Urinary Incontinence (UI) is a condition where urine leaks out involuntarily. It can happen to men and women, young and old. Let’s find out what are the causes, symptoms, diagnosis and treatments of urinary incontinence.
Discover the Truth About Urinary Incontinence
Myth # 1 – It’s only for Older People (false)
Myth # 2 – Leaking a Little Urine is Normal (false)
Myth # 3 – Bladder Problem is Normal with Childbirth (false)
Fact # 1 – Sounds and Thoughts Can Trigger Urine Leakage (true)
Fact # 2 – You Should Not Avoid Liquids (true)
Fact # 3 – Men Can Do Kegels Too (true)
Women, Stress Incontinence and Safe Surgery
What is Diurnal Enuresis?
Bedwetting: Does This Require Medical Attention?
Causes and Symptoms of Bedwetting
Prevention of Bedwetting
Various Bedwetting Ages
Before Visiting The Doctor about Bedwetting
8 Things You Should Know About Incontinence Surgery
Botox Can Treat Urinary Incontinence
Urological Conditions in Men
Medications for an Overactive Bladder
Urinary Incontinence after Stroke
Tell Tale Signs of an Overactive Bladder
More than 25 million Americans are affected by Urinary Incontinence. However, because you don’t usually talk about how you leak urine every time you laugh, it’s not a common topic discussed. It’s probably for this reason that there have been many misconceptions surrounding this condition.
Many people who suffer from urinary incontinence come up with their own conclusions instead of talking about it with their doctors to get things straight. It’s about time to bust the myths and discover the truth about this bladder problem.
It’s true that a large percentage of people suffering from this condition are 40 years old and up. This can be accounted to estrogen loss during menopausal stage for women and problems with bladder function for men. But people as young as 20 years old can also experience urinary incontinence.
The problem with this is that many don’t see it as a problem. Some people who experience minor accidental leakage from time to time think that it’s normal, and they don’t talk to the doctor until they come to the point when they already have an overactive bladder and cannot wait until they get to the toilet to answer the call of nature. It’s a must not to downplay this condition and talk to your doctor about it immediately.
Many people think that incontinence is a normal part of childbirth. Although childbirth increases the risk, not everyone who gives birth will suffer from urinary incontinence. There are plenty of women who have delivered 9-pound babies vaginally and did not have urinary incontinence.
Now, let’s get over to the facts.
Coughing, laughing, and jumping are not the only things that can trigger incontinence but so do some sounds and thoughts. For example, the sound of running water or thoughts of drinking liquid can immediately bring out the urge to rush to the restroom.
Some people make the mistake of thinking that the best way to prevent urinary incontinence is to stop drinking liquid altogether. That’s not the case. Drinking small amounts frequently throughout the day can actually improve bladder control, inhibit urine leakage, and even reduce odor.
Contrary to popular belief, Kegels isn’t only for women. The fact that men can also experience urinary incontinence makes it necessary for them to do Kegels as well. Men should practice the habit of squeezing the muscles they use to stop urination to help improve the bladder’s ability to control urine.
Stress Incontinence, or incontinence as it is commonly called, is a term used to describe urinating involuntarily. The most common causes of stress incontinence include the simple acts of laughing or coughing, and exercise. There is now a safe surgical procedure to correct this condition, known as Tension-Free Vaginal Tape (TVT) surgery.
Why Does Stress Incontinence Happen?
Stress incontinence happens when the nervous system, kidneys and the urinary tract do not function normally. This results to the inability to hold urine in. What keeps urine from passing through and leaking out is the bladder’s sphincter which encloses the urethra and shuts close whenever one hold’s urine in. If a woman suffers from stress incontinence, the muscles in the pelvic area and the bladder (including the sphincter) become weak and are unable to control urine from passing. The weakening of these muscles can sometimes be caused by medication, injuries or surgeries.
The TVT Surgery
The TVT surgery is currently the safest surgical treatment for women who are experiencing stress incontinence. This medical procedure involves the use of a mesh tape in the urethra for the purpose of stopping incontinence. Incisions are created in the stomach, as well as in the vagina in order to insert the tape. As soon as it is properly placed in the urethra, no stitching is required.
