Loss of bladder control, which is also known as urinary incontinence (UI), or urinary leakage occurs when urine leaks before you reach a restroom. Millions of people across the globe particularly women experience this problem mainly as they grow older and after childbirth.
A few drops of urine may leak in some women when they laugh or cough. Others may experience an urgent need to go to the bathroom but are incapable of getting in control. Urine leakage can also occur during sexual activity and can be a source of emotional misery.
Causes of Urinary Leakage
Urinary incontinence is normally caused by problems with nerves and muscles that regulate the flow of urine. The body stores urine in the bladder. It moves out of the body through the urethra, a tube that is connected to the bladder.
For urine to come out, the muscles in the wall of the bladder contract to allow it to move to the urethra. The sphincter muscles surrounding the urethra contract at the same time to allow urine to move out of the body. Loss of control occurs if the bladder muscles contract suddenly or if the sphincter muscles around the urethra are too weak to hold back urine.
UI is more prevalent in women than men. Menopause, childbirth, and pregnancy are the major reasons why more women than men experience UI. Men usually suffer from UI due to physical changes that come with aging, brain injury, diabetes, and stroke.
Other causes of UI in both men and women include:
- Certain medications, including diuretics and hormone replacement.
- Chronic constipation.
- Caffeinated and alcoholic drinks that cause the bladder to fill quickly.
- Infections of the bladder or the urinary tract. The bladder control resumes when the infection is cured.
- Nerve damage may trigger the delivery of impulses to the bladder at the wrong time.
- Conditions that cause nerve damage include diabetes, trauma, and multiple sclerosis.
- Being obese or overweight may put pressure on the bladder and cause UI.
Different Types of Urinary Incontinence
There are various types of UI depending on the cause:
Urine leaks when someone exercises, coughs, laughs, lift heavy objects, during other bodily movements that exert pressure on the bladder. This happens to be the most common type of urinary leaking in women. It often results from physical changes during menopause, pregnancy, and childbirth.
Also known as “overactive bladder,” leakage happens when a strong, sudden urge to urinate occurs. It may occur when you least expect it, especially after drinking water, during sleep, or when you touch running water.
This type of incontinence occurs in people who have problems with moving, thinking, or speaking that keeps them from accessing a washroom. Examples include people with Alzheimer’s disease or patients in wheelchairs who don’t get to the toilet in time.
This occurs when more than 2 types of incontinence strike simultaneously.
Leakage occurs for a short time following an illness like an infection or pregnancy. The leaking disappears when the illness is cured.
Informing your Doctor about UI
Most people feel uncomfortable speaking with their doctors about UI. However, UI is a common condition affecting millions of people around the world. It is worth noting that your healthcare provider may have come across many people with the condition. The good news is that the condition is curable.
Even if you are nervous, it is your responsibility to make the initial step. Feel free to speak with your doctor who may refer you to a specialist if he/she doesn’t treat the condition.
Dig deeper to find out if food, drinks, medications, or medical conditions are the cause of your UI. Also, ask your doctor about the best treatment for your UI.
Keeping a bladder log can help you figure out when you experience UI. It is important to present the log to your doctor.
Finding Out if You Have UI
If you think you have UI, it is important to undergo a physical examination. The doctor may ask questions like:
How often do you empty your bladder?
When and how do you leak urine?
How much urine do you leak?
Your doctor may recommend further tests including:
- Bladder stress test
- UI Treatment
Urinary incontinence can be treated in several ways. You should work hand in hand with your doctor to find out the best treatment for your UI.
Behavioral treatments: It involves changing some basic behaviors. They include shedding weight, dietary changes, quit smoking, limit alcohol intake, and bladder retraining.
Bladder control medications: These are drugs meant to help in relaxing the bladder muscles while preventing bladder spasms.
Devices: The most common device used in the treatment of UI is known as a pessary. It consists of a stiff ring that is inserted into the female reproductive organ to push against the wall of the urethra and vagina.
Nerve stimulation: This technique is used if behavioral treatments and medications fail to work. It involves the use of electric impulses on the nerves that regulate the bladder.
Biofeedback: This helps a patient learn how his/her body functions. An electrical patch is inserted in the bladder and urethral muscles. The patch is linked to a screen through a wire. The patient and the therapist can watch the screen to see how the muscles contract, which enables a person to control the muscles.
Surgery:If all other treatments fail to work, surgery is the most effective and final resort for patients with UI. You should engage your doctor to find out the best surgery for your UI.
Catheterization: A catheter may be recommended if your incontinence occurs because your bladder never empties completely. It consists of a small tube which links your bladder and a bag attached to your leg.
Exercises for Improving Bladder Control
This exercise aims at strengthening your ability to start and stop your urine stream. As you prepare to urinate, focus on stopping the urine stream by tightening the muscles that stop the flow. You should also focus on the sensation of the pelvic floor muscles by pulling inward, to stop the urine stream or at least to slow it.
To perform Kegel exercise, you should:
- Squeeze the same pelvic floor muscle used to stop the urine stream
- Hold for three seconds
- Release the muscles
- Repeat 25 times per session and gradually increase the frequency up to 50 times, two or three times daily.
Pelvic Floor Exercises
Short contractions: Take a deep breath in and exhale while tightening your pelvic floor muscles as fast as you can. Imagine they are lifting the pelvic muscles upward. You should then inhale while releasing the pelvic floor muscle contraction. Repeat the actions 10 times, three sets a day.
Long contractions: These are intended to help you achieve a pelvic floor contraction that lasts for about 10 seconds. You should tighten the pelvic floor muscles and hold the contraction as long as you can. You may start at 3 seconds and increase gradually. Repeat 10 repetitions of three sets every day.
Edited by: Jessa (March 8, 2019)