URINARY INCONTINENCE

As we grow older, our lives go through many changes, not to mention our bodies as well. These varieties of physical changes may be inconvenient, difficult, or even devastating.

One common uncomfortable change that the body goes through as it ages is urinary continence.

What is urinary incontinence?

Urinary IncontinenceUrinary incontinence is the loss of bladder control which results in accidental urine leakage. The leakage can happen suddenly, in small or large amounts.

Urine is a liquid by-product produced by the kidneys when it filters waste from the blood. It then flows through the ureter and is stored in the bladder. When the bladder is full, its nerves will send a signal that will make you feel the need to pee. When you urinate, the bladder muscles will tighten to push and release urine out through the urethra.

The urethra has sphincter muscles that control the release of urine. These muscles are strong enough to keep the urethra shut, which then helps you hold your pee.

However, when you have incontinence, your bladder muscles tend to suddenly tighten while the sphincter muscles are too weak to keep the urethra shut. As a result, you may experience a sudden, strong urge to pass urine, and are more likely to experience urine leakage from stress and pressure from activities, such as exercising, or even just by sneezing and laughing.

What are the causes of urinary incontinence?

Urinary incontinence is caused by problems with the nerves and muscles that help the bladder to pass or hold urine.

Also, the pelvic floor muscles that support your urethra, bladder, uterus, and bowels may become damaged or weak after pregnancy, childbirth, or menopause. With weakened muscles, your bladder and urethra are forced to work harder to hold urine.

Unfortunately, the extra pressure or stress on the bladder and urethra can cause urinary leakage or incontinence.

Urinary incontinence may also have other causes. You may experience incontinence due to aging of the bladder muscles, being overweight, nerve damage, or surgery in the reproductive organs, such as a hysterectomy.

Certain medications, caffeine, or infection may cause temporary incontinence as well.

Furthermore, the condition may also be a result of urinary tract infection, multiple sclerosis, stroke, a brain tumor, Parkinson’s disease, spinal injury, or urinary stones.

Major types of urinary incontinence

While urinary incontinence can happen for both men and women, it is twice as common for women.

As a woman, you can have urinary incontinence at any age—though it is more frequent in older women due to hormonal changes during menopause. Plus, since the female urethra is shorter, any damage or weakness to it will likely cause urinary incontinence.

Generally, there are two types of urinary incontinence:

• Stress incontinence
  As the name suggests, stress incontinence occurs when there is stress or pressure put on your bladder. Because your pelvic floor muscles are weakened, any stress or pressure easily triggers the release of urine.
  
  When you have stress incontinence, everyday actions that use the pelvic floor muscles, such as sneezing, laughing, jumping, lifting heavy objects, or coughing, tend to cause urine leakage. This also includes sudden physical activity and movements.
  
  Stress incontinence is the most common type of incontinence and the most frequent in younger women. The risk of this condition is increased when you are smoking, overweight, or have gone through childbirth.

• Urge incontinence
  Also called overactive bladder, urge incontinence occurs when your brain and spinal cord do not work properly with the bladder to allow you to hold urine and release it at the right time. The bladder may suddenly empty itself without warning, or you may feel like you need to pass urine more frequently.
  
  As a rule, urge incontinence is identified by having to pass urine more than eight times a day—and usually passing only a little urine once you get to the bathroom.
  
  It is a common condition in older women and tends to affect those with nervous system disorders, such as stroke or multiple sclerosis.

Symptoms of urinary incontinence include:

Going to the bathroom more often than usual—more than 8 times a day or more than twice at night.

Urinating while sleeping (bedwetting)

Spasms or pressure in the pelvic area that cause strong urges to urinate.

What are the treatment options?

The treatment offered for urinary incontinence varies from case to case. For a less severe condition, your female pelvic medicine and reconstructive surgery (FPMRS) physician may advise small changes to your lifestyle.

You may be encouraged to quit smoking, avoid caffeine and alcohol, lose weight, practice urge suppression, retrain your bladder, and perform pelvic floor exercises.

Your urogynecologist may also prescribe medical devices, like urethral insert and vaginal pessary, to help you control stress incontinence.

Additionally, fillers such as carbon beads and collagen may be applied for plumping up the tissues where urine is released from the bladder to help hold it.

In some cases, your FPMRS physician may recommend bladder-relaxing Botox, estrogen replacement therapy, or drugs like pseudoephedrine to help tone up the urethra. Likewise, electrical nerve stimulation procedures, such as sacral nerve stimulation and tibial nerve stimulation, are options that may be considered.

If these do not work, your urogynecologist may recommend surgery, such as the sling procedure or retro-pubic colpo-suspension to correct the underlying problem and relieve symptoms.

Compassionate, patient-centered care

Are you suffering from urinary incontinence? Perhaps, you feel too embarrassed to speak out, or you are already resigned to your condition, believing that nothing can be done. Well, there is a way out, but only if you take the first step to speak with a urogynecologist regarding your case.

At Advanced Urology Institute, we understand that many patients suffer in silence, thinking that their condition is a normal part of growing old or feel too embarrassed to share their burden. That is why we have assembled a pool of friendly, open, and compassionate physicians at our Fort Myers office to help patients overcome urinary incontinence and other pelvic floor issues.

Urogynecologists at AUI will listen and attend to your concerns during consultation, accurately diagnose your condition, and recommend the most effective, personalized treatment for you.

For more information on urinary incontinence, bladder problems, and pelvic disorders, visit the Advanced Urology Institute website.