Urinary Incontinence – Symptoms, Types, Causes, Risk factors, Diagnosis & Treatment

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Urinary Incontinence – Symptoms, Types, Causes, Risk factors, Diagnosis & Treatment

The involuntary or accidental leakage of urine is called as Urinary Incontinence (UI) or simple it means that a person has to urinate when he/she don’t want to. It is a common and sometimes embarrassing problem for most of the affected people. According to American Urological Association, one-quarter to one-third of men and women in United States are affected by Urinary Incontinence. The problem is much more common in women than men and around 30% of women aged 30-60 affected from it as compared to 1.5-5% of men. For majority of the people, some simple lifestyle changes and medications can ease the symptoms of Urinary Incontinence and cure the problem as well. 

Here are the symptoms, types, causes, risk factors, complications, diagnosis and treatment of Urinary Incontinence: 

What are the main types of Urinary Incontinence and their symptoms?

The main symptom of UI is the unintentional leakage (release) of urine while some people experience minor leakage and some frequently wet their clothes. Below are the main types and their respective symptoms of UI:

Stress Incontinence:

It is the most common type of UI, especially among the women. In this type, the stress means physical pressure and not the mental stress. When extra pressure is exerted on bladder and muscles that are involved in urinary control, the person feels to urinate involuntarily. This extra pressure is triggered by some actions which are sudden cough, laughing, sneezing, exercise and lifting something heavy.  

Urge Incontinence:

It is the second common type of UI and also known as “reflex incontinence” or “overactive bladder”. In this type, there is a sudden and involuntary contraction of the muscular walls of the bladder which causes you an urge to urinate that you can’t stop. When you have this urge to urinate, you have a very short span of time before it is released. This involuntary urination can be caused by some minor conditions such as infections or more severe problems such as neurological disorders or diabetes. 

Overflow Incontinence:

This type is more common in men who have prostate gland problems especially enlarged prostate that obstruct the bladder and blocked urethra (a tube that carries urine from bladder outside to the body). The bladder cannot hold the urine that body is making or the bladder can’t empty completely which causes small amount of urine leakage. So, in this case, you need to urinate frequently and experience constant dribbling from urethra.         

Functional Incontinence:

In this type of UI, the person knows that there is need to urinate but cannot make it to the bathroom in time either due to some physical impairment such as poor eyesight, poor mobility, or mental problems such as dementia, confusion, depression, anger. It is more common among elderly people. 

Mixed Incontinence:

In this type, a person may experience more than one type of UI at the same time. 

If you start experiencing any of these types of Urinary Incontinence frequently or when it start affecting your quality of life, restricting activities and limiting social interactions then feel comfortable to talk to urologist and seek medical advice.

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What are the Urinary Incontinence causes?

UI isn’t a disease; rather it is a symptom which is caused by every day habits, certain physical and mental problems. The doctor can thoroughly evaluate the exact cause behind your incontinence. 

Temporary UI is caused by certain foods, drinks and medications which stimulate the bladder and increase the volume of the urine. These include 

  • Alcohol 
  • Tea
  • Coffee
  • Carbonated drinks
  • Corn syrup
  • Artificial sweeteners
  • Foods that have high spice or sugar
  • Fruits that have high acid such as citrus fruits
  • Sedatives
  • Muscle relaxants
  • Heart and blood pressure medications
  • Large dose of vitamin B or C 

Some easily treatable medical conditions can also cause UI, such as constipation and urinary tract infections. 

Persistent UI which means that it can be persistent condition is caused by some physical problems or changes, such as: 

  • Aging
  • Enlarged prostate and prostate cancer
  • Pregnancy, childbirth and menopause
  • Any surgery that involves woman’s reproductive system such as removal of uterus may damage the supporting pelvic floor muscles, which can lead to incontinence.
  • Obstruction, a condition in which a tumor can develop anywhere along your urinary tract and blocks the normal flow of urine.       
  • Neurological disorders, involves Parkinson’s disease, multiple sclerosis, stroke, brain tumor, and spinal injury which interfere nerve signals that involved in bladder control causing incontinence. 

Which factors increase the risk of developing Urinary Incontinence?

The factors that increase your risk of developing the problem include:

  • Aging
  • Gender: Women are at high risk of developing stress incontinence while men with prostate gland problems are more likely to develop urge and overflow incontinence.
  • Overweight 
  • Neurological disorders
  • Diabetes

What are the complications of Urinary Incontinence?

The complications of severe UI include:

  • Skin problems: Development of rashes, skin infections and sores on the constant wet skin.
  • It increases the risk of developing urinary tract infections.
  • It can affect your social life, work and personal relationships. 

How is Urinary Incontinence diagnosed?

