Incontinence
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Urinary incontinence is an involuntary and uncontrollable leakage of urine. It affects millions of Americans, but few are willing to admit they have a problem with urinary leakage. Instead, many people choose to keep quiet. They may live in constant fear of having an embarrassing accident, and forgo social events and activities for this reason.
Fortunately, if you have urinary incontinence, you don’t have to let accidents or anxiety become part of your everyday life. Help is available. Talk to your doctor, because your symptoms will likely only get worse without treatment.
Urinary Incontinence Causes
Before we discuss the causes of urinary incontinence, let’s first review how the urinary system functions under normal conditions. Usually, the kidneys create urine, and the urine then flows into the bladder. As the bladder begins to fill, the bladder muscles stay relaxed. But when it’s time to urinate, the brain sends a message to the bladder. This message causes the bladder walls to tighten. At the same time, sphincters that normally prevent urine from entering the urethra (the long tube that connects to the bladder) suddenly open. These actions propel urine into the urethra and out of the body.
In cases of urinary incontinence, the process of urination doesn’t work correctly. The reason for this can differ from one type of incontinence to another. Basic causes include:
- Weak or damaged muscles around the sphincters
- Uncontrollable bladder tightening
- A blockage in the urethra
- An overly full bladder
Oftentimes, urinary incontinence in men is related to issues with the prostate. For women, a higher rate of incontinence is seen in those who have had children or undergone menopause. Additional risk factors that can contribute to incontinence in both men and women include aging, smoking, having a health condition (such as diabetes or high blood pressure), being overweight and having a family member with urinary incontinence.
Types of Urinary Incontinence
The general symptom of incontinence is involuntarily urinary leakage. But the frequency of such leakage, the amount you leak and the events surrounding each episode can vary based on the type of urinary incontinence.
It’s important to note that urinary incontinence can sometimes be a temporary problem. For instance, a urinary tract infection or constipation may result in temporary incontinence. But the more serious forms of incontinence are chronic, or long term. These can be separated into five main types.
Stress Urinary Incontinence
Usually related to weak pelvic muscles or damaged nerves, stress urinary incontinence is very common in women (though men can also experience stress urinary incontinence, typically due to nerve damage from a prostate gland removal). This type of incontinence causes leaks when you engage in physical activity. For instance, lifting, bending and walking — or even coughing, laughing and sneezing — can all lead to leaks in people with stress urinary incontinence.
Urge Incontinence
Urge incontinence occurs in people with overactive bladder (though not everyone with overactive bladder experiences urinary leaks). With this form of incontinence, you feel an uncontrollable urge to urinate and then experience a leak simultaneously or immediately thereafter. Neurological problems, diabetes or an enlarged prostate (in men) may all cause urge incontinence.
Overflow Incontinence
If you experience urinary dribbling (a constant drip of urine) or have small leaks many times throughout the day, you likely have overflow incontinence. This type of incontinence occurs when you have a full bladder but cannot empty it as you normally would — possibly due to a blockage or muscles that don’t tighten appropriately. Prostate issues may lead to this form of bladder leakage in men.
Total Incontinence
Total incontinence occurs in people whose bladders cannot store urine at all. This happens when the sphincter muscles (which prevent urine from flowing into the urethra from the bladder) are not functioning. A birth defect or injury may be the cause of total incontinence.
Mixed Incontinence
Some people suffer from more than one type of incontinence, which is called mixed incontinence. In most cases, it is stress urinary incontinence and urge incontinence that combine to form mixed incontinence. In these cases, you experience leaks when doing certain activities, and you also leak urine in conjunction with a sudden urge to go.
How Urinary Incontinence is Diagnosed
A physical exam, urine sample and explanation of your symptoms will help your doctor determine a diagnosis. Before your appointment, it might be helpful for you to keep a bladder diary. In the diary, you simply record when you urinated and when your leak(s) occurred each day. This will give your doctor a big-picture view of your symptoms. (If you believe certain activities, medicines or foods/beverages could be playing a role in your leaks, you may wish to make notes of those items in the bladder diary as well.)
Sometimes, your doctor will need additional information to form a diagnosis and determine the cause of your incontinence. Tests may be ordered to measure the speed of your urine flow, the amount of urine remaining in your bladder after you urinate and the pressure of your bladder as it begins to fill.
