Urinary Incontinence

This is a common urinary problem that concerns people. It is called urinary incontinence and means the loss of bladder control. The symptoms vary from mild to severe and can cause urine leaking when sneezing or coughing and a sudden urge to urinate that is strong enough that you cannot get to the toilet in time.

While this urinary problem mostly happens in older people, not everyone experiences it. In case urinary incontinence interacts with your daily routine, it is advised to see a doctor. In most cases, people treat the symptoms with lifestyle and dietary changes, or medical care.

Symptoms

The primary urinary incontinence symptoms include minor urine leaks that occur from time to time. However, other symptoms depend on the type you experience. For example:

Stress incontinence – In such cases, urine leaks when you put pressure on the bladder. It often happens in the following situations such as laughing, exercising or heavy lifting, sneezing, or coughing.
Urge incontinence – It occurs when a person experiences a sudden urge to urinate and experience involuntary urine loss. In such cases, people urinate frequently including during nighttime. Furthermore, infections, diabetes, or neurological disorders can provoke urge incontinence.
Overflow incontinence – The bladder does not empty completely, which leads to constant or frequent urine dribbling.
Functional incontinence – Mental or physical impairment prevents you from getting to the toilet in time. It usually occurs in people with other health conditions (such as arthritis).
Mixed Incontinence – Sometimes, people experience more than one urinary incontinence at the same time. Mostly, stress and urge incontinence occur.

When Should I Consult a Doctor?

If you notice urinary incontinence interacting with your daily activities, schedule an appointment with your doctor. For example:

The condition restricts your social interactions
It is a symptom of a more serious disease
Reduced quality of life
This urinary problem can also elevate the risk of falls in older people as they have a sudden urge to urinate.

Causes

There are multiple urinary incontinence causes including daily habits, medical conditions, or physical problems.

Temporary Urinary Incontinence

The following foods and drinks can act like diuretics, increase urine volume, and stimulate the bladder. Examples include:

Alcohol
Chocolate
Chili peppers
Artificial sweeteners
Caffeine
Carbonated drinks
Receiving large doses of vitamin C
Foods high in sugar, acid, or spice (such as citrus fruits)

In addition, some health conditions can provoke this urinary problem. Treating them you can get rid of urinary incontinence. For example:

Urinary tract infections – These infections irritate the bladder, which leads to strong urges to urinate.
Constipation – The rectum and bladder share multiple nerves. When you experience constipation, these nerves may be overactive making you urinate frequently.

Persistent Urinary Incontinence

There are some underlying physical problems or changes that provoke this urinary problem. Examples include:

Pregnancy – In such cases, hormonal changes and increased fetus weight provoke stress incontinence usually.
Childbirth – Childbirth often weakens the muscles necessary for bladder control. Delivery also causes bladder nerves and supportive damage, which leads to a prolapsed pelvic floor. Therefore, the bladder, uterus, rectum, and small intestine can move from the previous position and protrude into the vagina.
Age – The bladder cannot store the same urine capacity with aging. Thus, a person experiences involuntary contractions of the bladder occur frequently.
Menopause – Decreased Estrogen production often occurs in menopausal women. However, this hormone helps to maintain bladder and urethra health. As hormone production decreases deteriorated tissues become.
Enlarged prostate – Benign prostatic hyperplasia (enlarged prostate gland) usually provokes incontinence. This prostate condition occurs in older people mostly.
Prostate cancer – In case prostate cancer is not treated, stress and urge incontinence may occur. Sometimes, men experience urinary incontinence as an adverse reaction to cancer medicines.
Obstruction – Another cause of this urinary problem is a tumor that can appear along the urinary tract which leads to blocked urine flow. Additionally, urinary stones provoke urine leakage (rarely).
Neurological disorders – The following health conditions may interact with bladder nerves and cause incontinence. These include multiple sclerosis, Parkinson’s disease, stroke, brain tumor, spinal injury, and others.

Risk Factors

Health conditions – Certain neurological disorders or diabetes can elevate the risk of incontinence.
Family history – If you have family members with urge incontinence it increases your risk of developing this urinary problem.
Smoking
Extra body weight – If you experience extra body weight it can put an extra strain on the bladder, which weakens it.
Age – The strength of the muscles in the urethra and bladder becomes weakened with aging. That’s why urinary incontinence is more common in older people.
Gender – Women are more likely to develop this urinary problem because of pregnancy, childbirth, menopause, and others. Usually, women experience stress incontinence. In any case, males with prostate problems also are at higher risk of developing urge and outflow incontinence.

Complications

Skin issues (such as rashes)
Urinary tract infections
Decreased quality of life (this problem impacts your work and personal relationships)

Diagnosis

Doctors usually diagnose this condition by asking questions about symptoms and medical history. They can also perform a physical examination and order you to do some tests. For example:

Postvoid residual measurement – This test involves a measurement of urine that is left in the bladder after you urinate (void) into a container. Physicians usually use ultrasound or a catheter to determine how much urine is left. If in the bladder remains a large amount of urine it may be a symptom of urinary tract problems, obstruction, bladder nerves, or muscle problems.
Bladder diary – This test involves a measurement of urine according to how much you drink. It lasts for several days.
Urinalysis – Your doctor will send a sample of your urine to the laboratory to check for infections and other problems.

