Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened.
Urinary incontinence is a common problem that affects many people.
According to the American Urological Association, one-quarter to one-third of men and women in the United States experience urinary incontinence.
Urinary incontinence is more common among women than men. An estimated 30 percent of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men.
Urinary incontinence is a common problem. Urinary incontinence is when a person cannot prevent urine from leaking out.
It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity. The chances of it happening increase with age.
Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.
Treatment will depend on several factors, such as the type of incontinence, the patient's age, general health, and their mental state.
Pelvic floor exercises, also known as Kegel exercises, help strengthen the urinary sphincter and pelvic floor muscles - the muscles that help control urination.
Surgery is an option if other therapies do not work. Women who plan to have children should discuss surgical options with a doctor before making the decision.
Sling procedures: A mesh is inserted under the neck of the bladder to help support the urethra and stop urine from leaking out.
Colposuspension: Lifting the bladder neck can help relieve stress incontinence.
Artificial sphincter: An artificial sphincter, or valve, may be inserted to control the flow of urine from the bladder into the urethra.
Urinary Catheter: A tube that goes from the bladder, through the urethra, out of the body into a bag which collects urine.
Absorbent pads: A wide range of absorbent pads is available to purchase at pharmacies and supermarkets, as well as online.
The causes and the type of incontinence are closely linked.
This happens when there is an obstruction or blockage to the bladder. The following may cause an obstruction:
The type of urinary incontinence is normally linked to the cause.
The main symptom is the unintentional release (leakage) of urine. When and how this occurs will depend on the type of urinary incontinence.
This is the most common kind of urinary incontinence, especially among women who have given birth or gone through the menopause.
In this case "stress" refers to physical pressure, rather than mental stress. When the bladder and muscles involved in urinary control are placed under sudden extra pressure, the person may urinate involuntarily.
The following actions may trigger stress incontinence:
Also known as reflex incontinence or "overactive bladder," this is the second most common type of urinary incontinence. There is a sudden, involuntary contraction of the muscular wall of the bladder that causes an urge to urinate that cannot be stopped.
When the urge to urinate comes, the person has a very short time before the urine is released, regardless of what they try to do.
This is more common in men with prostate gland problems, a damaged bladder, or a blocked urethra. An enlarged prostate gland can obstruct the bladder.
The bladder cannot hold as much urine as the body is making, or the bladder cannot empty completely, causing small amounts of urinary leakage.
Often, patients will need to urinate frequently, and they may experience "dribbling" or a constant dripping of urine from the urethra.
There will be symptoms of both stress and urge incontinence.
With functional incontinence, the person knows there is a need to urinate, but cannot make it to the bathroom in time due to a mobility problem.
Functional incontinence is more prevalent among elderly people and is common in nursing homes.
This either means that the person leaks urine continuously, or has periodic uncontrollable leaking of large amounts of urine.
The patient may have a congenital problem (born with a defect), there may be an injury to the spinal cord or urinary system, or there may be a hole (fistula) between the bladder and, for example, the vagina.
The following are risk factors linked to urinary incontinence:
Ways to diagnose urinary incontinence include:
A bladder diary: The person records how much they drink, when urination occurs, how much urine is produced, and the number of episodes of incontinence.
Physical exam: The doctor may examine the vagina and check the strength of the pelvic floor muscles. They may examine the rectum of a male patient, to determine whether the prostate gland is enlarged.
Urinalysis: Tests are carried out for signs of infection and abnormalities.
Blood test: This can assess kidney function.
Postvoid residual (PVR) measurement: This assesses how much urine is left in the bladder after urinating.
Pelvic ultrasound: Provides an image and may help detect any abnormalities.
Stress test: The patient will be asked to apply sudden pressure while the doctor looks out for loss of urine.
Urodynamic testing: This determines how much pressure the bladder and urinary sphincter muscle can withstand.
Cystogram: An X-ray procedure provide an image of the bladder.
Cystoscopy: A thin tube with a lens at the end is inserted into the urethra. The doctor can view any abnormalities in the urinary tract.
The inability to retain urine can sometimes lead to discomfort, embarrassment, and sometimes other physical problems.
These include:
Skin problems - a person with urinary incontinence is more likely to have skin sores, rashes, and infections because the skin is wet or damp most of the time. This is bad for wound healing and also promotes fungal infections.
Urinary tract infections - long-term use of a urinary catheter significantly increases the risk of infection.
Prolapse - part of the vagina, bladder, and sometimes the urethra can fall into the entrance of the vagina. This is usually caused by weakened pelvic floor muscles.
Embarrassment can cause people to withdraw socially, and this can lead to depression. Anyone who is concerned about urinary incontinence should see a doctor, as help may be available.