Urinary incontinence - the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze, to suddenly having the urge to urinate and can’t get to the bathroom in time.
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.
Types of incontinence:
There are two common types of incontinence:
Stress incontinence is caused by a weakness of, or a problem with, the pelvic floor that results in accidental leaks. Coughing, sneezing, or laughing, heavy lifting, and exercise can trigger stress incontinence. This is most common after childbirth and menopause.
The pelvic floor is a group of muscles that supports the pelvic organs including the bladder, womb and rectum. Stress incontinence is also an issue among female athletes because their pelvic floor is under pressure from other muscles that have been strengthened around it and, therefore, becomes weaker.
Urge incontinence is the sudden urge to urinate that a person can't control. It is associated with an overactive bladder, which means the sufferer doesn’t have sufficient control over how the bladder fills and empties. When the urge to urinate comes, the person has a very short time to make it to the bathroom before the urine is released, regardless of what they try to do.
Bladder muscles can activate involuntarily because of damage to the nerves of the bladder, the nervous system, or to the muscles themselves.
The following are risk factors linked to urinary incontinence:
Gender: Women have a higher chance of experiencing stress incontinence than men, especially if they have had children.
Obesity: Extra weight puts pressure on the bladder and surrounding muscles. It weakens the muscles, making leakage more likely when the person sneezes or coughs.
Smoking: This can lead to a chronic cough, which may result in episodes of incontinence.
Old age: The muscles in the bladder and urethra weaken with age.
Some diseases and conditions: Diabetes, kidney disease, spinal cord injury, and neurologic diseases, for example, a stroke, increase the risk.
Prostate disease: Incontinence may present after prostate surgery or radiation therapy.
Treatment for urinary incontinence depends on the type of incontinence, its severity and the underlying cause. After an examination and tests, your doctor is likely to suggest the least invasive treatments first.
Your doctor may recommend:
Your doctor may suggest bladder training to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every 2.5 to 3.5 hours.
Scheduled toilet trips
Your doctor may suggest scheduled trips to the bathroom to urinate every two to four hours rather than waiting for the need to go.
Double voiding means urinating, then waiting a few minutes and trying again, which will help you learn to empty your bladder more completely to avoid overflow incontinence.
Fluid and diet management
You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.
Pelvic floor muscle exercises
Doing pelvic floor muscle exercises can help strengthen the muscles that help control urination. Also known as Kegel exercises, these exercises are especially effective for stress incontinence but may also help urge incontinence.
To do pelvic floor muscle exercises, imagine that you're trying to stop your urine flow. Then:
- Tighten (contract) the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.)
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
To help you identify and contract the right muscles, your doctor may suggest you work with a physical therapist or try biofeedback techniques.
If at-home treatments don’t work
There are also medications and medical devices commonly used to treat incontinence.
If other treatments aren't working, several surgical procedures can treat the problems that cause urinary incontinence.
If medical treatments can't completely eliminate your incontinence, you can try products that help ease the discomfort and inconvenience of leaking urine. Talk to your doctor about these treatment options.
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