Urinary Incontinence is involuntary or unintentional passing of urine. Even though it is quite common, it is often neglected due to social stigma attached to it. In India, about 15% of adults suffer from an overactive bladder. The severity of urinary incontinence ranges from occasionally leaking to not being able to control passing of urine before reaching a toilet.
Women are more likely to have an overactive bladder owing to conditions that stretch and weaken the pelvic floor muscles. Some of these conditions are – pregnancy, childbirth, chronic cough, obesity, and smoking. Women who’ve had multiple pregnancies are at a greater risk of having an overactive bladder.
Those who have suffered a spinal injury or have congenital spinal abnormalities can also be victims of urinary incontinence. If not treated early, urinary incontinence may affect the kidneys.
Types and Causes of Urinary Incontinence
There are four major types of urinary incontinences:
Urge to pass urine when bladder is under pressure while indulging in simple activities such as coughing, laughing, sneezing, or exercising. Stress incontinence is generally caused due to weak pelvic floor muscles.
If you often experience frequent dribbling of urine, and your bladder does not empty completely, you may have overflow incontinence. Some reasons behind overflow incontinence are – weak bladder muscles, tumours, enlarged prostate, constipation, nerve damage, and certain medications.
If you have urge incontinence or Overactive Bladder (OAB), you might feel the need to pass urine and may not be able to hold it till you reach the bathroom. Urge incontinence is a result of damage to the bladder’s nerves, muscles, and other parts of the nervous system. Several conditions like – Parkinson’s, Multiple Sclerosis, Diabetes, and stroke can therefore result in urge incontinence as a result of affecting the nervous system.
Immobility or loss of mental faculty could be a reason for a person not being able to reach toilet in time. Arthritis and Dementia, for example, may affect the abilities, in this regard.
More than one type of urinary incontinence is known as mixed incontinence. Pregnant women often experience both urge and stress incontinence.
Other Causes of Urinary Incontinence
- Urinary Tract Infections (UTIs): Infections in urinary bladder may result in strong urges and at times, incontinence.
- Constipation: Constipation affects the nerves that run common between rectum and bladder, causing them to be overactive and therefore, increasing urine frequency.
- Diet: Certain elements in our diet may act as diuretics resulting in increased urine frequency. Some of these elements are – alcohol, caffeine, chocolate, artificial sweeteners, carbonated drinks, and food items high in sugar, spice, and acid.
- Age: Involuntary bladder contractions become frequent as one gets older.
- Menopause: With a decrease in production of oestrogen during menopause, the lining of the bladder and urethra deteriorates which could lead to incontinence.
- Hysterectomy: Hysterectomy or removal of the uterus can damage the pelvic floor muscles, thereby aggravating urinary incontinence.
- Obstruction: Any obstruction along the urinary tract can lead to overflow incontinence. Tumours, urinary stones, etc. could act as an obstruction, leading to incontinence.
Diagnosing Urinary Incontinence
Urinary Incontinence is nothing to be ashamed of and it is important that you confide in your doctor for a faster diagnosis and appropriate treatment. Your doctor may appropriate diagnostic measures based on your symptoms and a thorough investigation. For women, pelvic examination and for men, rectal examination are a norm for diagnosing urinary incontinence.
Treating Urinary Incontinence
Initially, your physicians may suggest some simple steps to ascertain if the conditions could be improved like:
- Lifestyle changes: Losing weight, avoiding caffeine, alcohol, carbonated drinks, and spicy food. Include fibrous food in your diet to minimize constipation.
- Pelvic Floor Exercises & Bladder Training: Kegel exercises are hugely effective for controlling stress and urge incontinence by strengthening pelvic floor muscles. Bladder training (controlling the urge to urinate and delaying the urge as much as possible) is also helpful for urge incontinence.
- Devices and Absorbent Products: Panty liners, protective pads, and catheters are a few devices that help prevent awkward situations for those with urinary incontinence.
- Medication: Drugs such as – Anticholinergics, Mirabegron, Alpha Blockers, and Opical Estrogen (in the form of cream, ring or patch) may be useful, but to be taken only in consultation with a physician.
- Surgery: – Sometime doctors recommend some surgical interventions like - sling procedures, bladder neck suspension, artificial urinary sphincter, and prolapse surgery.
One of the most important ways that family members can help is – gently nudging the suffering member to use the toilet at frequent intervals.