Urinary Incontinence

Urinary incontinence is an involuntary loss of urine this happens when one loses control of the bladder. It involves leakage of few drops to a full accident. According to studies, Urinary incontinence is common among women above the age of 50. However, it is not considered as normal part of aging. Many women refrain from seeking medical help due to the social stigma around it. But Urinary incontinence can be treated medically.

Urinary incontinence is not a disease by itself; however, it may be a cause of an underlying disease. Symptoms of UI depend on its type.

Stress incontinence: Leakage of urine due to pressure exerted on the bladder while doing daily activities such as sneezing, coughing, laughing, lifting heavy objects, or exercising.

Urge incontinence: Losing control of the bladder with a sudden urge to urinate followed by involuntary leakage or loss of urine. This is also known as an overactive bladder. 

Mixed incontinence: In this condition, one experiences stress and urge incontinence together. This type is most common in women.

Overflow incontinence: When someone is not able to empty the bladder completely, urine may leak when the bladder is full. This condition is called overflow incontinence.

Functional incontinence: This type of incontinence does not always involve dysfunction of the bladder. This happens when a person is not able to get to the bathroom in time due to mobility limitations.  

Urinary incontinence is caused by dysfunction in the pelvic floor muscles or nerves that control the passage of the urine.  The condition may be temporary or chronic depending on its cause. Few common causes of UI are: 

Overweight: Excess body fat exerts pressure on the bladder which can weaken the muscles over time. Due to which the bladder is not able to hold as much urine.

Advancing age: Muscles and nerves supporting the bladder tend to weaken with age which increases the risk of UI. Even though UI is common in older women it is not a normal part of aging. One should get it treated.

Urinary tract infection: Bladder irritation or inflammation caused by infections may lead to UI. However, this is for short period. Bladder control resumes once the infection is treated.

Muscle damage: Muscles supporting the bladder may get damaged due to certain surgical procedures like Hysterectomy.

Constipation: People who have long-term chronic constipation often face bladder control issues. Strain exerted on the bowel muscles can pressurize the bladder and pelvic floor muscles leading to UI.

Medical conditions: Medical conditions like diabetes, kidney diseases, Parkinson’s diseases, and anxiety can also trigger UI in some people.

Other factors resulting in UI are smoking, family history, pregnancy, childbirth, menopause, excessive consumption of alcohol, caffeine, etc. 

Get in touch with your doctor if you experience:

Pregnant women often face UI problems. When the weight of the baby grows, it exerts pressure on the bladder, the pelvic floor muscles and the urethra. This pressure weakens these muscles causing UI. 

Nerves controlling the bladder are usually damaged during procedures of childbirth. Pressure exerted during vaginal childbirth to push the child can cause the bladder, uterus, rectum to slide down from their normal positions. These physical traumas often cause UI.

Mostly bladder problems are solved after childbirth. If these problems persist post childbirth then one should seek medical help.

After menopause production of a hormone called estrogen declines. This leads in distortion of the lining of the uterus. Estrogen is responsible for keeping urethra, bladder and the pelvic muscles healthy. Drop in estrogen levels can trigger UI.

Treatment plans are tailored on the basis diagnosis of the symptoms and medical history. The doctor may require bladder dairy having information liquid intake, no. of times bladder is emptied, amount to urine leakage, medicines consumed, etc. Other ways of diagnoses include urine and blood test, ultra sound, bladder stress test, etc. 

UI can be treated medically with the help of medicines that calm the overactive bladder, applying vaginal cream, ring or patch containing low dose of estrogen; with the help of surgeries like sling procedures, prolapse surgery, bladder neck suspension, etc. Certain medical devices like urethral insert and pessary are designed to help in the treatment of UI. Alternative therapies like bladder habit training, pelvic floor muscles exercises also help in treating UI.

UI can be prevented and managed well by certain lifestyle changes like quitting smoking, quitting consumption of alcohol, cutting back on carbonated drinks, tea, coffee, spicy and acidic foods, drinking plenty of water and maintaining healthy body weight.