Loss of bladder control, or urinary incontinence, is an embarrassing and common problem. How severe the loss of control depends on the severity of the condition and can range from leaking urine when you sneeze or cough to having an urge to urinate that is sudden and strong and doesn't allow you to reach a toilet before urinating.
Urinary incontinence occurs more often as a person ages but is not inevitable in the elderly. If you suffer from this issue, and it is affecting your daily activities, you should call All Women's Care to find out how medical treatments can ease your discomforts and stop urinary incontinence.
Symptoms of Urinary Incontinence
For most people, urinary incontinence involves minor leaking of urine. Some lose small amounts to moderate amounts more frequently. The different type of urinary incontinence include:
When you experience an intense, sudden urge to urinate that is followed by involuntary loss of urine, you have what is termed, urge incontinence. This condition can happen throughout the night and may be caused by a minor condition, such as an infection. Urge incontinence can also be caused by diabetes or a neurological disorder. If you experience this form of incontinence, you should contact your doctor at All Women’s Care to determine the cause for your symptoms.
Mental or physical impairments can be the cause of functional incontinence and can prevent you from reaching a toilet before urinating. An example of functional incontinence would be severe arthritis that does not allow you to move fast enough to reach a bathroom and unbutton or unzip your pants before urinating.
Stress incontinence will happen when you exert pressure on your bladder. This pressure can be the result of a sneeze, cough, exercise, lifting a heavy object, or coughing.
Overflow incontinence happens when you experience constant or frequent leaking of urine because your bladder doesn't completely empty when you use the bathroom.
You have mixed incontinence if you suffer from more than one of the above incontinence.
When You Should Contact All Women’s Care
Some women find discussing incontinence with others difficult, even with their doctor. You need to discuss these symptoms with your doctor, especially if the occurrences are beginning to affect your quality of life. Your physician at All Women's Care may discover your incontinence issues are a result of a more serious health condition, and you may be facing:
- A more serious underlying condition
- You may need to restrict your social interactions or activities
- You may be a risk of falling in your rush to the toilet
What Causes Urinary Incontinence?
Urinary incontinence is not a disease; it is a symptom. The incontinence can be caused by your daily habits, be the result of an underlying medical condition, or even be a physical problem. Your doctor at All Women's Care will want to conduct a thorough evaluation to determine the specific cause for your symptoms.
When Urinary Incontinence is Temporary
There are certain medications, foods, and even drinks that can be responsible for urinary incontinence. These drugs, foods, and drinks can stimulate your bladder and increase the amount of urine your body generates. These products include:
- Sparkling water or carbonated drinks
- Chili peppers
- Large doses of Vitamin C
- Blood pressure and heart medications, as well as muscle relaxants and sedatives
- Foods high in sugar, acid, spice and citrus fruits
Temporary urinary incontinence can also be caused by treatable medical conditions, such as:
Infection in the Urinary Tract
Infections in your urinary tract can irritate your bladder and generate a strong urge to urinate and, in many cases, incontinence.
Your rectum is located near your bladder and shares a lot of the same nerves. Compacted, hard stools in your rectum can cause your nerves to become overactive and increase the frequency of urination.
When Urinary Incontinence is Persistent
Urinary incontinence can become persistent when there are underlying medical or physical issues, including:
When you deliver your baby vaginally, it can weaken the muscles used for bladder control and can also damage your supportive tissues and bladder nerves. This weakening can lead to a prolapsed or dropped pelvic floor. When the pelvic floor becomes prolapsed, the rectum, uterus, small intestine, and bladder are pushed down from their normal position. These organs can then protrude out your vagina and will result in persistent incontinence.
The increased weight of the fetus and changes in hormones can lead to stress incontinence during pregnancy.
Women who have gone through menopause will produce less estrogen. This hormone is what helps keep the lining of your bladder and urethra healthy. When the tissues deteriorate from lack of estrogen, it can aggravate incontinence.
