Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine.
It is a common and distressing problem, which may have a large impact on quality of life.
Causes of UI may be:
- Urinary Tract Infection
- Multiple Childbirth
- Overactive Bladder
- Weak bladder Muscles
- Weak pelvic floor muscles-These muscles provide support for the bladder, intestine, and the uterus.
- Anxiety or Stress (Emotional factors)
- Pelvic organ Prolapse-This happens when organs shift out of place and into the vagina. This shift can prevent the bladder and urethra from working properly.
- Diseases like diabetes, Parkinson’s and multiple sclerosis (MS)- Can damage the nerves that control your bladder.
Risk Factors of UI
- Old age.
- Obesity and physical inactivity.
- Pregnancy and childbirth.
- Diseases that affect the nerves or spinal cord (neurological diseases).
- Chronic coughing-This can increase pressure on the bladder and pelvic floor muscles
Types of UI:
- Urge Incontinence: A sudden urge to urinate and passing urine involuntarily before you can get to a bathroom
- Stress Incontinence: Sudden forceful activity that forces urine to pass involuntarily like coughing, laughing, exercise, sneezing or even sometimes turning in the bed
- Overflow Incontinence: Needing to urinate often but urinating only a small amount or constantly dribbling urine.
- Functional Incontinence: Urinating because you cannot get to the bathroom in time due to a physical disability or communication/thinking problems, such as Alzheimer disease
- Proper Medical history and Physical examination
- Urine Tests
- Frequency-Volume charting: Urologist may ask to make a log of when you urinate, how much you urinate and kind of sensation with leakage of urine.
- USG /CT scan KUB (Kidney, Ureter and Bladder) region
- Cystoscopy: In this procedure, Urologists inserts a tube with a light and camera (cystoscope) through the urethra and into the bladder to check for problems.
- Urodynamic testing. These tests assess how well the bladder, urethra, and sphincter can store and release urine.
Depends on the type of incontinence that you have and its cause. It includes:
- Lifestyle changes
- Quit smoking.
- Reducing and maintain a healthy weight.
- Physical Activity/Exercise: Moderate intensity exercise of at least 15-30mins/day
- Eating a healthy diet.
- Avoid fried foods/high fat diet.
- Avoid refined carbohydrates like white bread and white rice.
- Limit alcohol and caffeine.
- Increase your fiber intake like fresh fruits, vegetables, whole grains etc.
- Strengthening Pelvic floor muscles by regular pelvic floor exercises.
- Bladder training to increase the amount of time between bathroom breaks
- Using techniques to suppress bladder urges like distraction techniques
- Medicines to relax the bladder muscles and prevent bladder spasms.
- Botox injections- These can help relax the bladder muscles.
- Electric Nerve Stimulation-Using pulses of electricity to help change bladder reflexes
- Surgery like Tension Free Vaginal Tapes (TVT-O, TVT-Retropubic)