Urinary Incontinence : Causes, Risk Factor, Prevention And Symptoms

Urinary incontinence, or the inability to control one's bladder, is a frequent and frequently unpleasant issue. The intensity might range from sometimes dribbling pee when you cough or sneeze to having a sudden, intense desire to urinate that prevents you from reaching a restroom in time.

Urinary incontinence is not a natural part of becoming older, despite the fact that it happens more frequently as individuals age. If your daily activities are being hampered by urine incontinence, do not delay seeing your doctor. The majority of people may address their urinary incontinence symptoms with easy food and lifestyle adjustments or medical attention.

Causes

Urinary incontinence can be brought on by everyday habits, underlying diseases, or physical problems. Your doctor can assist to discover the cause of your incontinence by conducting a complete assessment.

Diuretics are foods, beverages, and medications that stimulate the bladder and produce more pee. They consist of:

• Alcohol
• Caffeine
• Sparkling waters and carbonated beverages
• Synthetic sweeteners
• Chocolate
• Cayenne peppers
• Foods that are particularly rich in acid, sweetness, or spice, such as citrus fruits
• Sedatives, muscle relaxants, and medications for your heart and blood pressure

Other disorders that are readily managed and may contribute to urinary incontinence are:

Infection in the urinary system. Your bladder may become irritated by infections, which may lead to frequent urges to urinate and, rarely, incontinence.

Constipation. The rectum has many of the same nerves as the bladder and is close by. These nerves become hyperactive as a result of hard, compacted feces in your rectum, which raises the frequency of your urination.

Persistent urination problems

Urinary incontinence may also be a persistent condition brought on by underlying physical problems or changes, such as:

Pregnancy. Stress incontinence can be brought on by hormonal changes and the fetus's increasing weight.

Childbirth. A lowered (prolapsed) pelvic floor can result during vaginal birth, which can impair the muscles required for bladder control and harm the bladder neurons and supporting tissue. The bladder, uterus, rectum, or small intestine may protrude into the vagina as a result of prolapse when they are forced down from their normal positions. Such protrusions may be related to incontinence.

Age-related changes. The bladder muscle might become less effective with age.

Urine storage capacity of the bladder. Additionally, as you age, you have more frequent involuntary bladder spasms.

Menopause. Women generate less estrogen, a hormone that aids in maintaining the health of the lining of the bladder and urethra, after menopause. The ageing of these tissues might exacerbate incontinence.

Prostate enlargement. Incontinence frequently results from the expansion of the prostate gland, a disease known as benign prostatic hyperplasia, especially in elderly men.

Breast cancer. Urge or stress incontinence in men may also indicate untreated prostate cancer. The ageing of these tissues might exacerbate incontinence.

Obstruction. Overflow incontinence can result from a tumor anywhere along the urinary system blocking the normal flow of urine. Urinary stones, which develop as hard, stone-like lumps in the bladder, can occasionally cause pee spills.

Neurological conditions. Urinary incontinence can be brought on by multiple sclerosis, Parkinson's disease, a stroke, a brain tumor, or a spinal injury that disrupts the nerve impulses that govern bladder function.

How to check if you have Urinary Incontinence?

You might feel uncomfortable discussing incontinence with your doctor. However, it is crucial to seek medical care if incontinence occurs frequently or negatively impacts your quality of life since urinary incontinence may:

•  Impact your ability to engage in certain hobbies and social interactions
• Negatively affect your standard of living
• Elderly people are more prone to pass out when running to the restroom.
• Give indications of a deeper, more serious issue.

Risk Factors

Your chance of getting urine incontinence is affected by the following factors:

Gender. Stress incontinence is more common in women. This discrepancy can be attributed to normal female anatomy, menopause, pregnancy, and delivery. However, men who have issues with their prostate gland are more likely to experience urge and overflow incontinence.

Age. Your bladder and urethra muscles deteriorate in strength as you age. Your bladder's capacity decreases as you age, increasing the likelihood of an unintentional pee leak.

Overweight. Being overweight puts more strain on the muscles that surround and support your bladder, weakening them so that pee might seep out when you cough or sneeze.

Smoking. Your risk of urinary incontinence may rise if you consume tobacco.

Family background. If a close relative has it, your chance of having urine incontinence, particularly urge incontinence, is increased.

Other illnesses. Your risk of incontinence may rise if you have diabetes or neurological disorders.

Symptoms

Urine leaks are a common but small occurrence. Some people could lose pee in modest to large volumes more often.

There are many different types of urinary incontinence.

• Incontinence under stress. When you put a strain on your bladder by coughing, sneezing, laughing, working out, or lifting anything heavy, urine leaks.
• Incontinence is urgent. You have an abrupt, strong desire to pee followed by an uncontrollable loss of urine. Even at night, you may have frequent urination needs. An infection or a more serious illness like diabetes or a neurological issue may be the cause of urge incontinence.

Excessive incontinence. Your bladder is not completely empty, which causes you to pee often or constantly.

• Incontinence that is functional. You can not do it because of a physical or mental limitation to the restroom on time. For instance, you might not be able to unbutton your jeans quickly enough if you have severe arthritis.
• Continence of both types. You have more than one form of urine incontinence; this often means that you have both urge and stress incontinence.