The surgery can take a minimum of 30 minutes. Local anesthesia is administered to the patient prior to TVT surgery. With local anesthesia, the patient is numb and is unable to feel pain, but is awake for following the doctor’s instructions. For instance, the doctor may ask the patient to cough in order to determine the optimal placement in the urethra. This surgical procedure can also be performed in men who are experiencing stress incontinence.
As for recovery, the patient may need to stay overnight at the hospital, however this isn’t always necessary. A catheter can temporarily be used to pass urine. On average, recovery time takes about a week or two. Restrictions which will last for about six weeks are imposed during recovery, and these include cessation of strenuous activities and sexual intercourse. The possible risks for this surgery, despite it being the safest, include perforation of the bladder.
Unlike other procedures, the use of a tape in holding the urethra is what makes it safer than other surgical treatments for stress incontinence. The urethra does not need to be cut or stitched. After the surgery, the patient will need to urinate in order to check if the bladder and the urethra are functioning correctly.
Diurnal Enuresis is a medical term that is used to describe daytime wetting (incontinence) in children who are already past the age for toilet training. This incontinence may be caused by several reasons and will need to be evaluated by a doctor.
Diurnal enuresis is not the same as nocturnal enuresis or bedtime wetting. There are two types of diurnal enuresis, the primary type occurs in an older child, and the secondary type occurs in a child who has been previously toilet trained.
At What Age in Children Does Diurnal Enuresis Usually Happen?
In an article published by the National Kidney Urologic Diseases Information Clearinghouse (NKUDIC), incontinence in children happens less in kids who are five years old and above. Statistics show that around 10% of 5-year-old kids experience incontinence, 5% of 10-year-old kids experience incontinence and 1% of 18-year-olds experience incontinence. Studies have also shown that boys are more prone to it than girls are.
What Causes Daytime Wetting in Kids?
The most common cause for diurnal enuresis is constipation. Any related abnormal elimination of waste from the body is also a possible cause for daytime incontinence. Other causes of diurnal enuresis include structural problems, caffeinated beverages and food, voiding, a bladder that has decreased in capacity to store urine and urinary tract infections. Stress and anxiety can also be a cause for daytime incontinence.
How Is Diurnal Enuresis Diagnosed?
Diagnosis of diurnal enuresis will come after a full examination has concluded that all the symptoms lead to the condition. Other factors that need to be considered when making a diagnosis include medical history, physical examination and urinalysis. An ultrasonography examination of the kidneys and bladder may also be needed for a diagnosis.
Is There a Treatment for Diurnal Enuresis?
Generally, daytime wetness will resolve itself on its own as a kid becomes older. This is because with age, the bladder capacity increases, the production of antidiuretic hormone (ADH) becomes normalized and the child better recognizes the need to eliminate waste in the body. In fact, studies have shown that around 15 percent of kids above five years old are cured from diurnal enuresis.
Other ways to solve incontinence in kids include controlling the amount of fluids that are taken, not taking in as much caffeine and setting a schedule for urinating (for instance, every 2 hours). For more complicated conditions causing the daytime incontinence, treatment may include medication or bladder and urethra coordination training.
Bedwetting is usually not a serious problem but it can be embarrassing especially if the kid is already old enough. More often than not, kids stop wetting the bed on their own. Developing bladder control is a part of growing up, although it can take a while for some children to do so.
If you’re worried about your child’s bedwetting problem, there’s nothing that should stop you from seeing a doctor. Your doctor can easily tell you without having the child undergo tests if the problem is caused by an underlying medical condition or not.
However, bedwetting can be caused by Urinary Tract Infection (UTI) if it is accompanied by symptoms such as:
- pain during urination
- abdominal pain
In this case, a visit to the doctor is indeed necessary. Another case that may call for a visit is if your child has been dry for about 3 months or longer and then has begun to have the wetting problem again. This may be a sign of urinary tract infection or other health problem that warrants a doctor visit.
