Urinary incontinence describes the involuntary loss of urine. It is a condition much more common in women than men and its incidence increases with advancing age.
Types of urinary incontinence
There are 3 main types of urinary incontinence:
1. Stress Urinary Incontinence
This condition is caused by damage to the connective tissue supporting the urethra allowing small amounts of urine to leak when stress is placed on the bladder. This is the leakage that happens with coughing, laughing, sneezing, jumping and running. It is usually the result of vaginal deliveries. Treatment involves an outpatient surgery called a suburethral sling. The sling is a small, thin ribbon of plastic that acts as a hammock to support the urethra during stress.
2. Urge Incontinence
This condition is caused by overactive dyschronous nerves in the bladder wall triggering involuntary muscle contractions with resultant frequency and leakage. This problem increases in incidence with advancing age. The leakage can be large in amounts with the inability to stop it once it starts. Multiple voiding episodes at night is a common complaint. There are multiple treatment options that typically follow a step-by-step process. Treatments may include fluid restrictions, timed voiding, mediation, pelvic floor biofeedback, neuromodulation, or Botox.
3. Overflow Incontinence
This is caused by incomplete bladder emptying with subsequent leakage. This leakage occurs with no sense of urgency. This can occur during sleep and may be associated with hesitancy and difficulty initiating a stream. This leakage is common in patients with diabetes or multiple sclerosis. It is also a problem of men with prostate hypertrophy. Medicines to enhance bladder contraction and better emptying are useful as in prostate resection.
Incontinence of all types increases in incidence with advancing age. In fact, many patients have more than one type of incontinence. Other common diseases tend to aggravate incontinence. In particular, weight gain, obesity, diabetes and smoking tend to aggravate incontinence. Treatment depends on making the correct diagnosis.
Causes of urinary incontinence
There are several causes of urinary incontinence, including:
Age-related muscle weakness
As mentioned above, age usually causes the muscles supporting the bladder to become weaker, which increases the risk of urinary incontinence.
To counter this process, you can start by practicing healthy lifestyle habits, including eating a healthy diet, maintaining an appropriate level of hydration, and exercising regularly.
Physical damage to the pelvic floor muscle (typically after trauma)
When the muscles of the pelvic floor get injured, the muscles and nerves can get damaged, disrupting the process of urination.
Pelvic floor injury can also occur after surgeries, such as a hysterectomy.
Note that pregnancy and childbirth may also lead to the looseness of the bladder muscles.
Urinary tract infections (UTIs)
Urinary tract infections are a classic cause of urinary urgency and incontinence. Fortunately, most cases are reversible after the treatment of the infection.
Interstitial cystitis is a chronic condition that affects the bladder and causes inflammation.
Learn more about this condition by clicking on this link.
The treatments of urinary incontinence
The treatment of urinary incontinence depends on the type and severity.
However, the following treatments may be appropriate: