Urinary Incontinence

What is Urinary Incontinence?

The loss of control over your bladder is called urinary incontinence in medical terms. This is a common and embarrassing problem that might occur due to sudden and strong urgency to urinate. The condition affects your daily activities and can be embarrassing in public places.

Therefore, if you have urinary incontinence, approach your doctor immediately to seek relief from simple measures like lifestyle changes or medication.

Symptoms

The major symptoms of urinary incontinence are:

  • Minor and occasional leakage of urine
  • Stress incontinence
  • Urge incontinence
  • Overflow incontinence
  • Frequent wetting of clothes
  • Functional incontinence
  • Mixed incontinence

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Causes

For temporary urinary incontinence, the causes could be:

  • Alcohol
  • Carbonated drinks
  • Caffeine
  • Artificial sweeteners
  • Tea and coffee
  • Citric food
  • Food with high concentration of spices, sugar and acids
  • Vitamin B and C supplements
  • Medication for heart, high blood pressure, sedatives and muscle relaxants
  • Urinary tract infection
  • Constipation
  • For persistent urinary incontinence, the causes could be –
  • Pregnancy and hormonal changes
  • Childbirth
  • Age
  • Menopause
  • Hysterectomy
  • Enlarged prostate gland
  • Prostate cancer
  • Obstruction in urinary tract
  • Neurological disorders like multiple sclerosis, Parkinson’s disease, stroke, brain tumor or spinal injuries

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Risks

The risk factors of urinary incontinence are:

  • Female gender
  • Older age
  • Obesity
  • Diabetes
  • Neurological disorders

 

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Prevention

To prevent the issue, you are advised to:

  • Perform pelvic floor exercises
  • Avoid caffeine and acidic food
  • Maintain a healthy weight
  • Consume fibrous food

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How is it diagnosed?

To treat the disorder, it is imperative to know the type of incontinence. Therefore, the following diagnostic methods may be adopted by our specialists at Medanta 

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How is it treated?

At Medanta, your urologist may suggest many methods to treat your urinary incontinence. These methods include

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  • Behavioral techniques

    These include:

    • Bladder training - Required to delay urination once urgency is felt, with the goal being lengthening intervals of urinary trips to the toilet.
    • Double voiding – To empty the bladder more completely during urination, so as to avoid overflow incontinence.
    • Scheduling urination – To urinate at fixed intervals, rather than waiting for the urgency to happen
    • Food control – To reduce intake of alcohol, acidic food and caffeine
    • Exercises - To lose weight and kegel exercises to control the pelvic muscles, for stress and urge incontinence

  • Electrical stimulation

    Electrodes are inserted into rectum or vagina to gently stimulate the pelvic muscles electrically.

  • Medication

    Drugs like anticholinergics, mirabegron, alpha-blockers or topical estrogen may be suggested as per your requirements.

  • Device therapy

    Devices like urethral insert or pessary may be suggested for women.

  • Interventional therapy

    Bulking material injections and botox are preferred to reduce leakage of urine.

  • Absorbent pads

     If medications do not work, you could wear pads and protective garments to ease discomfort and inconvenience of leaking urine. They are light in weight and comfortable to use as underwear. Men may use a drip collector.

  • Catheter

    If the cause is incomplete voiding of the bladder, a catheter may be used to drain the bladder completely several times.

  • Nerve stimulators

     Like a pacemaker used in cardiology, a renal nerve stimulator delivers impulses only once the bladder is full and controls the incontinence impulses.

  • Surgical procedures

    Some commonly used surgical procedures are:

    • Sling procedures – A pelvic sling is created to keep the urethra closed, to prevent leakage of urine when you laugh, sneeze or cough.
    • Prolapse surgery – If you are a woman with mixed incontinence and pelvic organ prolapse, a combination of sling procedure and prolapse surgery may be used.
    • Artificial urinary sphincter – If you are a man with prostate cancer or enlarged prostate gland, a small ring filled with fluid is implanted around your bladder to keep it shut until the bladder is full. Urination is possible only by activating a valve beneath the skin, when you are ready to urinate.
    • Bladder neck suspension – An abdominal incision is done in this method to provide support to your bladder neck and urethra.

When do I contact the doctor?

Contact your doctor immediately if you feel the symptoms listed above.

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