It’s possible that the bedwetting problem results in your child’s social withdrawal. He/she may not be spending time with friends in fear that his/her condition will be discovered and made fun of. He/she may also have low self-esteem because of this.
Even if there is no health problem found, the visit to the doctor can still be useful as the doctor will give tips and techniques to your child on how to have better control over his/her bladder.
Some of the recommended strategies include:
- using the toilet before sleeping
- not drinking soda and caffeinated beverages: These beverages are diuretics, meaning they make a person release more fluids than necessary. Not only are these drinks unhealthy, they can also cause dehydration as well as bedwetting.
It’s also a must for parents to remember that children develop bladder control at different ages. Some would stop having wetting problems at around 5 or 6 while it may take longer for other kids. Some may wet until 10 years. If a child is in top health condition and has more dry than wet nights, then the bedwetting is most likely not caused by a medical condition.
Going to the doctor shouldn’t be stressful or embarrassing to your child.
To effectively ease any stress that he/she might be feeling about the visit:
- Remind him/her that bedwetting is a common problem that even older kids experience.
- Don’t forget to assure your kid that it’s not his/her fault that he/she wets the bed.
- Make sure that you talk to him/her about what to expect, before you take your kid to the doctor.
- You should also inform your little one that there’s nothing to be scared about the visit as this would only be like a routine checkup.
Surgery is now available as a form of treatment for those with stress incontinence. This type of urinary incontinence is a condition characterized with urine leakage when a person sneezes, coughs or laughs. A person may consider surgery if noninvasive approaches weren’t able to successfully control the symptoms. But before you do, you must first consider the following facts:
Surgery success is variable, meaning it differs from one person to another. But generally, it has been found that about 85 to 90 percent of women who undergo incontinence surgery are completely dry after a year. Experts do point out that the surgery is not a guarantee of a cure.
Kegels are exercises that can effectively strengthen the pelvic floor. Sometimes, a person doesn’t really have to undergo surgery but should only be committed to this exercise. If you’re able to do Kegels several times a day, you can expect about 70 percent improvement on your condition. If not, then that’s the time when you can talk to your doctor about the surgical treatment.
Also known as the tension-free sling procedure, the mid-urethral sling is the most popular form of surgical treatment for stress incontinence. In this procedure, the surgeon uses a thin strip of material such as synthetic mesh or the patient’s own tissue to support the urethra and bladder. The purpose of this strip is to help shut off the flow of urine when you cough, sneeze, or do anything else that can trigger leakage.
While stress continence surgery is effective, there can be potential side effects such as:
- pain during sex
- urinary problems
Sling procedures are notably lower in risk of complications because they require smaller pieces of mesh. Mesh particularly those made with synthetic materials has been associated with higher rates of infection.
One of the things that must be done to ensure the success of the surgery is finding the right surgeon. Seek a surgeon who has done fellowship in urogynecology or female pelvic medicine and reconstructive surgery. The more experienced a surgeon is, the better. Ask how many surgeries the doctor does in a year. Don’t forget to ask the complications with the procedure and how the doctor has dealt with these in the past.
Sling procedures can be done on an outpatient basis. This means, you don’t have to stay in the hospital overnight during the recovery stage. The surgical treatment can also be done using local anesthesia. Any pain felt after the surgery can be alleviated with ibuprofen and other over-the-counter medications.
You may need a catheter after the surgery if you experience any difficulty in urinating on your own. If the difficulty in urination persists, contact your doctor. It may be necessary to adjust or even remove the sling.
After the surgery, it’s important to limit physical activity to allow the body especially the surgical area to heal well.
During the first few weeks, avoid:
- heavy lifting
- using tampons
- having sexual intercourse
Botox has become the ultimate symbol of vanity, at least for some women. But did you know that it actually has been approved by the government to treat various medical problems?
- muscle ailments
- chronic migraines
- underarm sweating
- multiple sclerosis
- spinal cord injury
Here’s another one to add to that list: urinary incontinence.
What is Urinary Incontinence?
