Urinary Incontinence

Urinary incontinence also known as involuntary urination is a common and distressing problem which can have a huge impact on the quality of your life. 

Urinary incontinence is not just a medical problem but it can also affect your emotional, psychological and social life. 

About 25% of women in the United States suffer from urinary incontinence. 

The good news is that for most people, changing one’s lifestyle or medical treatment can ease the symptoms and improve the quality of life

 There are two basic types of incontinence, one is stress incontinence and the other is urge incontinence.

STRESS INCONTINENCE

This is when there is a loss of urine when you exert pressure on your bladder by either laughing sneezing exercising or lifting something heavy

URGE INCONTINENCE

This is when you have a sudden urge to urinate following a involuntary loss of urine. This frequently occurs on the way to the bathroom in the middle of the night or perhaps entering your home with a full bladder before you get a chance to get to the restroom.

Some patients have a mixture of both of these types and this is called mixed incontinence.

Many foods and drinks have been associated with loss of urine. They include caffeine, alcohol, carbonated drinks, artificial sweeteners, chocolate, and foods that are high in spice or acid especially citrus fruits.

Urinary incontinence may also be caused by a urinary tract infection.

Sometimes urinary incontinence is caused by a change in your anatomy. It is very commonly seen in pregnancy secondary to the hormonal changes and the baby pressing on your bladder. Childbirth, especifically vaginal delivery can also weaken the muscles needed to control your bladder and can sometimes cause a dropped or prolapsed bladder. Also as we age our bladders capacity decreases and there is more involuntary bladder contractions as we get older.

The onset of menopause is also related to bladder dysfunction. This is secondary to the loss of estrogen. This hormone helps keep the lining of the bladder in the urethra healthy.

Risk factors include being a woman, pregnancy, childbirth, menopause and advanced age. Being overweight also puts additional pressure on the bladder can increases the likelihood of allowing urine to leak when you cough or sneeze.

When seeking care for urinary incontinence your doctor will start with a thorough history and physical and will do some simple bladder tests in the office to determine what type of urinary incontinence you have.

Often times doing pelvic floor muscle exercises also known as Kegal’s, can significantly help in patients who have stress incontinence

Click here for more information on Kegal exercises.

There are many medications used to treat incontinence. Some of the medications can calm an over active bladder and are referred to as anticholinergics. They include Ditropan, Detrol, Enablex, Toviaz, Vesicare and Sanctura. 

Myrbetriq is the medication used to treat urgent continents. This medication relaxes the bladder muscle and also increases the bladder capacity.

In patients who have atrophic vaginitis, ( a condition caused by menopause and lack of estrogen), The topical application of low-dose estrogen can often times help alleviate these symptoms.

In patients who have significant prolapse of the bladder or uterus, sometimes a pessary is used which is a device similar to a diaphragm which helps hold up the bladder to prevent urinary leakage.

Other tactics that have been used to include Botox and nerve stimulator‘s which have mixed success.

In patients who have stress incontinence sometimes and surgical procedures can be helpful in these include sling procedures, bladder neck suspension as well as others.

Alternative treatments such as acupuncture and yoga have also been shown to have mixed results.

If you have urinary incontinence, speak up! Often times simple measures can greatly improve the quality of your life.