Definition & Overview

Urinary incontinence, or the accidental leakage of urine, is a common and annoying problem that mostly affects the older population, although it can also happen to anybody of any age. While some people believe that it is a part of the aging process, research and studies have proven that it is not. Instead, it is a symptom of an underlying medical condition. Therefore, treating urinary incontinence means treating the underlying condition.

Urinary incontinence can happen to both men and women and not only is it annoying, it’s embarrassing as well. For some people, the only solution is to wear an adult diaper whenever they leave home.

If you’re having problems controlling your bladder, it’s best to consult your doctor to receive treatment. Depending on the extent of the problem, the treatment can be as simple as making a few lifestyle changes and/or taking medications to ease the discomfort and cure the condition all together.

Cause of Condition

Several factors contribute to the occurrence of urinary incontinence in both men and women. These include the following:

  • Blocked urethra
  • Bladder does not empty completely
  • Wrong pressure on the bladder
  • Weak or damaged muscles around the urethra

Below are the different types of urinary incontinence and their causes.

Stress incontinence coughing, sneezing, laughing, or lifting can place undue pressure on the bladder thereby causing a leak. Men who have undergone prostate removal or radiation therapy for prostate cancer are commonly affected by this condition. Women will usually experience stress incontinence after childbirth. The condition can be worsened by other factors including obesity, smoking, excessive consumption of caffeine or alcohol, hormonal deficiency, and high impact activities.

Urge incontinence is caused by the overwhelming urge to urinate. This condition can result from bladder inflammation, bladder stones, infection, bladder cancer, nerve injury, or enlarged prostate.

Overflow incontinence is when urine dribbles out constantly, which results in frequent urination of small amounts. The condition is more common in men than in women. This is typically caused by weak bladder muscles, blockages in the urethra, nerve damage, and certain medications.

Functional incontinence occurs when the person has a physical disability that prevents him or her from reaching the bathroom soon enough. These can include back pain, arthritis, multiple sclerosis, Parkinson’s disease, or dementia.

Mixed incontinence happens when there is a combination of stress and urge incontinence.

Transient incontinence is when the condition is only caused by temporary situations, such as taking new medications, an infection, cough, or cold.

Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time.

Key Symptoms

Urinary incontinence is the involuntary release of urine from the bladder. Some people may experience the condition occasionally, but for others, it’s a constant annoyance. The condition itself is a symptom of an underlying medical condition, such as prostate cancer or nerve damage.

In most cases, the biggest problem with urinary incontinence is that it is annoying and sometimes embarrassing. However, there are cases that require immediate medical attention. If you experience any of the following symptoms, it’s best that you consult your doctor.

  • Numbness and weakness in your buttocks and lower extremities
  • Fever and abdominal pain
  • Change in your bowel movement
  • Blood in urine
  • Incontinence progresses
  • Incontinence prevents you from performing daily activities

Who to See & Types of Treatment Available

The first person you should see if you’re experiencing urinary incontinence is your family doctor. Other medical professionals who can also diagnose and treat your condition include an internist, urologist, and geriatrician.

In many cases, the symptoms of urinary incontinence can be controlled using simple home treatment methods. These will include making simple changes in your lifestyle, such as reducing or stopping the intake of caffeine or carbonated drinks, limiting alcohol intake, reducing intake of food that can irritate your bladder (vinegars, dairy products, chocolate, tomatoes, etc), quitting smoking, and avoiding constipation.

You may think that it’s necessary to avoid drinking fluids. This is a common misconception and can have drastic results. You always need to be hydrated as dehydration can be fatal. At the very least, it can cause constipation.

You also need to exercise on a regular schedule. It may appear difficult to perform exercises if you frequently need to visit the toilet, but exercising builds up your muscles thereby giving you more bladder control.

If your doctor decides to prescribe medications, those will likely be needed to treat the underlying condition. For instance, if an enlarged prostate causes the incontinence, you’ll be given medications to treat a condition called benign prostatic hyperplasia.

Other types of medications that can help improve the symptoms or remove them altogether are:

  • Antispasmodic or Anticholinergic medicines – these give you more bladder control and increase the capacity of your bladder.

  • Antidepressant medications

  • Botolinum Toxin - helps the bladder muscles relax.

The final option is to perform surgery. This is only recommended in severe cases and when other forms of treatment have failed.

The most common surgical procedures to treat urinary incontinence are:

  • Artificial sphincter – involves placing an inflatable tube around the urethra, which can be inflated or deflated to control urination.

  • Bulbourethral Sling – involves placing a sling beneath the urethra and attaching it to the pubic bone or muscle tissue, which will help raise the urethra and give you more control of your bladder.

  • Sacral Nerve Stimulation – involves placing a small electronic device that will stimulate the sacral nerve.

  • Urethral Bulking – involves bulking up the urethra wall by adding certain materials. This will help you control your bladder.
    References:

  • Deng DY. Urinary incontinence in women. Med Clin North Am. 2011;95:101-109.

  • Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds.
  • Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 3.
  • Resnick NM. Incontinence. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 25.
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