What is What is Incontinence??
Urine gets filtered in the kidney and is held in the bladder till it is full, resulting in the urge to urinate. The ability to fill and store urine in the bladder requires a properly functional sphincter muscle and bladder wall muscle.
Urinary incontinence is the unintentional passing of urine due to the loss of bladder control. It is a commonly experienced problem, affecting as many as three-six million people in the UK to some degree, and is more common in women. The severity of the condition can range from mild leaking to heavy wetting.
The loss of bladder control comes about when the muscles are too weak or overactive. There are two major types of incontinence;
Stress incontinence
When urine leaks out at times when pressure may be applied due to laughing, coughing, sneezing, weight lifting etc., due to the bladder muscles being too weak to stay closed
Urge incontinence
When urine leaks out as you feel a sudden urge to pass urine, even when there is little urine in the bladder, due to the bladder being overactive.
There are numerous factors that can cause urinary incontinence, some might result in short-term incontinence, while others might cause long-term incontinence. Treatment depends on the type and severity.
Symptoms largely vary from person to person, while some experience occasional minor leaks of urine, others wet their clothes frequently. Symptoms depend on the type of incontinence you are suffering from.
Stress incontinence
The amount of urine passed with this type is usually small, but can also cause you to pass larger amounts when your bladder is full.
Urge incontinence
You may feel the need to urinate often, even throughout the night, or during sex.
Common symptoms associated with urinary incontinence include;
- Problem with storing urine, resulting in the frequent need to go urinate, or urinate again soon after you have just been.
- Problem with passing urine, resulting in a slow stream of urine, straining to pass urine or stopping and starting as you pass urine.
- Problems after you have passed urine, resulting in the feeling that you hav not completely emptied your bladder.
Urinary incontinence occurs when the normal process of storing and passing urine is disrupted. This can happen due to a number of reasons, with certain factors further increasing your chance of developing the condition.
Certain foods, drinks and medications stimulate the bladder, increasing the volume of urine, causing temporary urinary incontinence. These include;
- Alcohol
- Caffeine
- Carbonated drinks
- Artificial sweeteners
- Foods high in spice, sugar or acid
- Large doses of vitamins
- Heart and Blood pressure medications, sedatives and muscle relaxants
- Urinary tract infection and constipation
Incontinence may be persistent for some people, usually caused by an underlying physical condition. These include;
- Pregnancy resulting in hormonal and weight changes
- Childbirth weakening bladder
- Aging decreasing bladder’s capacity
- Menopause resulting in hormonal
- Hysterectomy possibly damaging pelvic floor muscles
- Enlarged prostate causing pressure
- Prostate cancer
- Obstruction along the urinary tract
- Neurological disorders such as multiple sclerosis or Parkinson’s disease interfering with nerve signals
Certain factors increase your risk of developing the condition, including;
- Family history – genetic link to urinary incontinence
- Increasing age – as you get older, muscles in the bladder and urethra lose their strength.
- Gender – women are more likely to experience incontinence.
- Overweight – extra weight increases pressure on the bladder and surrounding muscles
Diagnosing the type and nature of urinary incontinence will allow for effective treatment decisions.
Your GP will likely ask questions about your medical history and symptoms with regards to when they occur, how frequently, if there is any difficulty in passing urine and any current medication you are on. Your doctor might also conduct a physical exam.
Further investigations might be recommended;
Urinalysis
It is done to look for white blood cells, red blood cells, bacteria and check for certain chemicals such as nitrates in the urine, which helps to diagnose any infection.
Dipstick test
A chemically treated stick is dipped into a urine sample to check for urinary tract infection. It will change colour if bacteria are present.
Post-void residual measurement
You are asked to urinate into a container measuring urine output. Doctor then checks the amount of urine leftover in the bladder using a catheter or ultrasound test. Large amount of left over urine may indicate obstruction in the urinary tract.
Treatment for urinary incontinence will depend on type of incontinence you have and the severity of its symptoms. If incontinence is found to be caused by an underlying condition, it is treated alongside as well.
We can prescribe Anticholinergics, which work to calm an overactive bladder. Medications include Detrusitol and Vesicare
