Incontinence is a common condition that involves the involuntary loss of urine. Although it is not usually a serious condition, incontinence can be embarrassing and affect a person's daily life. Incontinence is more common in women, especially during and after pregnancy, but can affect people of all ages.
Dr. Rehder does urodynamic testing in the office. This simple fifteen minute test can save you years of embarrassment.
Causes of Incontinence
Incontinence is often caused by a urinary tract infection or weak muscles in the urinary tract. Some medications may cause weak bladder muscles, therefore causing urinary incontinence. Weak muscles may prevent the closing off of the urethra, and performing certain activities may cause urine to leak. Normal urination involves emptying the bladder when the desire to urinate occurs, at which point the bladder contracts and urine flows out of the body. Once the bladder is empty, the muscles contract and urination stops. People with incontinence experience a disruption in this process that causes a loss of bladder control and results in symptoms.
Underlying Causes of Incontinence
In some cases, urinary incontinence may be a symptom of another condition and an underlying problem is causing the urine leakage. Some common bladder and pelvic floor disorders that may cause incontinence are:
Pelvic Organ Prolapse - Prolapse is the bulging, sagging or falling of pelvic organs such as the bladder, uterus, rectum or intestine.
Urinary Tract Infection - Symptoms of a urinary tract infection include burning when urinating, frequent urge to urinate, pelvic pain and fever.
Interstitial Cystitis - The inflammation or irritation of the bladder wall, experienced in interstitial cystitis, can cause chronic pain, the stiffening and scarring of the bladder, a decrease in the amount of urine the bladder can hold, painful sexual intercourse and a frequent need to urinate.
Bladder Cancer - The most telling sign of bladder cancer is blood in the urine. Other symptoms include pain when urinating, frequent need to urinate and an unproductive urge to urinate.
Symptoms of Incontinence
In addition to leaking urine, people with incontinence may also experience the following symptoms:
- Strong desire to urinate
- Pelvic pressure
- Frequent urination
- Painful urination
Incontinence is a common condition with many treatment options that can relieve symptoms and allow patients to perform their regular activities without the embarrassment and worry of urinary leakage.
Types of Incontinence
There are three main types of urinary incontinence:
Urge - Urge incontinence is most common and involves leakage that occurs after a sudden urge to urinate because the muscle wall of the bladder is overactive.
Stress - Stress incontinence is leakage that occurs after an activity such as coughing, laughing or sneezing places pressure on the bladder.
Overflow - Overflow incontinence occurs as the result of an inactive bladder muscle that does not completely empty the bladder after urination. This is the least common form of incontinence.
Diagnosis of Incontinence
Patients exhibiting the symptoms of incontinence should see their doctor to determine the cause, type and severity of their condition. Doctors can diagnose urinary incontinence through a series of tests and an evaluation of the patient's medical history. Patients may also be asked to keep a bladder or urination diary to record the frequency and circumstances of their urination. Testing may begin with a pelvic exam to detect any physical abnormalities, and may also include the following:
- Blood tests
- A pad test or dye test to determine urine leakage during stressful situations
Upon completion of testing, the doctor will be able to make an accurate diagnosis and determine the cause of the condition in order to recommend the most appropriate approach in treatment.
Treatment of Incontinence
There are many different treatment options available for patients with urinary incontinence, depending on the severity of their condition. Conservative treatments are often effective, and may include the following:
- Bladder training
- Avoiding alcohol and caffeine
- Medication to control pelvic muscle spasms.
- Kegel exercises to strengthen the pelvic floor muscles and prevent urine leakage
For more severe cases of incontinence, a medical device or surgery may be used to relieve symptoms. Some options may include:
Medical Device - A urethral insert or pessary may be inserted through the vagina to prevent urine leakage.
Surgery - To provide support to the bladder neck. It may be performed through the abdomen or vagina, or using minimally invasive techniques.
There are certain risks associated with any type of surgery, including infection, bladder spasms or recurring incontinence. A doctor will determine which treatment is best for the patient after a thorough medical and physical evaluation of their condition.
Prevention of Incontinence
Not all cases of urinary incontinence can be prevented, however the following recommendations may help in controlling incontinence in some people:
- Drinking less fluids
- Emptying the bladder regularly
- Avoiding caffeinated beverages
- Kegel Exercises