Urinary Incontinence is a condition that involves loss of bladder control. As a result, accidental leakage of urine occurs, where the symptoms can range from mild leakage to uncontrollable urination.
Urinary Incontinence comes in three forms:
- stress incontinence
- urge incontinence
- overflow incontinence
Stress Incontinence: This is the involuntary loss of urine after activities that put abdominal pressure on the bladder. Such actions include coughing, lifting sneezing, and laughing.
Urge Incontinence: This refers to the involuntary loss of urine due to an overwhelming urge to urinate.
Overflow Incontinence: This is the consistent dribbling of urine associated with frequent urination in small amounts.
Causes of Urinary Incontinence
Causes vary according to type.
• Stress Incontinence
Stress Incontinence is caused by stretched pelvic floor muscles which is common with weight gain or childbirth. When the muscles are stretched in a way that can no longer support the bladder efficiently, the bladder lowers down and pushes against the vagina. This prevents muscle tightening that control flow of urine. When there is additional pressure on the bladder such as from coughing, sneezing or laughing, leakage can occur.
• Urge Incontinence
Urge incontinence is a result of involuntary contraction of the bladder muscle that produces a strong urge to urinate. If the person is not able to get to the toilet in time, he/she may leak urine. Having an overactive bladder is another common cause of urinary incontinence.
• Overflow Incontinence
This is more common in men than women, where an enlarged prostate impedes the flow of urine out of the bladder.
Other possible causes of overflow incontinence include:
- blockages of the urethra
- urinary stones
- scar tissue
- swelling from infection or kinks caused by dropping of the bladder within the abdomen
- weak bladder muscles
- injury of nerves that affect the bladder
- nerve damage from diseases such as diabetes, alcoholism, Parkinson’s disease, multiple sclerosis, or spina bifida
- medications that affect nerve signals to the bladder, such as anticonvulsants and antidepressants
FDA Approval of Botox as a Treatment for Urinary Incontinence
Just recently, the U.S. Food and Drug Administration (FDA) approved Botox as a treatment for urinary incontinence in patients suffering from neurological problems such as multiple sclerosis and spinal cord injury. Botox, which is botulinum toxin, has been approved as treatment for various conditions since it was first made available in the market in 2002.
Patients with neurological conditions usually suffer from bladder overactivity, which then results in the inability of the bladder to store urine. Injecting Botox directly to the bladder effectively relaxes it so that patients can have more control on their muscles and less occurrence of urine leakage.
Two clinical trials were done and these involved 691 patients with urinary incontinence due to multiple sclerosis or spinal cord injury. Those who received Botox treatment reported significant reduction of incontinence episodes compared to the group that received placebo treatment.
It has been found that an injection can effectively control incontinence for almost up to one year, even though there are some common side effects such as:
- urinary tract infection
- urinary retention
Because of the enormous benefits, Botox continues to be a hot commodity in the medical market with annual sales reaching about $1.5 billion worldwide.
Urological Conditions can affect anyone irrespective of gender. Some conditions are very common in men, while some others are more common in women. In men, it usually affects the prostrate, kidneys, testicles, bladder and penis. If you have any symptoms related to these parts of your body, you should consult your doctor as soon as possible.
Hematuria is a condition in which blood is seen in urine. In most cases, it will be very normal and does not require any treatment. It is usually caused due to infection, or inflammation of the kidneys. It can even appear after doing exercises. If you find blood in your urine, it will be better to consult your doctor to rule out any underlying diseases. Your doctor may conduct a physical examination, and urine and blood tests. A cystoscopy may also be necessary to examine the bladder more closely.
Urinary incontinence occurs when the bladder is emptied involuntarily, or when it is not emptied completely. The main cause of the problem is the improper functioning of the bladder muscles which aid in urination. Generally, four types of urinary incontinence are seen in men. It includes stress incontinence, overflow incontinence, mixed incontinence, and urge incontinence. Sometimes it may be a temporary problem. Urinary incontinence can lead to retention of urine in the bladder. This will in turn cause urinary infections. If not treated, it can lead to other serious diseases.