Change in Age
When your bladder ages with the rest of your body, it can decrease its capacity to store your urine. As this condition increases, involuntary bladder contractions occur more frequently.
In men, incontinence can occur when their prostate becomes enlarged. The condition is called prostatic hyperplasia and happens when the prostate gland enlarges and causes incontinence.
In women, your uterus and bladder are supported by a lot of the same ligaments and muscles. If you’ve had a surgery that involved your reproductive system, such as removal of your uterus, it can damage your supporting pelvic floor muscles. When these muscles are damaged, it can cause incontinence.
Neurological disorders such as a brain tumor, stroke, spinal injury, multiple sclerosis, or Parkinson’s disease can interfere with your nerve signals that are involved with bladder control. When these signals are interfered with, it can cause urinary incontinence.
If you have a tumor anywhere along your urinary tract, it can block the normal flow of urine. This blockage will result in urinary incontinence. Hard, stone-like masses called urinary stones can form in your bladder, which can result in urinary incontinence.
Risks Associated with Urinary Incontinence
Some factors increase your risk of urinary incontinence:
As a person ages, their muscles in the bladder and urethra become weak. The changes in one's body as they age reduce the amount their bladder can hold and increases their chances of the involuntary release of urine.
Women are more likely than men to develop stress incontinence. Childbirth, pregnancy, menopause, and the overall anatomy of a female are responsible for the difference. Men can also develop incontinence with prostate gland problems and the increased risk of overflow and urge incontinence.
The use of tobacco increases a person’s risk of urinary incontinence.
Excess weight applies pressure to the bladder and its surrounding muscles. This pressure will weaken those muscles and allow urine to leak out when an overweight person sneezes or coughs.
Certain neurological diseases and diabetes increase a person’s risk of incontinence.
If members of your family have shown symptoms of urinary incontinence, especially urge incontinence, your chances of developing this condition are higher.
Complications Associated with Urinary Incontinence
Urinary incontinence can cause certain complications, such as:
Urinary Tract Infections
Urinary incontinence increases a person’s risk of developing recurrent urinary tract infections.
Urinary incontinence can be responsible for the development of sores, skin infections, and rashes when the skin is always wet.
Daily and Personal Life Impact
Suffering from the symptoms of urinary incontinence can seriously impact a person’s daily and social life. This condition can interfere with your work, social, and personal relationships.
Prevention of Urinary Incontinence
It is not always possible to prevent the symptoms of urinary incontinence from developing, but there are some steps to take to reduce your risks:
- Perform pelvic floor exercises to maintain muscle control
- Stay at a healthy weight
- Eating more foods that contain fiber can prevent constipation, which is a cause for incontinence
- Stay away from acidic foods, alcohol, and other irritants such as coffee
- Do not smoke
Diagnosing Urinary Incontinence
When you visit with your doctor at All Women’s Care, they will need to determine the type of urinary incontinence you’ve developed. Your symptoms will tell the doctor a lot about the form of incontinence you’re experiencing and will help them in creating a treatment plan for you. Your exam will more than likely begin with a look at your medical history and a physical exam. One maneuver used to demonstrate your incontinence is to cough for the doctor. There are also tests done to diagnosis your incontinence type:
Diary of your bladder
The doctor may ask you to record your intake of drinks for several days. This record will also include when you urinate, how much you are urinating, and whether or not you've experienced an urge to urinate. They may also want to know the number of incontinence episodes you've had.
Analysis of your urine
Analysis of your urine, or urinalysis, is a sample of your urine collected to look for signs of blood in the urine, or any signs of an infection or abnormalities.
Measurement of your post-void residue
Your doctor will ask that you urinate into a container so the amount can be measured. After you have voided all the urine you can into the container, the doctor will check your bladder using a catheter or ultrasound to see what amount remains in your bladder. If it is discovered there is a significant amount of urine remaining in your bladder, it is an indication of an obstruction in your urinary tract or a problem with your bladder muscles or nerves.