Prevention

Sometimes urinary incontinence cannot be avoided. Try the following to lessen your risk:

• Keep a healthy weight.
• Exercise your pelvic floor.
• Avoid bladder irritants including alcohol, coffee, and meals high in acid.
• Consume extra fiber to avoid constipation, which can lead to urine incontinence.
• Do not smoke, or if you do, get help to stop.

Treatments

The kind of incontinence, its degree, and its underlying cause all affect how it is treated. Treatments may need to be combined. In the event that an underlying ailment is the source of your symptoms, your doctor will first address that issue.

If these methods do not work for you, your doctor can suggest less intrusive therapies to try first before moving on to additional possibilities.

Your physician could advise:

• Bladder training to postpone peeing once the need strikes. Initially, you could try to resist the need to urinate for 10 minutes at a time. The objective is to increase the interval between bathroom visits until you only need to urinate every 2.5 to 3.5 hours.
• Double voiding, for you to be able to fully empty your bladder in order to prevent overflow incontinence. Double voiding entails peeing, waiting a little while, and then attempting again.
• Instead of waiting until you feel the urge to urinate, make scheduled excursions to the bathroom every two to four hours.
• To restore control of your bladder, regulate your fluid intake and nutrition. Alcohol, caffeine, and meals high in acid may need to be restricted or avoided. Losing weight, upping physical exercise, or cutting back on liquid intake can also help.
• Exercises for the rectus muscles
• Pelvic floor muscles in women
• To strengthen the muscles that aid in urine control, your doctor might advise that you perform these exercises often. These methods, sometimes referred to as Kegel exercises, are particularly helpful for stress incontinence but may also reduce urge incontinence.

 Drugs that are often used in incontinence remedies include:

Anticholinergics. These drugs may assist with urge incontinence and can soothe an overactive bladder. Examples include trospium chloride, tolterodine (Detrol), oxybutynin (Ditropan XL), fesoterodine (Toviaz), darifenacin (Enablex), and tolterodine.

Mirabegron (Myrbetriq). This medicine can increase the quantity of pee your bladder can hold and is used to treat urge incontinence. It relaxes the bladder muscle. Additionally, it could allow you to urinate more frequently, which would help you completely empty your bladder.

Alpha stutterers. These drugs relax the muscles in the prostate and the bladder neck, making it simpler for men with urge incontinence or overflow incontinence to empty their bladder. Tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), and doxazosin are among examples (Cardura).

Transdermal estrogen. The tissues in the urethra and vaginal regions may benefit from the use of low-dose topical estrogen in the form of a vaginal cream, 

Interventional treatments for incontinence could include:

Injecting bulking materials. The urethral tissue is injected with a synthetic substance. The bulking substance prevents urine leaks by keeping the urethra tight. In general, more intrusive procedures like surgery are more successful than this method for treating stress incontinence. It might be necessary to repeat it more than once.

OnabotulinumtoxinA (Botox). People with hyperactive bladders and urge incontinence may benefit from botox injections into the bladder muscle. People are often only given botox prescriptions after other treatments have failed.

Nerve stimulants. There are two kinds of equipment that activate the bladder control neurons with harmless electrical pulses (sacral nerves). One kind is inserted beneath the skin in the buttock and is wired to the lower back. The second kind is a vaginally implanted, detachable plug. If previous treatments have failed, stimulating the sacral nerves can treat urge incontinence and overactive bladder.

Surgery for urinary incontinence

Several surgical techniques can address the issues that cause urine incontinence if other therapies are ineffective:

Sling techniques. The usage of synthetic material (mesh) or strips of human tissue to make a pelvic sling around your urethra and the muscle that links your bladder to your urethra (bladder neck). When you cough or sneeze, the sling especially helps keep the urethra tight. Stress incontinence is treated using this technique.

Suspension of the bladder neck. Your urethra and bladder neck, a region of thickened muscle where the bladder joins to the urethra, are intended to get assistance from this surgery. Since it requires an abdominal incision, general or spinal anesthetic is used during the procedure.

A prolapse operation. Surgery may combine a sling treatment with prolapse surgery in patients who have pelvic organ prolapse and mixed incontinence. Even when pelvic organ prolapse is repaired, symptoms of urinary incontinence may not always go better.

Artificial sphincter in the bladder. To maintain the urinary sphincter closed until there is a need to urinate, a tiny, fluid-filled ring is inserted around the bladder neck. You deflate the ring and let pee from your bladder flow when you squeeze a valve placed beneath your skin.

Catheters and absorbent pads

You can use things that reduce the discomfort and inconvenience of leaking pee if medical therapies fail to cure your incontinence:

Pads and clothing for protection. Most goods are comfortably wearable underneath daily attire and are not much bulkier than regular underwear. A drip collector, which is a tiny pocket of absorbent padding placed over the penis and secured in place by form-fitting underwear, can help men who struggle with pee dribbles.

Catheter. Your doctor may advise that you learn to place a soft tube (catheter) into your urethra many times a day to drain your bladder if you are incontinent because your bladder does not empty correctly. You will be shown how to properly clean these catheters so they may be reused.

Complications of Urinary Incontinence

Chronic urinary incontinence complications include:

Skin conditions. Skin that is continually damp might develop blisters, rashes, and skin diseases.

Infection in the urinary tract. Your risk of recurrent urinary tract infections rises with incontinence.

Impact on your private life. Your social, professional, and personal relationships may be impacted by urinary incontinence.

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