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Urinary Incontinence: Causes, Symptoms, Risk Factors, Treatment, and Prevention.

What is Urinary Incontinence?

Urinary incontinence refers to a condition, in which the person loses control over the bladder and passes out urine involuntarily. It is one of the most common problems in the aged people, which causes discomfort in performing daily activities. It occurs when the control over the urinary sphincter is reduced or lost completely.

Urinary incontinence occurs due to the involuntary contraction of the bladder muscle, thereby resulting in immediate urinary urgency. The unintentional loss of urine can occur due to various conditions, such as weak bladder muscles, damage to the nerves that control the functions of the bladder, and certain other medical conditions.

Urinary incontinence

The different types of urinary incontinence include:

  1. Urge incontinence: Urge incontinence occurs due to an overactive bladder, which results from underlying conditions, such as infection, neurological disorder, or diabetes.
  2. Stress incontinence: It occurs due to the pressure exerted on the bladder by coughing, sneezing, lifting heavy weights, laughing, and by performing physical exercises.
  3. Overflow incontinence: Dribbling of the urine may occur, due to the inability to empty the bladder completely.
  4. Functional incontinence: It happens due to a serious underlying physical or mental health condition that decreases the ability of bladder control.
  5. Reflex incontinence: Reflex incontinence occurs when there is a serious underlying neurological disorder, such as spinal cord injury or multiple sclerosis.
  6. Mixed incontinence:Mixed incontinence occurs when there are symptoms of more than one type of urinary incontinence.

What are the Causes of Urinary Incontinence?

Urinary incontinence may occur due to physical problems and various underlying medical conditions. It occurs when the muscles of the bladder become too weak to hold back the urine.

Temporary Urinary Incontinence:

Temporary urinary incontinence occurs when certain food and medications trigger the bladder to produce more amount of urine and increase the urge to urinate.

  • Certain foods, such as chili peppers, spicy foods, citrus fruits, artificial sweeteners, carbonated drinks, chocolates, and caffeinated drinks can cause temporary urinary incontinence.
  • Urinary tract infections can irritate the bladder and increase the urge to urinate.
  • Hard stools in the rectum (constipation) can cause the nerves associated with the bladder to increase the urine urgency.
  • Certain blood pressure medications, muscle relaxants, and sedatives can result in urinary incontinence.

Persistent Urinary Incontinence:

Persistent urinary incontinence occurs due to the physical changes that occur in the body. They include:

  • Age: Aging decreases the bladder capacity to retain urine for a more extended period. The bladder contractions often increase with the process of aging.
  • Pregnancy: Pregnancy imparts pressure on the bladder muscles, which can result in stress incontinence. Also, hormonal changes that occur during pregnancy can bring changes in the bladder’s ability to hold urine.
  • Childbirth: Vaginal delivery weakens the bladder muscles and decreases the bladder control. Sometimes, it can cause damage to the supportive tissue and bladder nerves, which may lead to urinary incontinence.
  • Neurological disorders: Certain neurological disorders, such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, a brain tumor, or a stroke can interfere with the nerve signals that control the bladder muscles.
  • Tumor: A tumor that presses against the bladder can increase pressure on the pelvic floor muscles and can result in incontinence.
  • Prostate problems: An enlarged prostate or an untreated prostate cancer often causes urinary incontinence.
  • Menopause: A consistent drop in the estrogen levels deteriorates the tissue that line the bladder, thereby aggravating urinary incontinence.
  • Hysterectomy: Any surgery that involves the female reproductive organs or removal of the uterus can cause damage to the pelvic floor muscles and can cause incontinence.

Symptoms of Urinary Incontinence:

The signs and symptoms vary based on the type of urinary incontinence, which include:

  • Constant dripping of urine
  • Urge to urinate during sex
  • Leakage of urine after a cough or a sneeze
  • Incomplete emptying of the bladder
  • Sudden contraction of the bladder muscles
  • Frequent urge to urinate
  • Trouble in stopping the urine stream

Risk Factors of Urinary Incontinence:

The following are the individuals who are at an increased risk for developing urinary incontinence:

  • Women are prone to the risk of stress incontinence due to various underlying causes, such as pregnancy, childbirth, and menopause
  • Men who are suffering from the problems associated with the prostate gland are at an increased risk of overflow incontinence
  • Individuals who are obese are prone to the risk of developing urinary incontinence
  • People with a close family history of urinary incontinence are at a higher risk of developing the condition
  • Peoplesuffering from diabetes mellitus are at a higher risk of developing urge incontinence
  • Tobacco smoking can aggravate the risk for stress incontinence
  • People participating in high sports that involve running, jumping, and tremendous physical activity can be prone to occasional episodes of urinary incontinence

Complications of Urinary Incontinence:

An untreated or chronic urinary incontinence can lead to complications, such as:

  • Skin infections, rashes, and sores
  • Recurring urinary tract infections
  • Renal impairment
  • Emotional distress

Diagnosis of Urinary Incontinence:

To diagnose, urinary incontinence, the doctor will review the symptoms and medical history of the patient. Based on the information provided, the doctor will recommend the following tests to demonstrate urinary incontinence.

  • Urinalysis: A sample of the urine is collected and tested for the signs of infection, traces of blood in urine, and other abnormalities.
  • Bladder diary: The doctor will ask to maintain a bladder diary, in which he will ask to make a note of the amount of water consumed and the number of incontinence episodes.
  • Postvoid residual (PVR) measurement: During this test, the doctor will ask to empty the bladder completely and uses a device to measure the amount of urine left over.
  • Urodynamic test: The test helps to measure the pressure on the bladder muscles and urinary spinchter while emptying the bladder.
  • Pelvic ultrasound: A pelvic ultrasound scan is done to create images of the bladder and to check for the abnormalities present in the urinary tract.

Treatment of Urinary Incontinence:

The treatment and management of urinary incontinence depend on the age and overall health of the individual. The treatment options include:

  • Medications: The doctor will prescribe anticholinergic medications, such as fesoterodine, oxybutynin, and tolterodine to reduce urge incontinence. The doctor will prescribe alpha blockers to reduce overflow incontinence in men. The doctor will prescribe a low-dose of topical estrogen (vaginal cream) to rejuvenate the tissues in the vaginal area.
  • Medical devices:The doctor would insert a tampon-like disposable device or pessary to prevent urine leakage, especially before performing physical sports activities.
  • Electrical stimulation: The doctor will insert temporary electrodes into the vagina or rectum to provide gentle electrical stimulation to the pelvic floor muscles. This is an effective treatment for urge and stress incontinence.
  • Interventional therapies: Botulinum toxin type A (Botox) and bulking material injections are helpful to control an overactive bladder. Also, nerve stimulators are implanted under the buttock region to regulate the nerves that are involved in the bladder control.

Prevention of Urinary Incontinence:

The following are the preventive measures to reduce the risk of urinary incontinence:

  • Quit smoking and excessive consumption of alcohol
  • Avoid acidic foods that irritate the bladder
  • Practice Kegel’s exercise (pelvic exercises) to strengthen the bladder muscles
  • Eat a fiber-rich diet to avoid strain in having a bowel movement

 

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