These three tests are the most common ones to perform when a person seeks medical attention for urinary incontinence. The results of these often inform the doctor of your condition and allow them to develop a treatment plan to deal with urinary incontinence. If these tests do not provide the information needed by your doctor, there are more-involved testing that can be performed, such as urodynamic testing or a pelvic ultrasound. These two tests are generally only done if it has been determined you require surgery for incontinence, or more information is needed to diagnose the cause of incontinence.
Urodynamics or urodynamic testing assesses how your bladder and urethra are functioning in terms of releasing and storing urine. This test can help your doctor understand your incontinence symptoms such as sudden or intense urges to urinate, frequent urination, or other incontinence symptoms.
The test takes about a half-hour and involves the use of a catheter to fill your bladder and measure how much it can hold. It will also measure how much is emptied and if it is a complete void or partial. The urodynamic test will show if your bladder has any involuntary contractions that can cause urine leakage.
Urodynamic testing can range from precise measurements to simple observations depending on what your doctor needs to see involving your incontinence symptoms.
Treatments for Urinary Incontinence
The type of urinary incontinence you are diagnosed with by your doctor at All Women's Care will determine the kind of treatment plan you will have. The treatment plan will also depend on the severity of your incontinence and the underlying cause of your symptoms.
There are some treatments for incontinence that are least invasive that may be tried first before you move on to other options:
Techniques to Modify Behaviors
Train your bladder
You can try training your bladder to delay urination when you get the urge to urinate. Start by trying to hold off going to the bathroom for about ten minutes when you get the urge to urinate. Your goal will be to lengthen the time between your trips to the bathroom until you are only going every two-and-half to three hours.
Voiding twice, or double voiding is to help to empty your bladder more thoroughly each time you urinate. When you go to the bathroom, you will urinate, then wait a few minutes and go again. This process will help you avoid overflow incontinence.
Diet and fluid management
Gaining control of your bladder can often be accomplished by managing your diet and intake of fluids. Cutting down on alcohol, acidic foods, and caffeine can reduce the symptoms of incontinence. Losing weight is another to decrease the incontinence as well as increasing your physical activity.
Schedule your urination
You can train your bladder to urinate by scheduling a bathroom visit every two to four hours rather than waiting for the urge to go.
Other techniques that may be suggested by your All Women’s Care physician to avoid invasive surgeries are exercises.
Muscle Exercises for Your Pelvic Floor for Urinary Incontinence
Exercises done frequently to strengthen your pelvic floor can reduce incontinence. These exercises, known as Kegel exercises, are effective for stress incontinence and can also help with urge incontinence.
Muscle exercises for your pelvic floor are done as you imagine you are trying to stop your urine flow. Tighten or contract your muscles that are used to stop urination and hold that position for about five seconds. If five seconds is too long, start with two or three seconds and build yourself up to a five-second hold. Perform this exercise ten times. Your goal will be to do ten consecutive holds of five seconds in length each day.
If you are unsure about how to perform these Kegel exercises, speak with your doctor at All Women's Care. They can help you identify the muscles to use or refer you to a physical therapist to try some biofeedback techniques.
Electrical Stimulation for Urinary Incontinence
Another less invasive treatment for urinary incontinence is electrical stimulation. With this process, electrodes are temporarily inserted into your vagina or rectum to strengthen and stimulate your pelvic floor muscles. The use of gentle electrical stimulation is effective for stress incontinence and can also help with urge incontinence. This treatment may have to be repeated multiple times over several months.
Medications for Urinary Incontinence
Other forms of treatment for urinary incontinence include medications:
Myrbetriq or Mirabegron
Myrbetriq is used to treat urge incontinence as it relaxes the bladder muscles and increases the amount of urine your bladder can store. This medication might also increase the amount of urine you are able to empty at one time, so your bladder is voided more completely each visit to the bathroom.
Anticholinergics are medicines used to calm an overactive bladder and are effective with urge incontinence. Examples of these medications are Detrol, Toviaz, Enablex, Vesicare, Sanctura, and Ditropan XL.
