Urinary incontinence : Causes-Symptoms-Diagnosis-Treatment
What is Urinary Incontinence?
Urinary incontinence means that someone leaks excretory products by accident. whereas it will happen to anyone, urinary incontinence, additionally referred to as hyperactive bladder, is additionally common in older individuals, particularly women. Bladder management problems are often embarrassing and cause people to avoid their traditional activities. However, incontinence can often be stopped or controlled.
What happens within the body to cause bladder control problems? settled in the lower abdomen, the bladder may be a hollow organ that's a part of the urinary system, that also includes the kidneys, ureters, and urethra. Throughout urination, muscles in the bladder tighten to maneuver urine into the cylindrical channel. At identical time, the muscles around the urethra relax and let the excretory product pass out of the body. Once the muscles in and around the bladder don’t work the manner they should, urine will leak, leading to urinary incontinence.
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| Urinary Incontinence |
Urinary incontinence is when someone leaks urine unintentionally. This can happen when the control over the bladder's sphincter is lost or weakened.
Urinary incontinence is a common problem that affects many people.
One-quarter to one-third of men and women in the United States experience urinary problems.
Urinary incontinence is more common among women than men. This means that about 30 percent of women aged 30-60 have it, while only 1.5-5 percent of men do.
Urinary incontinence is when a person cannot keep their urine in.
Coughing can cause it. Pregnancy and obesity are known to increase the chances of coughing.
The likelihood of it happening increases as one ages.
Kegel exercises and bladder control can help prevent or reduce urinary incontinence.
Treatment for incontinence will depend on a number of factors, such as the type of incontinence, the age of the patient, their general health, and their mental state.
Medical terms
Urinary incontinence — the loss of bladder management — may be a common thusmetimes|and infrequently} embarrassing problems. The severity ranges from often unseaworthy excreta once you cough or sneeze to having an Associate in Nursing urge to urinate that's so explosive and powerful you don't get to a bathroom in time. Though it happens a lot of often as individuals get older, incontinence isn't an inevitable consequence of aging. If urinary incontinence affects your daily activities, don't hesitate to envision your doctor. For many people, straightforward manners and dietary changes or treatment will treat symptoms of urinary incontinence.
Urinary incontinence is the involuntary loss of urine It can range from a brief somewhat common leakage to continuous and uncontrollable urination Most people with urinary incontinence aren’t aware they have an issue until it becomes severe or chronic but you can sometimes identify possible symptoms in advance by knowing your risks for developing urinary incontinence.
Urinary incontinence is when a person has involuntary loss of urine from the bladder It’s a common problem especially among older women and in some cases can be treated easily That said there are many causes of urinary incontinence that require treatment by a doctor or other healthcare professional Treatment for these cases may involve using devices such as pads or pessaries to catch the urine Surgery may also be necessary for severe cases In general though urinary incontinence need not interfere with daily life and activities as long as you take steps to manage it effectively.
Symptoms Urinary incontinence
Many people experience occasional, minor leaks of weewee. Others could lose little to moderate amounts of urine a lot. forms of incontinence include:
Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
Urge incontinence. You have a sudden, intense urge to urinate followed by AN involuntary loss of urine. you will urinate often, together throughout the night. Enuresis is also caused by a minor condition, equivalent to infection, or a lot of severe conditions such as a nervous disorder or diabetes.
Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
Functional incontinence. A physical or mental impairment keeps you from making it to the restroom in time. For example, if you've got severe arthritis, you'll not be ready to undo your pants quickly enough.
Mixed incontinence. You experience quite one style of incontinence — most frequently this refers to a mixture of urinary incontinence and urge incontinence.
When to see a doctor
You may feel uncomfortable discussing incontinence together with your doctor. however if incontinence is frequent or has effects on your quality of life, it' necessary to hunt medical recommendation as a result of incontinency may:
Cause you to restrict your activities and limit your social interactions
Negatively impact your quality of life
Increase the risk of falls in older adults as they rush to the toilet
Indicate a more serious underlying condition
Causes Urinary incontinence
Urinary incontinence will be caused by everyday habits, underlying medical conditions or physical problems. An intensive analysis by your doctor will facilitate verifying what's behind your incontinence.
Factors include:
pregnancy and childbirth
After menopause, the level of estrogen in a woman's body falls, which can make her muscles weaker.
Surgeries such as hysterectomy can be risky.
age
obesity
Urge incontinence
Some possible causes of urge incontinence have been identified:
Urinary tract infections (UTIs) are a type of inflammation of the bladder.