This is most commonly seen in older men. Any underlying disease or radiation therapy for the treatment of cancer can lead to erectile dysfunction. A number of treatment options are available for this condition. You can discuss with your doctor about the right treatment for you.
Urinary stones are usually formed by deposition of calcium in the kidneys, which will join together to form stones. These stones will move down to the urinary tract and block it. The patient may experience excruciating pain on the sides of the abdomen, which is the first sign of presence of kidney stones. You doctor will do ultrasound scans to determine the position and size of the stones. The treatment includes use of painkillers, and Extracorporeal Shock Wave Lithotripsy to break down the stones.
Benign Prostatic Hyperplasia
This condition is also commonly seen in older men, and is characterized by the increase in size of the prostate gland. If you have noticed any sudden changes in the frequency of urination, especially in the night, or if you have difficulty in starting the flow of urine, you should consult your doctor as soon as possible. As this is very common, men over the age of 50 are always advised to have regular prostate check-ups.
Overactive Bladder (Incontinence) is a condition wherein a person frequently experiences a strong urge to urinate. Most of the time, this urge to urinate is uncontrollable and can lead to embarrassing situations. This condition can be treated with several types of medicines.
Ditropan is generically known as oxybutynin. It stops an overactive bladder by reducing the spasms created by the muscles of the bladder. This drug has a number of side effects which include dizziness, nausea, stomach pain, insomnia, weakness, drowsiness, dry mouth, constipation, dry eyes and diarrhea. Ditropan is not recommended if the patient is unable to urinate, has an intestinal blockage, or has uncontrolled glaucoma.
Toviaz is generically known as fesoterodine. By relaxing the muscles of the bladder, it reduces the urge to urinate. Common side effects of this drug include dry eyes/mouth/throat, constipation, cough and back pain. Toviaz is also linked with a difficulty in completely emptying the bladder and should be used with caution in people with liver or kidney diseases, problems with urinating, glaucoma, severe constipation and muscle weakness. This drug is not recommended for people who have blockages in the urinary tract or untreated glaucoma.
Solifenacin succinate is the generic chemical name for VESIcare. It stops an overactive bladder also by relaxing the muscles of the bladder. VESIcare alleviates symptoms such as urine leakage, frequent urination and urinary urgency. Common side effects of this drug include blurred vision, constipation, dry eyes, weakness, stomach pain and fatigue. Caution should be practiced in taking this drug for people with blockages in the intestine and people who have problems with urinating. VESIcare is not recommended for people who have kidney or muscle diseases, as well as men with enlarged prostates.
Detrol, as well as Detrol LA, is generically known as tolterodine. This drug also treats the symptoms of an overactive bladder. Common side effects of this drug include dry eyes, constipation, stomach pain, drowsiness, dizziness, headache and blurred vision. People who have gastric or urinary retention should avoid taking this drug. People with kidney, liver, stomach and intestinal diseases should practice caution when using this drug. Caution should also be practiced in taking this drug for people who have abnormal heart rhythms and enlarged prostates.
Enablex is generically known as darifenacin. It treats incontinence by reducing muscle spasms in the urinary tract and bladder. Common side effects of this drug include dry eyes, stomach pain, flu-like symptoms, dizziness, weakness, nausea, headache painful urination or being unable to urinate and excessive thirst. Caution should be practiced when taking this drug by people with glaucoma, ulcerative colitis, intestinal blockages or muscle problems.
Urinary Incontinence is seen in almost 60% of people after they experience a stroke. However, it is only a temporary problem in most of the people. Usually, recovery takes place before the patient is discharged from the hospital. Stroke may or may not lead to urinary incontinence, and many treatment options are available.
Stroke or Cerebrovascular Accident (CVA)
The brain needs oxygen to function properly, and this is supplied by the blood flowing through it. When the blood supply to a part of the brain is disturbed, stroke occurs. If the brain does not get enough oxygen, the cells will die. As the brain cells regulate and carry out all other functions of the body, any disturbance in its function will lead to other serious problems. Apart from urinary incontinence, people affected by stroke may also exhibit difficulty in talking, swallowing, and moving the limbs. The part of the body affected entirely depends on the part of the brain involved.