Estrogen (topical form)
Women can apply a low-dose form of topical estrogen in the form of a vaginal cream, patch, or ring to rejuvenate and help tone tissues in the vaginal area and urethra. It is not recommended to take the pill form of estrogen for incontinence symptoms.
Men can use alpha-blockers to deal with overflow or urge incontinence as these medications will relax muscle fibers in the prostate and bladder neck muscles. This medication will make it easier to empty the bladder. Examples of alpha-blockers include Cardura, Rapaflo, Flomax, and Uroxatral.
Medical Devices to treat Urinary Incontinence
There are also treatments for urinary incontinence that will include the use of medical devices, such as:
A pessary is a stiff ring that is inserted into your vagina and is worn all day. The pessary is generally used for women who have a prolapse that is causing the incontinence. This device will hold up your bladder and prevent urine leakage.
A urethral insert is a tampon-like, disposable device that is inserted into your urethra before you perform certain activities. You would use this device before playing tennis or other daily activity that has been resulting in incontinence. The urethral insert is a plug that will prevent leakage and is removed to allow urination.
Interventional Therapies for Urinary Incontinence
Other methods to help you find relief from urinary incontinence includes one of three interventional therapies:
Botulinum toxin type A or Botox is an injection into your bladder muscle that has been effective for people with overactive incontinence. This therapy is typically prescribed for patients only if other treatment plans have not been successful.
Injection of bulking material
The injection of a bulking material consists of a synthetic material being injected into the tissue surrounding your urethra. This synthetic, or bulking material, will help keep your urethra closed and prevent urine leakage. This procedure is not as effective as a more-invasive treatment, such as surgery for stress incontinence. Another disadvantage is that it will more than likely have to be repeated regularly.
Nerve stimulators are a device much like a pacemaker and are implanted under your skin. This device will deliver a painless, electrical pulse to your nerves which control your bladder. By stimulating these nerves (sacral nerves), you can control urge incontinence if other treatments have not been successful. The device is typically implanted under the skin on your buttock and connected to wires on your lower back, right above the pubic area, or to a special device inserted into your vagina.
Surgery for Urinary Incontinence
If your doctor has tried all other treatments for your urinary incontinence, and it is still impairing the quality of your life, surgery may be the last option for you. There are several choices of surgery for urinary incontinence, and you and your doctor at All Women's Care will discuss which option is your best.
Bladder Neck Suspension
The bladder neck suspension procedure has been designed to support your urethra and bladder neck. Your bladder neck is an area of thick muscles where your bladder connects to your urethra. The surgery will involve an abdominal incision and performed under spinal or general anesthesia.
The sling procedure for urinary incontinence involves using small pieces of your body's tissue or artificial material or mesh to build a sling around your urethra and the bladder neck. The sling will help to keep your urethra closed, especially when you sneeze or cough. The sling procedure is most effective for stress incontinence.
Artificial Urinary Sphincter
The artificial urinary sphincter is used in men and is a fluid-filled ring that is implanted around the bladder neck. This device will keep the urinary sphincter closed until the man is ready to urinate. When urinating, a valve needs to be pressed that has been implanted under the skin, so the ring deflates and allows urine to flow.
Prolapse surgery is done on women who suffer from mixed incontinence and pelvic organ prolapse. This surgery may combine a sling procedure with a prolapse surgery.
Once your doctor has diagnosed your incontinence and discovered the cause for your symptoms, they can discuss your options for treatments. Whether the treatment will be medication, changing lifestyles, exercise, or surgery, you will find the best treatment possible at All Women's Care.
Where Can I Find Help For Urinary Incontinence Near Me?
Urinary incontinence can have a severe impact on your personal and social life. Talk with your doctor at All Women's Care to find a solution and improve your quality of life. Call us today at 213-250-9461, so we can diagnose your symptoms and begin a treatment plan to ease your discomforts and get you on the road to recovery right away.