Urinary Incontinence is the involuntary leakage of urine: it is a common and distressing problem which may have a large impact on the quality of life, as it constitutes a social and/or hygiene problem.

The involuntary passage of urine varies in amounts: from occasionally happening after laughing, coughing or sneezing, to a strong urge of urination without getting the chance to get to the toilet.

It is advisable talk to your doctor if you have any symptoms of urinary incontinence, as usually there are simple treatments that help you with the problem

Stress Incontinence:
This type of incontinence is usually present when involuntary leakage occurs from effort or exertion, or from coughing, sneezing, or laughing

Urge Incontinence:
Urge Incontinence occurs when there is a feeling of a sudden and strong urge to urinate.
Often individuals do not have time between the urge and the loss of urine to make it to the toilet. Although most cases are idiopathic, patients with neurologic disorders (including dementia) are particularly at high risk

Overflow Incontinence:
This type of incontinence occurs when individuals urinate but do not completely empty the bladder, which may cause frequent or constant dribbling.
Overflow Incontinence accounts for around 5% of incontinence in women, but because of the prevalence of prostate disorders, accounts for 30% to 50% of incontinence in older men

Mixed Incontinence:
Occurs when two or more of the above types are present simultaneously, most often urge incontinence in combination with another type.
Mixed Incontinence is very common, and may occur in as many as 50% of incontinence patients

Functional Incontinence:
Is the inability or unwillingness to go the toilet, because of physical, cognitive, psychological or environmental factors (patients who are physically restrained or who have severe depression)

Incontinence may be sudden and go away after a short period of time. Or it may continue for a long time.

Talk to your doctor to get an evaluation and the needed help and treatment

Causes of Sudden or Temporary Incontinence:

o Bedrest – i.e. when recovering from surgery
o Urinary tract infections
o Prostate infection or inflammation
o Severe constipation
o Weight gain
o Mental confusion
o Certain medications (Diuretics, antidepressants, tranquilizers, others..)
o Excessive alcohol intake
o Irritation of the bladder due to excessive intake of caffeine
o Drinking excessive quantities of fluids o Artificial sweeteners and spicy food

Causes of Urinary Incontinence that may be Long Term:

o Pregnancy and Childbirth: Hormonal changes during pregnancy, as well as delivery can weaken the muscles needed for bladder control
o Aging
o Menopause
o Hysterectomy
o Enlarged Prostate and Prostate Cancer
o Nervous System Conditions
o Bladder Spasms and Bladder Cancer
o Depression

 

Complications caused by Urinary Incontinence:

o Embarrassment of the patient
o Skin irritations
o Negative influence on the urinary system

There are some things that can increase the risk of Urinary Incontinence; known as the Risk Factors. These include:

Genetic Factors: If other people in the family have experienced this problem, you might be at risk

Increasing Age

Gender: Females are more likely to have “Stress Incontinence”, while Males are at higher risk of “Urge and Overflow Incontinence”

High Weight

Other Diseases: Such as Neurological Diseases and Diabetes

The treatment depends on identifying the TYPE of Incontinence, the SEVERITY, and the CAUSE.


Behavioral Therapies: the first line of treatment, because they are safe and often effective. Two principles underlie the behavioral treatments:

1- Keep the bladder volume low by frequent voiding
2- Inhibit detrusor contraction by retaining cerebral and pelvic incontinence mechanisms


Bladder Training:

Progressively lengthening the interval between voiding, by trying to hold off for a few minutes each time there is an urge to urinate


Pelvic Muscle Exercises (Kegel Exercises):

These exercises are used to strengthen the muscles that help control urination. Patients are instructed to contract the pelvic muscles for 10 seconds at a time, 30 to 80 times per day


Electrical Stimulation:

Electrical Stimulation of the pelvic floor muscles by introducing electrodes through the anus or vagina


Absorbent Pads:

There are products that ease the discomfort and embarrassment caused by incontinence. Most products are now discreet and no more bulky than normal underwear, and can be easily worn under clothing. The range include products that are suitable for both Men and Women (Fine Care® Range of Products)


Urinary Catheters:


Those are soft tubes (catheters) that are inserted into the urethra several times a day to drain the bladder


Injection of Botulinum Toxin (Botox):

Botox injection is a new and promising treatment for patients with incontinence


Medications:

Medications commonly used to treat incontinence include: Oxybutynin, Tolterodine, Adrenergic Agonists, Estrogen and Duloxetine


Medical Devices:

For Women: Pessaries, suction devices that occlude the urethral outflow, and ballooned inserts that lie within the urethral orifice
For Men: Penile Clamps


Surgical Options:

Surgical treatment is used when other treatments are not effective. Surgical options including injections of urethral bulking agents and suburethral sling are often effective for women with stress incontinence. Form men with stress incontinence, injection of periurethral bulking agents (collagen) or surgical implantation of an artificial urethral sphincter can improve or eliminate incontinence

Making the following changes in your lifestyle may help the problem:

o Lose weight
o Stop smoking
o Drink less fluids and limit the intake of alcohol and caffeine, which are considered diuretic
o Avoid constipation
o Eat foods that are rich in Magnesium, or take supplements rich in Magnesium
o Take Vitamin D
o Try to prevent skin irritations by:
- Use a washcloth to clean yourself
- Use a barrier cream
- Avoid frequent washing
- Leave your skin to air-dry

Reduce fluid intake before bedtime, and try not to drink after 6pm

o Avoid food and beverages that irritate the bladder and that include caffeine, alcohol, acidic foods and drinks, chocolate, artificial sweeteners and spices
o Urinate twice before going to bed
o Do Kegel exercises