Cause of Urinary Incontinence after Stroke
Urinary incontinence occurs when the anterior cerebral artery is occluded. This artery supplies the anterior part of the brain including the frontal lobe. Any disturbance in the supply of blood to this part may result in urinary incontinence.
Patients with urinary incontinence will not be able to empty the bladder voluntarily. This is because such people will not be able to sense that the bladder is full. In some cases, dribbling occurs when the bladder is full. When the anterior cerebral artery is affected, it may also result in weakness or paralysis of the lower limbs on one side, aphasia, change in behavior, and grasp reflex on one side of the body. As the lower limbs are affected, the patient will not be able to walk to the toilet, and may not be able to hold urine for a long time due to incontinence.
The type of treatment needed will depend on the severity of the condition. If not treated early, urinary incontinence will lead to retention of urine in the bladder, which may result in urinary infections.
One of the treatment methods used is behavioral therapy. In this method, the patient is encouraged to urinate at regular times. For this, the bladder is trained and fluid intake is managed.
Another treatment option is physical therapy. Pelvic-floor muscle exercises will improve the strength of the muscles which will in turn help in voluntary control of urination.
The doctor may also prescribe anticholinergic medicine, which will reduce the frequency of urination. Apart from that, topical estrogen and imipramine may also be prescribed.
Overactive Bladder (OAB) is one of the most common forms of incontinence. It falls under urge incontinence, which is different from stress incontinence that causes accidental urine leakage when a person laughs or coughs. Urge incontinence occurs when the urinary muscle spasms contract to indicate the urgency to urinate, thus the name. Although this can occur in both males and females, it is more common in women with a large number of cases occurring during pregnancy. If you suspect having this condition, this list of symptoms would strengthen your theory and perhaps aid in your decision to see your doctor about it.
Symptoms of Overactive Bladder
The most common symptom of overactive bladder is experiencing the need to urinate immediately. If you feel like you need to urinate often such as 8 to 10 times a day, this may be a sign that your bladder is overactive. This condition would have you waking up to make a trip to the restroom 2 or more times a night.
Sometimes, even if you have just gone to the bathroom, you would feel the immediate need to go back again. In addition to that, you also find yourself more and more often inside the restroom and everytime you go there, you only urinate a little. Incontinence or accidental urine leak is also a major symptom. It’s possible for a person to experience just a few of these symptoms or have each one of these.
Diagnosis of Overactive Bladder
First, your doctor will run a physical exam. He/she will also talk to you to find out what kinds of fluids you take in and how much you drink everyday. He/she will also inquire about how often and how much you urinate or have accidental leaks. To make things easier for you, jot down these notes prior to your medical checkup so you can readily give accurate answers. Apart from this, you will undergo a urine test, blood test, and pelvic exam (for women) or rectal exam (for men). If your doctor thinks you have additional health problems such as prostate disease or diabetes, you will be subjected to further examinations.
Causes of Overactive Bladder
The primary cause of an overactive bladder is an overactive muscle in this organ that releases urine. Many factors can cause this muscle to become overactive and these include bladder infection, stress, and other ailments like Parkinson’s disease or stroke. In most cases, however, it is hard to pinpoint which of these is the actual cause of the condition. In addition to these, some medicines have been found to cause an overactive bladder so if you are taking any medication, make sure you consult your doctor if you begin to experience any of the symptoms mentioned earlier. Of course, you must not stop taking your medicines without talking to your doctor first.
Treatment of Overactive Bladder
The first step in treating an overactive bladder is to establish urinating schedule at home. By urinating on schedule such as every 2 hours, you can form the habit of bladder retaining, which in turn helps you in regaining control over your bladder. It would also be effective to engage in Kegel exercises to strengthen pelvic muscles that can control urine flow. Cutting down on caffeinated drinks can also help. If none of these works, consult your doctor as soon as possible.