In case doctors need more details they can perform pelvic ultrasound or urodynamic tests. However, previous tests are done before surgery.

Treatment

Physicians usually prescribe a mix of treatments to treat urinary incontinence. However, it depends on the underlying cause, the severity, and the symptoms. They also recommend invasive treatments if others fail.

Behavioral Techniques

Bladder training – This procedure helps you to delay the time between trips to the toilet.
Double voiding – Helps to empty the bladder completely and avoid overflow incontinence.
Scheduled trips to the toilet – For instance, urinate every 2-4 hours and do not wait need to go.
Fluid and diet management – These behavioral techniques can help to recover bladder control. However, you should avoid alcohol, caffeine, or acidic foods. Moreover, reducing liquid consumption, losing weight, or increasing physical activity can help to lessen the symptoms.

Pelvic Floor Muscle Exercises

Your healthcare professional may recommend some special exercises that strengthen the muscles. These exercises are known as Kegel exercises and they are effective for urge and stress incontinence. Check below how to do pelvic floor muscles:

Try to contract the muscles that you usually use to interrupt urinating and hold for 5 seconds then relax for 5 seconds. However, if it is difficult to maintain pelvic muscles contracted for 5 seconds, try to hold and relax for 3 seconds.
Thereafter, you should perform these exercises until you reach 10 seconds of holding and contracting.
Generally, it is advised to repeat this exercise 10 times daily.

If you do not understand what muscles are involved in bladder control, discuss it with your healthcare professional.

Medicines

Anticholinergics – Medicines used to lessen overactive bladder and treat urge incontinence. These medicines include Tolterodine, Darifenacin, Fesoterodine, Solifenacin, and Trospium chloride.
Mirabegron – This medicine doctors usually recommend in the urge incontinence treatment. It works by relaxing the bladder muscles and increasing the amount of urine the bladder can hold.
Alpha-blockers – Healthcare professionals usually prescribe this medicine for men who experience urge or overflow incontinence. They help to relax the bladder and prostate muscles. These medicines include Tamsulosin, Alfuzosin, Silodosin, and Doxazosin.
Topical Estrogen – Estrogen vaginal cream, ring, or patch can help to rejuvenate tissues in the vaginal area and urethra.

Electrical Stimulation

This treatment involves certain electrodes that are temporarily placed in the vagina or rectum. It helps to strengthen and stimulate pelvic floor muscles. This is an effective treatment for urge and stress incontinence.

Medical Devices

The following devices are manufactured for women with urinary incontinence. For example:

Pessary – This is a silicone ring that is placed into the vagina all day. It also can be used for vaginal prolapse. Pessary supports the urethra and helps to prevent leakage of the urine.
Urethral insert – This is a small device that is inserted into the urethra before physical activity (including tennis) that provokes incontinence. This device prevents urine leakage and is removed before urination.

Surgery

This procedure is done if other urinary incontinence treatments are not working. Check below some surgery types:

Artificial urinary sphincter – The surgeon will implant around the bladder neck a small fluid-filled ring that helps to keep the urinary sphincter closed until you need to urinate. After that, you will press on a valve implanted under the skin and that ring will deflate allowing urine to flow from the bladder.
Prolapse surgery – This treatment is used in females with mixed incontinence and pelvic organ prolapse. Despite repairing pelvic organs, you may need additional treatments to improve incontinence symptoms.
Bladder neck suspension – First you will receive a spinal or general anesthesia. Thereafter, the surgeon will perform the surgery that helps to support the bladder neck, and urethra.
Sling procedures – This procedure helps the urethra stay closed, especially when you are coughing or sneezing. It is effective in the stress incontinence treatment.

Other Therapies

Nerve stimulators – This treatment method involves certain devices that use harmless electrical impulses that help in the bladder control nerves (sacral nerves) stimulation.
Onabutolinumtoxin A (Botox) – In case other urinary incontinence treatments are not effective for you, doctors may prescribe Botox injections. They help with overactive bladder and urge incontinence.
Material injections – In such cases, you’ll get injected synthetic material into tissues around the urethra. Therefore, these materials help to keep the urethra closed and decrease leakage of the urine.

Frequently Asked Questions

What are the primary causes of urinary incontinence?

Congenital bladder problems
Spinal cord injuries
Bladder fistula

What foods can help with urinary incontinence?

Fruits (including bananas, apples, blackberries, grapes, and others)
Vegetables (such as broccoli, carrots, celery, cucumbers, asparagus, and others)
Foods high in fiber (for example, almonds, barley, beans, lentils, oats, and others)

Talk with your doctor about other foods that you can add to your diet.

Is it possible to cure urinary incontinence?

Sometimes, surgery can cure this urinary problem. For instance, your incontinence occurs due to a change in the bladder position or its blockage (enlarged prostate). If you have additional questions, ask your healthcare professional.