Neurological conditions such as multiple sclerosis (MS), stroke, and Parkinson's disease can affect the brain.
A larger prostate can cause the bladder to droop and the urethra to become irritated.
Overflow incontinence
When there is a blockage in the bladder, this happens. Some things that can cause a blockage include:
an enlarged prostate gland
a tumor pressing against the bladder can cause difficulty urinating.
urinary stones
constipation
Urine leakage from the bladder after surgery went too far.
Total incontinence
This can result from:
an anatomical defect present from birth
A spinal cord injury that impairs nerve signals between the brain and the bladder can cause urinary problems.
A fistula occurs when a tube or channel forms between the bladder and nearby area, such as the vagina.
Other causes:
These include:
Some medications, like diuretics and antihypertensive drugs, can make you sleepy. Sleeping tablets, sedatives, and muscle relaxants can also be used to relieve pain.
alcohol
urinary tract infections (UTIs)
Urinary incontinence is usually caused by a certain cause.
They include:
Stress incontinenceWhen someone coughs, laughs, or is doing an activity such as running or jumping, urine leaks out.
Urge incontinenceWhen the urge to urinate suddenly becomes intense, urine leaks at the same time or shortly afterwards.
Incontinence caused by urine overflow.Leaking can happen if the bladder is not emptied completely.
Total incontinence: The bladder cannot store urine
Functional incontinenceIf a person does not have time to go to the bathroom in time, their urine will escape. This can be due to a mobility issue.
Mixed incontinence: A combination of types
The main symptom of urinary incontinence is the unintentional release of urine. This can happen in different ways depending on the type of urinary incontinence.
Temporary urinary incontinence
Certain drinks, foods and medications may act as diuretics — stimulating your bladder and increasing your volume of urine. They include:
Alcohol
Caffeine
Carbonated drinks and sparkling water
Artificial sweeteners
Chocolate
Chili peppers
Foods that are high in spice, sugar or acid, especially citrus fruits
Heart and blood pressure medications, sedatives, and muscle relaxants
Large doses of vitamin C
Urinary incontinence may also be caused by an easily treatable medical condition, such as:
Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate and, sometimes, incontinence.
Constipation. The body part is found close to the bladder and shares several of an equivalent nerve. Hard, impacted stool in your rectum causes these nerves to be hyperactive and increase urinary frequency.
Persistent urinary incontinence
Urinary incontinence may also be a persistent condition caused by underlying physical issues or changes, including:
Pregnancy. Hormonal changes and the increased weight of the fetus can lead to stress incontinence.
Childbirth. Vaginal delivery will weaken muscles required for bladder management and harm bladder nerves and adjunct tissue, resulting in a born (prolapsed) girdle floor. With prolapse, the bladder, uterus, body part or bowel can get pushed down from the standard position and protrude into the vagina. Such protrusions could also be related to incontinence.
Changes with age. Aging of the bladder muscle will decrease the bladder' capability to store urine. Also, involuntary bladder contractions become a lot more frequent as you get older.
Menopause. After menopause, girls turn out less estrogen, an endocrine that helps keep the liner of the bladder and canal healthy. Deterioration of those tissues will irritate incontinence.
Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
Prostate cancer. In men, enuresis or urinary incontinence is related to untreated prostate cancer. However, incontinence may be a facet result of treatments for prostate cancer.
Obstruction. A growth anyplace on your tract will block the conventional flow of piddle, resulting in overflow incontinence. Urinary stones — hard, hard plenty that kind within the bladder — generally cause urine leakage.
Neurological disorders. Multiple sclerosis, Parkinson' disease, a stroke, a tumor or a spinal injury will interfere with nerve signals concerned in bladder control, inflicting urinary incontinence.
Risk factors Urinary incontinence
Factors that increase your risk of developing urinary incontinence include:
Gender. Women are additional seemingly to their own stress incontinence. Pregnancy, childbirth, climacteric and traditional feminine anatomy account for this difference. However, men who have endocrine issues are at accrued risk of urge and overflow incontinence.
Age. As you get older, the muscles in your bladder and canal lose a number of their strength. Changes with age cut back what proportion your bladder will hold and increase the possibilities of involuntary excretory product release.
Being overweight. Extra weight will increase pressure on your bladder and close muscles, which weakens them and permits pliers to break after you cough or sneeze.
Smoking. Tobacco use may increase your risk of urinary incontinence.
Family history. If a close family member has urinary incontinence, especially urge incontinence, your risk of developing the condition is higher.
