Urinary Incontinence

Urinary Incontinence General Information

Urinary incontinence is an involuntary leakage of urine. This condition is very common, and is perhaps one of the most unpleasant and distressing problem which may affect a patient. It may have severe psychological consequences and may have a profound impact on the patient’s and their family’s life. Incontinence typically appears in elderly patients. It is also present in nightly episodes in small children (the so-called “wetting the bed”). It is caused by a disruption in the control of the bladder muscles or in the balance between the bladder pressure and urethral pressure, causing the urine to leak from the bladder. This disruption may occur as a passing episode or as a constant situation, and it can be caused by several factors, either medical conditions or injuries that damage the pelvic floor muscle or the nervous connections between the bladder nerves and the brain.

This condition comes most of the time as a consequence of another medical cause. If you begin experiencing Urinary Incontinence and you have not been warned that it may be a consequence of any medical condition you already have or of any treatment that you are currently undergoing, it is highly advised that you contact your personal health care specialist in order to further investigate and discover any affection that is affecting you.

Urinary Incontinence Symptoms

There are several types of Urinary incontinence which may affect a person. Stress incontinence is caused by a weakness of the pelvic floor muscle, and consists in a leak of urine in small amounts when coughing, sneezing, laughing and exercising, or any other activities that increase pressure in the abdomen. In women, it may be caused by physical changes resulting from pregnancy, childbirth, and menopause. In men the most common form of incontinence is encountered after a prostatectomy.

Urge incontinence appears as a loss of urine resulting from a sudden need to urinate. It is caused by inappropriate and involuntary contractions of the detrusor muscle. Urine leaks will often be experienced while sleeping, after drinking, or when touching water or hearing it run. Involuntary bladder muscles contractions can occur as a result of damage to the bladder nerves, to the central nervous system or directly to the muscles.

Another type of incontinence is the functional Urinary Incontinence, and it occurs when the patient does not recognize the basic need to urinate, does not remember where the toilet is, or does not manage to get to the toilet in time. In such cases the urine volume leaked may be large. This type of incontinence is typically caused by confusion, dementia, eyesight or mobility disorders, depression, anxiety or anger. Situations in which you are unable to reach a toilet may also result in incontinence.

Urinary Incontinence may also appear as overflow incontinence. This is manifested by the bladder constantly dribbling, or continuing to leak after the patient has urinated. It occurs when the patient's bladder is always full resulting in a frequently leak of urine, and it is generally caused by weak bladder muscles failing to completely empty the bladder, or by a blocked urethra. Also several medical conditions can block or affect the neural signals from the bladder or the urine expulsion by the detrusor muscle.

Urinary Incontinence Treatment

Commonly, your personal health care specialist will recommend a number of self-care practices or changes in the lifestyle for treating the Urinary Incontinence, which have been proven to be very effective and should be used regularly in combination with therapy for the medical conditions that are causing the affection. Losing weight, quitting smoking and limiting the general quantity of liquids that you consume every day are just a few of them. The doctor may give you a list of foods and ingredients that are or contain bladder irritants and which you should avoid. You may also be required to incorporate a number of exercises such as bladder retraining and pelvic floor muscle exercises in your daily routine in order to prevent urinary incontinence. Also, biofeedback and electrical stimulation of the pelvic muscles are practices that also help in this situation.

Medication therapy can also be employed for reducing Urinary Incontinence. They may act by inhibiting the contractions in the case of an overactive bladder, by relaxing the bladder muscles, which leads to a more complete emptying of the bladder during urination, or by tightening the muscles around the bladder’s neck and around the urethra, preventing leakage. It has also been suggested that some hormones (estrogen in particular) cause the muscles involved in urination to correct their function in cases of Urinary Incontinence.

A few examples of drugs that may be administered in order to correct the Urinary Incontinence are: tolterodine (Detrol), oxybutynin, trospium, imipramine, solifenacin (Vesicare), propantheline, pseudoephedrine or duloxetine (Cymbalta), but the prescribing doctor may recommend other drugs that are not in this list. In order to find out more regarding the effect, the side effects and risks of the medication that you have been prescribed, it is advised that you ask your prescribing doctor. In the case of medication, it is highly advised that you closely follow the dosage that is prescribed and do not in any way modify the doses, either by changing the intake schedule or by taking reduced or increased doses of the medicine. While smaller doses will have a reduced effect in treating the condition, higher doses present the risk of overdose, possibly with lethal consequences.

Pessaries may also be used to reduce the leaking. They compress the urethra against the opposite bone and elevate the bladder neck. However, using these may lead to a higher risk of vaginal and urinary tract infections, so it is recommended that your specialist health care provider monitors evolution of the situation. In extreme cases, where none of the treatments have had any positive results, surgery is employed in order to correct the Urinary Incontinence. There are many surgical procedures that have a very high chance of success, including catheterization, incorporation of an artificial sphincter or bladder repositioning.