Urinary Incontinence Treatment
The type of urinary incontinence you have will largely dictate how your doctor decides to treat or manage it. Your doctor may choose one or more incontinence solutions — including behavioral therapy, medical interventions and/or leakage management.
Behavioral Therapy for Incontinence
Many people wonder how to cure incontinence naturally. Behavioral therapy techniques (or lifestyle changes) are natural remedies that may help you control leakage. But don’t just adopt these habits and then skip going to the doctor. Medical attention is still necessary if you’re experiencing incontinence. Your doctor will need to make sure a serious medical issue isn’t causing your symptoms. Not to mention, behavioral therapy techniques won’t work for all people or all types of incontinence, so getting your doctor’s input about these therapies is a crucial first step.
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Train your bladder.
- Different bladder voiding techniques may help you learn to control leakage. One method is to practice double voiding. After passing urine, you wait a few seconds and then try to pass urine again.
- Another voiding technique is to urinate on a set schedule. Your doctor may recommend that you use the bathroom every three hours, for instance. It is important to attempt to urinate at your set times even if you don’t always feel the urge to go.
- A third technique (which you should only try if your doctor recommends it) is deferring urination. When you feel that you need to go, you simply try to postpone urination for a few seconds or minutes. Over time, you may be able to delay urination for longer periods.
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Limit caffeine and alcohol.
- Reduce your caffeine consumption by cutting back on soda, tea and coffee. Also, don’t consume more than one drink of alcohol a day.
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Do Kegel exercises.
- Kegel exercises focus on strengthening the pelvic floor muscles. To locate the correct muscles, try to halt urination midstream. The muscles you use to do this are your pelvic floor muscles. To strengthen them, tighten and hold the muscles for a few seconds. Do this multiple times a day to improve both strength and control.
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Maintain a healthy weight.
- Excess weight can put extra pressure on the bladder. Over time, this extra pressure can cause muscle weakness — leading to urinary incontinence. Losing weight will help relieve the pressure and may enable you to regain control of your bladder.
Other Treatments for Incontinence
Along with behavioral therapy, medical interventions are another form of treatment for incontinence . Some people — particularly those with urge incontinence — may find that prescription medications can be effective in easing their symptoms. The medications aim to relax the bladder muscles so they don’t tighten involuntarily.
Botox® injections into the bladder can also help with urge incontinence. With this form of treatment, the bladder muscles are partially paralyzed, which prevents involuntary tightening.
Nerve stimulation is a third type of incontinence treatment. It can be helpful if you are experiencing leaks due to communication problems between the brain and bladder.
A fourth type of incontinence treatment is surgery, but this is used as a last resort. Surgeries can be performed to replace a portion of the bladder, or to remove the bladder entirely.
Leakage Management
If your incontinence symptoms cannot be stopped and you continue to leak urine, leakage management options will be considered.
One such option — for both men and women — is a catheter, which is a hollow, flexible tube that’s inserted into the urethra and directed up into the bladder. Urine then flows out of the body through the catheter. (Catheters can be especially helpful if you have overflow incontinence.)
Depending on your situation, you may be able to use a type of catheter that you insert yourself three or five times each day. After the urine is collected, you take out the catheter and dispose of it. But in some cases, a more permanent solution is necessary. Indwelling catheters are a type of catheter that is worn at all times. Urine travels out of the body via the catheter and is stored in a bag.
A special type of catheter for men is a condom catheter. A condom catheter is an external bladder leakage product that’s worn like a condom, but at the tip of the “condom” there is a tube for urine to pass through. The tube leads to a storage bag that is typically strapped to the thigh.
For both men and women, additional incontinence products include absorbent pads and adult diapers. Penis clamps are also available for men.
Sauk Prairie Healthcare is Here to Help
At Sauk Prairie Healthcare, we understand that urinary incontinence can be a stressful problem — and we also understand why you may be hesitant to seek help. But our Urologist specializes in incontinence and will provide a comfortable environment for you to discuss your symptoms. Your questions will be answered openly and honestly. Your condition will be explained thoroughly. And a treatment plan will be created just for you — enabling you to live life free from accidents once again.
Schedule your appointment today. Call 608-643-7262.