Some diseases. Neurological disease or diabetes may increase your risk of incontinence.
Complications Urinary incontinence
Complications of chronic urinary incontinence include:
Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.
Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.
Prevention Urinary incontinence
Urinary incontinence isn't always preventable. However, to help decrease your risk:
Maintain a healthy weight
Practice pelvic floor exercises
Avoid bladder irritants, such as caffeine, alcohol and acidic foods
Eat more fiber, which can prevent constipation, a cause of urinary incontinence
Don't smoke, or seek help to quit if you're a smoker
Is incontinence a normal part of aging?
Incontinence refers to the inability to control urination. When this happens it can have both physical and emotional consequences Incontinent people often feel shame, embarrassment or they may be anxious about having accidents in public places However incontinence is a common problem that can affect anyone regardless of age or gender.
How can I increase my urine flow naturally?
Doctors generally consider urine output of less than one cup per day to be insufficient and a sign that the patient may not be drinking enough liquids If your output is low try these tips: 1. Don’t hold it in! If you feel the need to urinate but are not near a toilet try to find one quickly Urinating on demand prevents excess water from building up in your body 2. Ensure you are getting the right amounts of fluid each day by taking inventory throughout the day and drinking more if necessary -- especially before bedtime when you are likely to lose some fluids while sleeping.
What drinks make you pee fast?
Water is by far the best drink to keep your body hydrated and eliminate waste effectively Other drinks that promote urination include black coffee and tea both of which contain caffeine Cranberry juice is a natural diuretic which helps your kidneys release urine more quickly by flushing out excess water from your system Alcohol contains diuretic properties too so it can also help you pee faster But be careful because too much alcohol can actually lead to dehydration.
Diagnosis Urinary incontinence
Often, the designation method for incontinence will start with a speech communication along with your health care supplier regarding your anamnesis and bladder management issues. It's vital to see the kind of incontinence that you simply have, and your symptoms typically tell your doctor which sort you have. That info will guide treatment decisions. Your doctor is probably going to start out with an intensive history and physical exam. you will then be asked to try and do an easy maneuver which will demonstrate incontinence, like coughing.
After that, your doctor will likely recommend:
Urinalysis. A sample of your urine is checked for signs of infection, traces of blood or other abnormalities.
Bladder diary. For many days you record what proportion you drink, after you urinate, the {number} of water you produce, whether or not you had an associated urge to urinate and also the number of incontinence episodes.
Postvoid residual measurement. You're asked to urinate (void) into an instrumentality that measures piss output. Then your doctor checks the number of leftover urine in your bladder employing a tubing or ultrasound test. an oversized amount of leftover urine in your bladder might mean that you just have associate degree obstruction in your tract or a drag along with your bladder nerves or muscles. If any info is needed, your doctor may suggest more-involved tests, love urodynamic testing and girdle ultrasound. These tests are typically done if you're considering surgery.
Treatment Urinary incontinence
There are many alternative factors that your attention supplier will think about once making a treatment arrange for your incontinence. The sort of incontinence and also the ways that it affects your life are each massive considerations. Your provider also will ask you about the type of treatment you're most snug with. There are 3 main varieties of treatment you'll be able to hunt for incontinence — medications, lifestyle changes and surgery. Every choice has pros and cons that your provider will discuss with you.Treatment for incontinence depends on the type of incontinence, its severity and the underlying cause. a mixture of treatments could also be needed. If an Associate in Nursing underlying condition is inflicting your symptoms, your doctor can initially treat that condition. Your doctor might suggest less invasive treatments to begin with and go to different choices if these techniques fail to assist you.
Behavioral techniques
Your doctor may recommend:
Bladder training, to delay excretion once you get the urge to go. you will begin by associate degree attempt|attempting} to carry off for ten minutes whenever occasion|anytime} you are feeling an urge to urinate. The goal is to elongate the time between visits to the restroom till you're urinating solely every 2.5 to 3.5 hours.
Double voiding, to help you learn to empty your bladder a lot to avoid overflow incontinence. Double emission suggests that urinating, then waiting a number of minutes and attempting again.
Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
Fluid and diet management, to regain management of your bladder. you'll ought to shrink on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity can also ease the problem.
Pelvic floor muscle exercises
Your doctor may suggest that you simply do these exercises often to strengthen the muscles that facilitate management urination. conjointly called Kegel exercises, these techniques are particularly effective for urinary incontinence however may additionally help urge incontinence.
