What is Urinary Incontinence?
Urine is formed in the kidneys and then passes through the ureters (narrow tubes) into the sac-like bladder, where it is temporarily stored until muscles surrounding the outlet of the bladder are signaled by the brain to relax and allow urine to flow out. Urinary incontinence also referred to as an overactive bladder, is the inability to control the flow of urine. The condition is more common in women than in men.
Types of Urinary Incontinence
Types of urinary incontinence:
- Stress incontinence: Leakage of small amounts of urine when pressure is exerted on the bladder while coughing, laughing, sneezing, lifting a heavy object or exercising
- Urge incontinence: Leakage of urine at unexpected situations after having a sudden urge, including during sleep
- Functional incontinence: Physical or mental disability that prevents you from reaching a toilet in time
- Overflow incontinence: Unexpected leakage of small amounts of urine because of a full bladder
- Mixed incontinence: Presence of more than one type of incontinence
Causes of Urinary Incontinence
The causes of urinary incontinence include:
- Weak muscles in the lower urinary tract
- Pregnancy, childbirth, menopause, weight gain or other conditions that stretch the pelvic floor muscles
- Urinary tract infection (UTI)
- Bladder cancer or stones
- Blockage within the urinary tract
- Removal of the uterus (hysterectomy)
- Neurological disorders
Symptoms of Urinary Incontinence
The common symptoms include a sudden, urgent and uncontrollable need to urinate, involuntary release of urine and frequent urination.
Diagnosis of Urinary Incontinence
To diagnose urinary incontinence, your doctor will review your medical history and ask you to maintain a diary on the pattern of your voiding. A thorough physical examination is also performed. Your doctor may perform a bladder stress test to view the loss of urine when you cough. A urine analysis and culture of a sample of your urine may be ordered to examine for signs of infection or urine stones. Pelvic ultrasound and cystoscopy (a thin tube with a camera inserted into the urethra) may be ordered to view abnormalities in the urinary tract. Urodynamics measures the pressure in the bladder and the flow of urine.
Treatment for Urinary Incontinence
Urinary incontinence in women can be treated with non-surgical methods such as pelvic floor exercises (Kegel exercises) to strengthen the pelvic floor muscles, electrical stimulation, where an electrical current is applied to stimulate the muscles, medication and medical devices that are inserted into the urethra or vagina to support the bladder. You will also be taught how you can train yourself and schedule your trips to the toilet. When these methods fail, your doctor may inject bulking material or Botox around the urethra or bladder muscles. Surgery is considered as the last treatment option if conservative treatment methods are unsuccessful. The most common methods include:
- Urethral sling procedure involves placing a sling of body tissue or synthetic material around the urethra to keep it closed.
- Bladder neck suspension is performed to support the bladder neck and urethra.
- Prolapse surgery is performed when one of the organs in the pelvis prolapses causing incontinence.