What is Urinary Incontinence?

What is Urinary Incontinence?

Urinary incontinence Urinary incontinence refers to a loss or leaking of urine due to faulty bladder control. An estimated 25% to 33% of people in the United States suffer from urinary incontinence. That means millions of people live with the condition.

There are many different types of urinary incontinence. Although both men and women suffer from the condition, several factors unique to women increase the risk of urinary incontinence in females. It’s a common misconception that this is a normal part of aging. It is not. Thankfully, there are lots of ways to manage urinary incontinence and minimize the effect it has on your life.

Wide-Ranging Consequences

Urinary incontinence is more than a health concern. It affects people on a social, psychological, and emotional level. People who have urinary incontinence may avoid certain places or situations for fear of having an accident. Urinary incontinence can limit life, but it doesn’t have to. The concern is treatable once the underlying cause is identified and addressed.

Symptoms of Stress Incontinence

Common in Women

Stress incontinence occurs when pelvic floor muscles weaken. The condition is the most common type of urinary incontinence in young women. Stress incontinence is the second most common type in older women.

Activities like exercise, walking, stretching, bending, laughing, coughing, sneezing, or lifting place strain on weakened pelvic floor muscles, and that leads to leaks. Any activity that increases physical strain on pelvic floor muscles may lead to stress incontinence-even sex. The amount that leaks varies. It may be a few drops or up to a tablespoon or more, depending on severity.

Prevalence

Some studies suggest 24% to 45% of women over the age of 30 suffer from stress incontinence. If you suffer from urinary incontinence, you are definitely not alone. Weakness in not just the pelvic floor muscles, but also in the urethral sphincter often plays a role in this type of urinary incontinence.

Causes of Stress Incontinence:

Weak Tissues Lead to Leaks

Weakness of the pelvic floor muscles and tissues that support the bladder and urethra causes stress incontinence. These muscles and tissues may be weakened by a variety of things. Some of the factors that contribute to the disorder are modifiable, and some are not. Knowledge is power. Knowing the modifiable factors is the first step toward managing the condition.

Causes of Pelvic Floor Muscle Weakness

Anything that damages, stretches, or weakens pelvic floor muscles may lead to stress incontinence. Some causes cannot be changed. Increasing age and female gender increase the risk. Menopausal status, pelvic floor surgery, pelvic radiation, injury to the nerves in the lower back, chronic coughing, chronic constipation, smoking, obesity, pregnancy and vaginal childbirth are also causes. Women who have multiple pregnancies are at an even greater risk.

Symptoms of Urge Incontinence:

Overwhelming Urges

Urge incontinence occurs due to overactivity of the detrusor muscle. The hallmark symptom of this kind of urinary incontinence is a sudden, overwhelming urge to void, accompanied by loss of urine. Frequent urination and night-time urination often occur with this type of urinary incontinence. The amount lost is variable. Hearing running water or changing position may trigger bladder contractions and lead to urine loss. This type of incontinence can occur in anyone of any age, but it is more typical with advancing age. Just 9% of women between the ages of 40 and 44 suffer from urge incontinence while 31% of women over the age of 75 suffer from the condition.

Mixed Incontinence

Sometimes stress incontinence and urge incontinence occur at the same time. This is called mixed incontinence. People who suffer from urge incontinence lose greater amounts of urine than those who suffer from stress incontinence. Those who suffer from stress incontinence notice leaks with activities that increase abdominal pressure. Keeping a voiding diary, noting the time, place, and activities associated with symptoms of urine loss can help the physician determine whether you suffer from stress incontinence, urge incontinence, mixed incontinence, or another issue.

Causes of Urge Incontinence:

The Root of the Problem

The causes of urge incontinence fall into two main categories. Irritation within the bladder is one potential underlying cause also known as “detrusor instability”. The other is known as “detrusor hypereflexia” which is a loss of the nervous system’s inhibitory control of bladder contractions. Neurological conditions like stroke, Parkinson’s disease, multiple sclerosis, dementia, and damage to the spinal cord may injure nerves that control the bladder and lead to urge incontinence. Diabetes and cardiovascular conditions can also affect associated nerves. Alcohol consumption and diuretic medicine may underlie urge incontinence. Infections or inflammation that either irritated the bladder or damage its nerves may trigger symptoms.

Something More Serious?

Urge incontinence may be a sign of something more serious, depending on how the body reacts. If the patient observes blood when they urinate, recurrent urinary tract infections (UTIs), or an inability to empty your bladder completely, the patient should see their doctor right away. These are red flags that indicate something more serious than just urinary incontinence may be going on. Further testing is warranted to get to the root cause in these cases.

What Is Overactive Bladder?

The condition known as overactive bladder may or may not be associated with urge incontinence. OAB refers to sudden, uncontrollable bladder contractions. When these contractions are associated with leaks, urge incontinence is also present. OAB is disruptive because strong, frequent bladder contractions prompt numerous trips to the bathroom throughout the day and sometimes also at night. OAB can interfere with work, fitness, and social life. If you get up multiple times at night to urinate, OAB can also keep you from getting a good night’s sleep.

A Common Problem

OAB is an extremely common disorder. Approximately 33% of people in the United States have OAB. An estimated 40% of women in the U.S. have the condition. Despite the fact that millions of people and a large percentage of women have OAB, it is not normal and patients don’t have to live with uncomfortable, limiting symptoms. There are treatments that can help.

Medication Triggers of Urinary Incontinence

Check the Medicine Cabinet

Certain medications may trigger urinary incontinence or make it worse. Drugs that affect the brain, nervous system, muscle tone, and fluid balance may trigger the problem. Patients should never stop taking a prescription or change the dose of any medication without speaking with the health professional that prescribed the medication. If a patient has concerns that a medicine they’re taking may be contributing to their symptoms, they should discuss the issue with their physician or get a second opinion. It may be possible to substitute a problematic drug with another drug that does not cause side effects.

 

Some Medications Worsen The Problem

Certain classes of medicine increase the risk of incontinence symptoms. Blood pressure medications may relax the bladder, increase coughing, or decrease the tone of the urethral sphincter, all of which may contribute to this health concern. Pain relievers may increase fluid retention or relax or inhibit contraction of the bladder. Drugs to treat depression, Parkinson’s disease, or psychosis may increase the retention of urine. Antihistamines and anticholinergic drugs may have similar effects.

Incontinence and Emotional Health

Quality of Life Issue

Incontinence can take a serious toll on quality of life. Women who are affected by it report more depression and limitations in sexual and social functioning than those who do not have the condition. Incontinence also has a negative effect on self-esteem. In general, if it negatively affects a woman’s quality of life, then she should seek treatment.

An Honest Conversation

Many women feel embarrassed about suffering from incontinence, but they need not. This is a common problem. Effective treatments are available. Women need to be honest with their doctors. Do they avoid certain activities because of their symptoms? Does incontinence impair their work, sleep, sex life, or social functioning? Different interventions are available depending on how incontinence impacts them. Speaking candidly with a doctor is the best way to identify treatments that are most appropriate for the situation.

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