To do pelvic floor muscle exercises, imagine that you're trying to stop your urine flow. Then:
Tighten (contract) the muscles you'd use to prevent urinating and hold for 5 seconds, and so relax for five seconds. (If this is often too difficult, begin by holding for 2 seconds and quiet for 3 seconds.)
Work up to holding the contractions for 10 seconds at a time.
Aim for at least three sets of 10 repetitions each day.
To help you establish and contract the proper muscles, your doctor could advise that you just work with a girdle floor healer or attempt training program techniques.
Medications
Medications commonly used to treat incontinence include:
Anticholinergics. These medications will calm an hyperactive bladder and should be useful for urge incontinence. Examples embrace oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium chloride.
Mirabegron (Myrbetriq). Used to treat urge incontinence, this medication relaxes the bladder muscle and may increase the quantity of piss your bladder can hold. it should conjointly increase the amount you're ready to urinate at one time, serving to empty your bladder a lot.
Alpha blockers. In men who have enuresis or overflow incontinence, these medications relax bladder neck muscles and muscle fibers within the prostate and create it easier to empty the bladder. Examples embody tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), and doxazosin (Cardura).
Topical estrogen. Applying low-dose, topical sex hormones within the style of a duct cream, ring or patch might facilitate tone and rejuvenate tissues in the duct and vaginal areas.
Electrical stimulation
Electrodes are quickly inserted into your body part or channel to stimulate and strengthen girdle floor muscles. mild electrical stimulation may be effective for enuresis and urge incontinence, however you will want multiple treatments over many months.
Medical devices
Devices designed to treat women with incontinence include:
Urethral insert, a small, tampon-like disposable device inserted into the duct before a selected activity, like tennis, that may trigger incontinence. The insert acts as a plug to forestall discharge and is removed before urination.
Pessary, a flexible siloxane ring that you just insert into your duct and wear all day. The device is additionally utilized in girls with channel prolapse. The contraceptive device helps support the urethra, to forestall excreta leakage.
Interventional therapies
Interventional therapies that may help with incontinence include:
Bulking material injections. A synthetic material is injected into tissue encompassing the channel. The bulking material helps keep the urethra closed and scale back excretion leakage. This procedure is for the treatment of enuresis and is usually less effective than more-invasive treatments corresponding to surgery. it should be perennial over once.
OnabotulinumtoxinA (Botox). Injections of botulinum toxin A into the bladder muscle could profit folks that have Associate in Nursing hyperactive bladder and urge incontinence. Botox is usually prescribed to folks as long as different treatments haven't been successful.
Nerve stimulators. There are 2 sorts of devices that use painless electrical pulses to stimulate the nerves concerned in bladder management (sacral nerves). One kind is established underneath your skin in your cheek and connected to wires on the lower back. The opposite type could be a removable plug that's inserted into the vagina. Stimulating the sacral nerves will control hyperactive bladder and enuresis if other therapies haven't worked.
Surgery
If different treatments aren't working, many surgical procedures will treat the issues that cause urinary incontinence:
Sling procedures. Synthetic material (mesh) or strips of your body' tissue are wont to produce a girdle sling beneath your duct and therefore the space of thickened muscle wherever the bladder connects to the urethra (bladder neck). The sling helps keep the urethra closed, particularly after you cough or sneeze. This procedure is employed to treat stress incontinence.
Bladder neck suspension. This procedure is meant to produce support to your duct associate degreed bladder neck — a district of thickened muscle wherever the bladder connects to the urethra. It involves an abdominal incision, therefore it' done throughout general or spinal anesthesia.
Prolapse surgery. In girls who have girdle organ prolapse and mixed incontinence, surgery might embody a mixture of a sling procedure and prolapse surgery. Repair of pelvic organ prolapse alone doesn't habitually improve incontinence symptoms.
Artificial urinary sphincter. A small, fluid-filled ring is planted round the bladder neck to stay the urinary sphincter muscle shut till there's a desire to urinate. To urinate, you press a valve implanted beneath your skin that causes the ring to deflate and permits wee wee from your bladder to flow.
Absorbent pads and catheters
If medical treatments can't eliminate your incontinence, you'll strive merchandise that facilitate ease the discomfort and inconvenience of unseaworthy urine:
Pads and protective garments. Most merchandise are not any additional larger than traditional underclothes and might be simply worn below everyday clothing. Men who have issues with dribbles of excreta can use a drip collector — a little pocket of absorbent artifact that's worn over the phallus and commanded in situ by tight underwear.
