bladder irritant; heavy smokers are more likely to have stress incontinence. If you are a woman with stress incontinence, you might be told to exercise the muscles in your pelvic floor using Kegel exercises. Incontinence can be affected by body weight and fitness level as well. If this is the case, your doctor may suggest losing weight and exercising.
Vitamins, Herbs, Alternative Medicine
There are some alternative remedies that have been used to help incontinence. However, always consult to your doctor before trying them, as they may interfere with any prescribed medications. Magnesium supplements may help with overactive bladder and can potentially aid with nighttime bathroom trips. Additionally, having enough Vitamin D in your system may be linked to decreased chances of pelvic floor disorders.
Short-leaf buchu, brewed into a tea, has been used to relieve incontinence. A plant called cleavers can be used for a comparable effect. Gosha-jinki-gan, a Chinese traditional medicine, has historically been used to treat urinary incontinence. And although findings are mixed, acupuncture could potentially relieve urinary incontinence, if only temporarily.
For those looking for a clinical solution, there are some medications that may help with urinary incontinence. However, be mindful that any prescribed medication is meant to be used in tandem with bladder control exercises. Drugs called anticholinergics can help with overactive bladder, and may help with urge incontinence. Alpha blockers can be helpful for men with urge or overflow incontinence. Some antidepressants also assist with bladder control, but shouldn’t be taken by patients who do not suffer from depression.
Among some of the treatments designed to combat incontinence you’ll find medical devices and inserts. A urethral insert is a small plug inserted into the urethra. It’s designed to block the flow of urine and can be removed when you are ready to urinate. Similarly, a pessary shaped like a ring can be inserted into the vagina to help hold up the bladder. This is helpful if you have a prolapsed bladder or uterus, both of which can occur from childbirth. For urge incontinence, your doctor may suggest implanting a nerve stimulator so that mild electrical impulses will stimulate the nerves relating to bladder control.
There are some procedures that involve inserting or injecting compounds into the body to help control leaks at the source. In cases of stress incontinence, one such procedure involves injecting bulking material around the urethra to narrow it. This can wear down however, and needs to be repeated regularly. Your doctor may suggest Botox injections into the bladder muscle to relax it; this is used in cases of overactive bladder only if other treatments have not worked.
In severe cases of incontinence, there are several kinds of surgeries that may be offered to you. In a sling procedure, used for stress incontinence, a sling is created around your urethra and bladder neck (where the urethra connects to the bladder) to help hold the urethra closed. A bladder suspension specifically works to support your bladder neck and reduce leakage. In women who have prolapsed pelvic organs, a prolapse surgery can help alleviate any symptoms incontinence. Men who have had prostate issues can have an artificial urinary sphincter made from a ring implanted around the bladder neck. This ring is designed to keep the urethra closed until you push a valve to open it, thus allow urination.
Living with the Effects of Incontinence
While you are exploring treatments, or if incontinence persists after treatment, there are other ways to manage the effects of urinary incontinence. Wearing absorbent liners and pads inside your clothes is one option. Similarly, absorbent underwear is available for more severe cases of incontinence.
You may want to put an absorbent pad on your bed as well if nighttime incontinence is an issue. If getting up often during the night is problematic, make sure you have a clear and easy path to the bathroom. Alternatively, if you have functional incontinence, you might want to have a bedpan or bedside commode.
Living with incontinence, you will need to take extra care to avoid rashes and skin irritation. Use a clean cloth to wash yourself, let your skin air dry, and use a cream, like cocoa butter or petroleum jelly, to protect your skin from urine. Talk to your doctor if you get a serious rash or if you have any other concerns.