In order to determine the specific type of UI, at first the doctor reviews your complete medical history thoroughly and then performs a physical exam. After that the doctor will likely recommend following tests:

  • Blood Test: It helps to assess the function of kidneys.  
  • Urinalysis: Sample of your urine is taken to check for infections, blood traces or other abnormalities.
  • Bladder Diary: You are advised to take a record for several days of some major things such as how much you drink, when you urinate, whether you had an urge to urinate, the amount of urine you produce and number of incontinence episodes. 
  • Post-Void Residual Measurement: You are asked to urinate in a container that measures the urine output. After that, the doctor checks amount of leftover urine in bladder by using ultrasound test or a catheter. If leftover urine is in large amount in your bladder then it means that you have urinary tract obstruction or there is a problem with bladder nerves and muscles. 

Some special tests may also recommend if further information is needed by the doctor, these include:

  • Urodynamic Testing: This test is used to measure the strength of your bladder and health of your urinary sphincter. This allows the doctor to know that how much pressure both these can withstand. 
  • Cystoscopy: A cystoscope is a thin tube having a tiny lens that the doctor inserts into your urethra to view the abnormalities in urinary tract.
  • Cystogram: It is an X-Ray procedure that helps to visualize the bladder and assess urinary tract problems. 
  • Pelvic Ultrasound: In this test, the urinary tract and genitals are checked whether there are any abnormalities. 

What is the treatment of Urinary Incontinence?

The Urinary Incontinence treatment depends on the type, its severity and actual cause behind it. A combination of different treatment options may also be needed depending on the individual conditions. The doctor will suggest less invasive treatment options at first and after that he/she can go for other options, if needed and in case the problem still persists. 

Behavioural Techniques for Treatment:

  • Bladder Training: In this technique, you may be asked to delay the urine whenever you have an urge to urinate. The goal of this technique is to extend the time between your trips to the bathroom until you start urinating every 2-4 hours. 
  • Double Voiding: In this technique, you may be asked to urinate then wait for few minutes and again urinate. It helps you to learn emptying your bladder completely to treat overflow incontinence. 
  • Schedule Toilet Trips: It means that you go to the toilet on the set timings during the day every 2-4 hours instead of waiting for an urination urge.
  • Fluid and Diet Management: It helps to regain the control of bladder. The doctor advises you to limit using alcohol, caffeine and acidic foods. The doctor may also recommend reducing consumption of liquid, losing weight and increasing the physical activity. 

Pelvic Floor Muscle Exercises:

These pelvic floor exercises also known as Kegel exercises help to strengthen the urinary sphincter and pelvic floor muscles, these muscles help to control urination. These exercises are effective for stress and urge incontinence. The doctor can better explain you how to perform Kegel exercises. 

Medications:

The doctor prescribes medications along with some other techniques and exercises. Some commonly used medications to treat UI are Anticholinergics (it calms an overactive bladder), Mirabegron (it relaxes the bladder muscle), Alpha Blockers (for relaxing bladder neck muscles & muscle fibers in prostate) and Topical Estrogen (it rejuvenates tissues in urethra & vaginal areas).  

Surgery:

In case if other treatment options didn’t work then different surgical procedures will be used to treat the problem. Affected women who plan to have children should discuss surgical options thoroughly with the doctor. Commonly used surgical procedures include:

  • Sling Procedures: A mesh, synthetic material or strips of your body’s tissues in the form of a tape is inserted under the neck of the bladder (a thick muscular area where bladder connects to urethra) which helps to support the urethra and stop urine from leaking out. This procedure is used to treat stress incontinence in women. 
  • Bladder Neck Suspension: This procedure provides support to urethra and bladder neck.
  • Artificial Sphincter: An artificial sphincter (valve) may be inserted around the neck of bladder to control the flow of urine from the bladder into the urethra. This procedure specifically helps those men whose incontinence links with an enlarged prostate gland or prostate cancer.

Absorbent Pads and Catheters:

If the problem still persists and other treatment options didn’t work to eliminate your incontinence then you can also try out some products helping to give you ease from discomfort and inconvenience that happens due to urine leakage. These include:

Pads and Protective Garments: You can use various products that are not more bulky as normal underwear and you can easily wear them under everyday clothing.

Catheter: In this method, the doctor may recommend inserting a soft tube called catheter, into your urethra several times a day in order to drain your bladder. The doctor will instruct you on how to insert and clean these catheters to safely reuse.

Want to get rid of Urinary Incontinence, Consult Urology Care of Central New Jersey specialists:

If you’re experiencing the symptoms of Urinary Incontinence and if it’s affecting your everyday life then you can contact Urology Care of Central New Jersey specialists who have experience, expertise, efficiency and training in performing tests for diagnosing the problem and are being treating patients with different urological problems resulting in curing the diseases that can lead them to live a healthy life. 

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