Did you know that urinary incontinence is one of the most under-reported medical issues? This is for several very different reasons:
- Often, someone struggling with urinary incontinence is too embarrassed to admit they have the issue; or
- Many assume it is a “fact of life” that will occur due to age or other factors; and
- They might assume that there is nothing that can be done
It is unfortunate that such thinking is a common occurrence because it should not embarrass anyone to have urinary incontinence because it is a very common symptom of a surprisingly long list of conditions. Additionally, it is important to know that it is not a fact of life, nor something you have to learn to live with. After all, it is, as stated, a symptom. That means a physician may be able to work with you to identify, and in many instances, remediate the cause.
First and foremost, though, let’s answer a key question: Just what is urinary incontinence?
Urinary Incontinence Explained
The technical definition of urinary incontinence is the involuntary release of urine. We control urine through voluntary functions. As the Urology Care Foundation explains, “The brain and the bladder control urinary function”. And they do so in a very ordered manner.
- Your bladder stores urine until you are ready to release it, and you are able to “hold it” because of an array of muscles in the pelvic floor, including those around and in the bladder.
- Typically, smooth muscle in the bladder is “relaxed,” and this actually holds the urine inside of the organ. The bottom of the bladder features a sphincter that remains closed and also seals off the upper end of the urethra (the tube responsible for transporting urine out of the body). Clearly, you need the muscles of the sphincter to be responsive and healthy, too.
- To urinate, your brain transmits your conscious message to the muscles and bladder, opening the urethra and sphincter and emptying the bladder.
Healthy bladder function allows you to empty the bladder fully and then relax the muscles bringing your bladder from its contracted condition to its closed position. It will eventually refill and once you are ready to empty it, it will allow the process to be repeated.
Urinary incontinence, then, is when this very orderly process is somehow impeded or interrupted. There are ways that medical experts describe urinary incontinence, and they use the following terms:
- Stress – When urinary incontinence is due to stress, usually called SUI, it signifies some sort of weakness in the muscles. For example, you cough very hard and leak urine or you lift something and realize you’ve expressed some urine. This is one of the most common manifestations of urinary incontinence
- Overactive bladder – This is also quite common and frequently called urge incontinence because it manifests as an overwhelming (sometimes uncontrollable) need to urinate. As the UCF explains, “your brain tells your bladder to empty – even when it isn’t full. Or the bladder muscles are too active. They contract (squeeze) to pass urine before your bladder is full. This causes the urge (need) to urinate.”
- Mixed – This is the occurrence of both SUI and OAB
- Overflow – This is when the body makes more urine than the bladder holds OR a full bladder does not empty fully and it then leaks afterward
- Functional – This is not technically incontinence because it is caused by the inability to reach the toilet in a reasonable span of time. For example, someone with extreme arthritis may struggle for a length of time to reach the toilet and suffer from incontinence because of the overly long delay
Naturally, this means there are many causes for urinary incontinence.
What Causes UI?
Any sort of urinary incontinence should be seen more as a symptom of another condition. There are many causes for UI in men and women of any age, and these include:
- Pregnancy and childbirth
- Prostate issues
- Neurological disease
- Medical conditions
- Risk factors that include lifestyle (smoking, drinking, drug use)
Because the condition manifests in many ways, (i.e., one patient experiences urinary incontinence during the evening hours as they sleep while another experiences it whenever they strain or are active) it must also be treated very differently based on each individual case. Of course, there are also preventative measures everyone can take to reduce their risks for developing the condition.
Preventing and Treating Urinary Incontinence
It may not always be possible to avoid urinary incontinence, but the following steps will usually reduce the risks:
- Smoking cessation
- Consuming a high fiber diet to prevent constipation
- Skipping alcohol and caffeine that are both dehydrating and irritating
- Keeping a healthy weight
- Exercising daily
- Doing regular pelvic floor exercises to strengthen muscles around the bladder and urethra
- Getting regular checkups that include incontinence screenings
If the condition still develops, a physician must be consulted right away. They can best determine the cause and then steer patients towards the best treatment options. This may include behavioral methods that include limiting fluid intake to certain amounts and certain hours, timed voiding and bladder training, and double voiding (visiting the toilet to empty the bladder, waiting a few moments and emptying it again).
Muscle training using kegel exercises is known as a good treatment for those with periodic or light incontinence due to aging, muscle weakness and more. Biofeedback is also put to use in a similar way and for similar symptoms.
When behavioral and muscle training are not enough, there are also some medications as well as surgical interventions. And because such a huge number of people struggle with urinary incontinence, there are many well-designed and effective incontinence products available. From catheter products to protective bed pads and entirely undetectable urinary incontinence undergarments, it is possible to lead a normal healthy life even with incontinence that cannot be remedied through medical intervention.
The first step is to accept that it is not an embarrassing issue and that it is treatable, even if limited to incontinence products. Life can be enjoyed in the same ways it was before incontinence, and the first step is to speak with a medical professional to discuss the issue.