What is urinary incontinence?

Urinary incontinence is involuntary urination or any uncontrolled leakage of urine. It is the loss of bladder control and is a common and embarrassing problem. The severity of the condition ranges anywhere from occasionally leaking urine when you cough or sneeze to having such an extremely sudden and strong urge to urinate that you cannot get to a toilet in time.

Possible Causes: 

Urinary incontinence, or, the loss of bladder control, ranges from occasionally leaking urine while coughing or sneezing or having an extremely sudden and strong urge to urinate not allowing you to get to a toilet in time.

Normal functioning of the bladder requires coordination between the brain, spinal cord, and the bladder. Urinary incontinence is not a disease by itself, it’s a symptom. It can be caused by underlying medical conditions, physical problems, habits, as a side effect of a medication prescribed, or conditions such as a bladder infection. 

Pelvic muscle weakness after childbirth or old age and the thinning of the urethral lining after menopause can cause incontinence too. 

There are two types of underlying causes for urinary incontinence, temporary and persistent.

• Temporary urinary incontinence - Easily treatable medical conditions as well as certain foods and medications that act as diuretics and stimulate the bladder, increasing the volume of urine.
• Alcohol, caffeine, carbonated drinks and sparkling water.
• Chocolates, chili peppers, citrus fruits, artificial sweeteners.
• Sedatives, blood pressure medications, muscle relaxants.
• Urinary tract infections and constipation.
• Persistent urinary tract incontinence - caused by underlying physical conditions, like:
• Pregnancy, childbirth and menopause.  Hormonal changes as well as weakening of muscles associated with these conditions can lead to incontinence.
• Changes with age. Ageing of the bladder muscles decreases the control of the bladder and its capacity.
• Hysterectomy, enlarged prostate, prostate cancer, obstruction by a tumour, and neurological disorders. These conditions can cause incontinence for reasons like pelvic muscle damage, blockage, cancer treatment or nerve injuries.

Risk Factors: 

Factors that increase the risk of developing urinary incontinence are:

• Gender: Women are more likely to have incontinence because of pregnancy, childbirth, menopause. However, men with prostate gland problems are at risk too.
• Old age: Muscles in your bladder and urethra weaken with age leading to less control and capacity of your bladder.
• Being overweight: This increases pressure on the bladder and pelvic muscles.
• Neurological diseases or diabetes: It can increase your risk of incontinence.
• Smoking.

Signs & Symptoms: 

The different types of urinary incontinence are organised by their own signs, symptoms and circumstances:

• Stress incontinence: Urine leaks caused by pressure or strain on the abdomen and bladder by coughing, sneezing, laughing, lifting something heavy or exercising.
• Urge incontinence: Sudden and intense urge to urinate and uncontrolled loss of urine may be caused by conditions like infections, that irritate the bladder and make it overactive, neurological disorders or diabetes.
• Overflow incontinence: Weakening of the bladder or a blocked urethra that does not allow the bladder to empty completely causing frequent dribbling of urine.

Diagnosis: 

At Medcare, you will be treated by specialists who will evaluate your condition to find the most effective treatment for urinary incontinence. They will conduct a complete history and physical examination, including a pelvic examination.

To help confirm the diagnosis, tests mentioned below might be suggested:

• Urinalysis: A urine sample is examined to check for the presence of an infection, blood or other irregularities.
• Stress-test: You will be asked to cough, bend or do other activities with a full bladder to check if stress on the bladder causes leakage.
• Post-void residual urine measurement: To check whether urine remains after you have emptied your bladder completely, a small, soft tube called a catheter will be inserted into the bladder to drain and measure the remaining urine. An ultrasound bladder scan also be conducted.
• Cystoscopy: Examining the inside of the bladder to visually check for abnormalities with the help of a viewing telescope called a cystoscope.
• Urodynamic testing: Tests to examine the bladder and urethral sphincter muscle function by inserting a small tube into the bladder or examining the bladder with X-rays.

Treatment Options: 

The possible treatment options include:

• Behavioural therapy and physiotherapy: Physiotherapists will prescribe exercises that strengthen the pelvic muscles and improve pelvic support to help regain bladder control and maintain continence. Understanding reasonable fluid intake and scheduling visits to the toilet can also be effective in treating urinary incontinence.
• Medication: Drugs that will help relax the bladder, will be prescribed. Our physicians will also investigate whether any medication you are currently prescribed contributes to incontinence.
• Surgery: To treat urinary incontinence, correct poor bladder support and seal the urethra completely, surgery is another available option.  Our expert urologists will determine what would be the right procedure for you after investigating your condition.