Urinary Incontinence is the involuntary loss of bladder control. It is estimated that over thirty percent (30%) of people living in the United States suffer from urinary incontinence, making it a common and embarrassing problem for many. While incontinence affects both men and women, females are at an increased risk due to several factors but is typically not age related. Many people who experience incontinence avoid certain situations and places from fear of embarrassment. This condition does not have to limit your life and is almost always treatable once the underlying cause is found and addressed.
Types of incontinence
There are many different types of urinary incontinence. Each has its own specific causes and treatments and can affect different people for different reasons.
Stress Incontinence is more common in women than men and can occur when the pelvic floor muscles weaken. Everyday activities such as bending, laughing, stretching, coughing and sneezing can cause strain and weaken these muscles causing unwanted leakage to happen. The severity of the leakage varies based on several factors but can be anywhere from a few drops to a tablespoon of urine depending on the severity.
Urge Incontinence is caused by over-activity of the detrusor muscle. Urge Incontinence is just what it sounds like - its main symptom being an overwhelming or sudden urge to void the bladder followed by a leaking of urine. Frequent and nighttime urination both often occur with this type of incontinence. Other triggers can include an individual simply hearing the sound of running water or just changing positions while sitting or lying down. Urge incontinence is more typical in patients that are ages 75 and older but can affect both men and women of any age.
In some patients both stress incontinence and urge incontinence may occur at the same time, this is what is known as Mixed Incontinence. Basically, it is simply having the combination of the two.
It is basically still unknown if an overactive bladder condition is associated with urge incontinence. Overactive Bladder or (OAB) for short is a sudden and uncontrollable bladder contraction. OAB can cause frequent trips to the restroom throughout the day and night interfering with sleep, work and often an individual's social life. Approximately thirty percent (30%) of men and forty percent (40%) of all women in the US are affected by OAB. Obviously, it is not normal and not something you have to live with. There are treatments available that can help.
There are many ways to treat bladder incontinence, however you should always check with your primary care doctor or a urologist if your symptoms do not improve. If you do not have a urologist, you can call Philadelphia Urology Associates for an appointment or second opinion at 215-563-1199.
Lifestyle changes can often help with mild cases of incontinence. Make sure that you are drinking adequate fluids to avoid dehydration. Four to six glasses a day are recommended, however you should refrain from drinking too much fluids after dinner and before bed time. Try to avoid caffeine, because caffeine is a diuretic that is found in coffee, tea and many sodas. Alcohol and smoking can also lead to incontinence and should be minimized or discontinued if you have symptoms.
Women can perform Kegel exercises to help strengthen the pelvic floor muscles which reduces and can even cure the symptoms of stress incontinence. A regular routine is suggested to both achieve and maintain the maximum benefits. Kegel exercises can be done at home with just a little bit of time and effort, plus they require no gym equipment. To perform Kegel exercises, simply start by contracting the muscles you would use to stop urinating. Then hold this for three to five seconds, followed by then relaxing for the next three seconds. Gradually work up to three sets of 10 repetitions over the course of the next several weeks. Once you get comfortable and make progress you should be able to perform them while standing or sitting. If you are having any trouble finding the “correct muscles”, consider contacting a urologist. A urologist can assist you by using a bio feedback machine that allows you to see real time feedback until your body can perform these on its own.
Bladder training is also a great way to treat incontinence. To get started, try to go to the restroom at specific and set times. The objective here is to urinate frequently which should help to minimize the urge, thus helping you to minimize or avoid any accidents. Over time your bladder will become stronger, thus minimizing your trips to the bathroom by spreading them further apart. It is important to stick to the schedule whether you feel the need to urinate or not. You should be able to train your bladder in one to three months, so keeping a diary and recording your trips to the bathroom (and the exact times you peed) can be extremely helpful in analyzing your progress. This will allow you to see how often you are urinating and help monitor what fluids or liquids you are taking in. Keeping a diary can help both you and your doctor to determine your triggers and symptoms and thus optimize your treatment.
Medications can also be used to treat your incontinence.
- Antispasmotics – These are used to help decrease bladder contractions and minimize leaks.
- Tricyclic Antidepressants – These may be to help decrease nerve signals and minimize spasms in the bladder.
- Antidiuretic hormone – Used to help your body retain water, which will result in a more "concentrated" urine.
Only your doctor can prescribe these medications and all medications can have side effects. Common side effects can include dry mouth, decreased sweating, light sensitivity and over-heating in extreme weather conditions. If you experience any side effects, please consult your doctor, who can then adjust the strength of the medication or perhaps prescribe another medication which may have fewer side effects.
If you or a loved one are experiencing urinary incontinence, please contact Philadelphia Urological Associates online for an appointment today or call us now at 215-563-1199. Dr Sloane and his team are experts in the field and can offer you the help you deserve.