Many individuals suffer from urinary incontinence and often refuse to discuss this with their doctor out of embarrassment. There are several treatment options now available for this disorder, but patients must be encouraged to discuss their signs and symptoms if they are to get the best treatment.
What is urinary incontinence?
Urinary incontinence (UI) is loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age. Women experience urinary incontinence twice as often as men. Most bladder control problems happen when muscles are too weak or too active.
Types of urinary incontinence?
There are three main types of urinary incontinence, namely, urge incontinence, stress incontinence and mixed incontinence. Symptoms and signs will vary depending on the type of incontinence and treatment is also different.
Urge Incontinence
Urge incontinence can be defined as detrusor instability or a dysfunction of the muscles of the bladder that may be due to neuronal dysregulation, bladder irritants or infections. Urge incontinence is what most individuals see on the TV commercials. Urge to go to the bathroom multiple times a day and before you get there you may leak. This can also occur at night where you wake up and find yourself a little wet. Typically this type of incontinence is treated with bladder retraining, biofeedback and Kegel’s exercises.
Stress Incontinence
Stress incontinence can be defined as the involuntary loss of urine with laughing, sneezing, coughing, running, jumping etc. Any type of stress that leads to leakage is stress incontinence. This type of disorder has been amenable to pelvic rehabilitation but in some cases requires surgery.
Mixed Incontinence
Mixed incontinence, as the name implies, is a combination of the two mentioned above and as many can discern may require treatment that incorporates the two treatment modalities mentioned.
Symptoms of urinary incontinence
The main symptom of urinary incontinence is a problem controlling urination.
Symptoms of stress incontinence include the following:
o Involuntary release of urine, especially when you cough, sneeze, or laugh
o Leaking a small to moderate amount of urine
Symptoms of urge incontinence including the following:
o Frequent and sudden uncontrollable need to urinate
o May leak a moderate to large amount of urine, although a small amount is possible
Bladder irritants
A wide variety of things can irritate the bladder and also cause urinary incontinence. These substances can irritate the lining of the bladder causing detrusor or bladder muscle irritably and urge incontinence. Some of the common culprits are below:
• Caffeine
• Alcohol
• Acidic fruits and fruit juices from oranges, grapefruits, lemons and limes
• Spicy foods
• Tomato-based products
• Carbonated drinks
• Artificial sweeteners
Diagnosis
A careful history and physical is needed for all individuals with urinary incontinence symptoms. Your doctor might ask you to do a number of test and investigations to confirm the diagnosis. In some cases detailed urodynamic tests are required to make the diagnosis. Urodynamic tests are a series of measurements that takes bladder pressures, abdominal pressures, bladder wall pressures, and urethral pressures to determine where the problem area is.
Treatment
Treatment will vary from one individual to the other and the type of incontinence. To improve or eliminate urinary incontinence, you can make lifestyle changes and get treatment depending on which type you have. If you use any bladder irritants you should try to decrease or eliminate them as much as possible.
For stress incontinence, treatment options include:
• Pelvic floor exercises. If you have had a baby, chances are you have been told to do Kegel exercises. These help to strengthen the pelvic floor after childbirth. It is wise to keep doing the Kegels to keep your pelvic muscles and tissues strong, which can help prevent stress incontinence. To do Kegels:
1. Pretend you are trying to stop the flow of urine.
2. Hold the squeeze for 10 seconds, then rest for 10 seconds.
3. Do 3 or 4 sets daily.
Biofeedback training can also be used for treating incontinence. Surgery is also an option for treatment.
For urge incontinence, treatment options include:
• Timed voiding and bladder training. You can also “retrain” your bladder, gradually increasing the time between bathroom visits. Kegel exercises are also helpful.
• Medications, electrical stimulation, or surgery. Doctors sometimes prescribe medicines designed to inhibit the contractions of an overactive bladder. Electrical stimulation of the bladder nerves helps in some cases. Surgery is reserved for severe cases. It aims to increase the storage capacity of the bladder.
Conclusion
Many individuals suffer unnecessary from the symptoms of urinary incontinence. It is no secret that all types of urinary incontinence can be embarrassing to talk about, but overcoming your reluctance is worth it. Treatment can reduce or eliminate the problem. If you have signs and symptoms of urinary just mention them to your doctor during your next visit. Once the diagnosis is made, treatment can be instituted and you can go on and enjoy living in comfort without urinary symptoms.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB, BS, DGO, MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