Catheter. If you're incontinent as a result of your bladder not emptying properly, your doctor could advocate that you simply learn to insert a soft tube (catheter) into your canal many times daily to empty your bladder. You'll be tutored on a way to clean these catheters for safe reuse.
More Information
Bladder control problems in women: Seek treatment
Bladder control problems: Medications
Surgery for stress incontinence in women
Lifestyle and home remedies
Problems with piddle escape could need you to require additional care to forestall skin irritation:
Use a washcloth to clean yourself.
Allow your skin to air-dry.
Avoid frequent laundry and douching as a result of these will overwhelm your body' natural defenses against bladder infections.
Consider using a barrier cream, such as petroleum jelly or cocoa butter, to protect your skin from urine.
Ask your doctor regarding special cleansers created to get rid of pee which will be less drying than alternative products. If you've got enuresis or nighttime incontinence, build the bathroom additional convenient:
Move any rugs or furniture you might trip over or collide with on the way to the toilet.
Use a night light to illuminate your path and reduce your risk of falling.
If you have functional incontinence, you might:
Keep a bedside commode in your bedroom
Install an elevated toilet seat
Widen an existing bathroom doorway
Alternative medicine
There are not any medicine therapies that are established to cure urinary incontinence. Early studies have shown that stylostixis will give some profit. Yoga additionally could provide some benefit for urinary incontinence, however additional study is needed.
Coping and support
If you're embarrassed by a few bladder management problems, you'll try and cope on your own by carrying absorbent pads, carrying further garments or maybe avoiding going out. However, effective treatments are on the market for urinary incontinence. It's vital to raise your doctor regarding treatment. Once you do, you'll air your thanks to return an energetic and assured life.
Preparing for your appointment
If you have got urinary incontinence, you're likely to start out by seeing your medical aid doctor. You will be called a doctor who specializes in tract disorders (urologist) or a gynecologist with special coaching in feminine bladder issues and urinary performance (urogynecologist).
What you can do
To get ready for your appointment, it helps to:
Be aware of any pre-appointment restrictions, such as restricting your diet
Write down your symptoms, including however usually you urinate, nighttime bladder activity and episodes of incontinence
Make a list of all your medications, vitamins and supplements, including doses and how often you take the medication
Write down key medical information, including other conditions you may have
Ask a relative or friend to accompany you, to help you remember what the doctor says
Take a notebook or electronic device with you, and use it to note important information during your visit
Write down questions to ask your doctor
For urinary incontinence, some basic questions to ask your doctor include:
What's the most likely cause of my symptoms?
What kinds of tests do I need? Do these tests require any special preparation?
Is my urinary incontinence temporary?
What treatments are available?
Should I anticipate any side effects of the treatment?
Is there a generic alternative to the medicine you're prescribing for me?
I have other health conditions. How can I best manage these conditions together?
Don't hesitate to ask other questions during your appointment as they occur to you.
What to expect from your doctor
Your doctor is likely to ask you a few questions, such as:
When did you first begin experiencing symptoms, and how severe are they?
Have your symptoms been continuous or occasional?
What, if anything, seems to improve or worsen your symptoms?
How often do you need to urinate?
When do you leak urine?
Do you have trouble emptying your bladder?
Have you noticed blood in your urine?
Do you smoke?
How often do you drink alcohol and caffeinated beverages?
How often do you eat spicy, sugary or acidic foods?
General summary
Yoga can cure your incontinence Yoga is a powerful method of curing this condition and regain control over one's bowel and bladder functions The breathing exercises practiced in yoga have been found to play a very important role in controlling one's muscles as well as the nerves in the pelvic region that control defecation and urination When these are properly controlled it will lead to better functioning of these muscles after some time.
Home remedies for incontinence are a great cheap way to treat the condition Many people opt for surgery as their only solution but home remedies can ease symptoms and allow more time between treatments There isn't one specific cure for urinary incontinence A variety of different treatments work best for different cases so there may be some trial and error involved in finding what works best for you Although each remedy has its own package insert or other indication on what it does and how much to take ask your doctor about your situation before taking them as there's always a chance that you could have an allergic reaction to any of.
Many people think that incontinence only affects older adults and that the condition is caused by age or childbirth While pregnancy genetics and the natural deterioration of muscle tone with age can contribute to urinary incontinence it does not mean a younger person who exercises regularly and is in good health cannot develop this condition Pregnant women are particularly at risk for developing incontinence due to the immense pressures their bodies are put under during pregnancy.
