Did you know that 1 in 3 women may experience bladder leakage, also known as urinary incontinence? UI is not just a medical problem. Because some women with UI are afraid to do normal day-to-day activites, it has an emotional and psychological effect. A common misconception is that urinary incontinence is just part of getting older. Fortunately, UI doesn’t have to keep people from enjoying life because it can be managed or treated.
Types of UI and Causes
Urinary incontinence isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.
Temporary Urinary Incontinence
Certain drinks, foods and medications can act as diuretics — stimulating your bladder and increasing your volume of urine. They include:
- Decaffeinated tea and coffee
- Carbonated drinks
- Artificial sweeteners
- Corn syrup
- Foods that are high in spice, sugar or acid, especially citrus fruits
- Heart and blood pressure medications, sedatives, and muscle relaxants
- Large doses of vitamins B or C
Urinary incontinence also may be caused by an easily treatable medical condition, such as:
- Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence. Other signs and symptoms of urinary tract infection include a burning sensation when you urinate and foul-smelling urine.
- Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.
Persistent Urinary Incontinence
Urinary incontinence can be a persistent condition caused by underlying physical problems or changes, including:
- Pregnancy. Hormonal changes and the increased weight of the uterus can lead to stress incontinence.
- Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions can be associated with incontinence.
- Changes with age. Aging of the bladder muscle can decrease the bladder’s capacity to store urine.
- Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
- Hysterectomy. In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
- Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
- Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
- Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage.
- Neurological disorders. Multiple sclerosis, Parkinson’s disease, stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.
Treatment for urinary incontinence depends on the type of incontinence, its severity, and the underlying cause. A combination of treatments may be needed. Your doctor is likely to suggest the least invasive treatments first and move on to other options only if these techniques fail. Your doctor may recommend:
- Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every two to four hours.
- Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
- Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
- Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.
Pelvic Floor Muscle Exercises
Your doctor may recommend that you do these exercises frequently to strengthen the muscles that help control urination. Also known as Kegel exercises, these techniques are especially effective for stress incontinence but may also help urge incontinence.
To do pelvic floor muscle exercises, imagine that you’re trying to stop your urine flow. Then:
- Tighten (contract) the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.)
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
To help you identify and contract the right muscles, your doctor may suggest you work with a physical therapist or try biofeedback techniques.
Many treatment options for UI are available. Monarc® sling system is a simple procedure that corrects the conditions that cause UI and can free you from the limitations.
How Does Monarc work?
In women with stress urinary incontinence, pelvic muscles and tissue have been weakened by pregnancy, childbirth, trauma, radiation, prior surgery, muscle damage or hormonal changes, causing the bladder and urethra to relax from their normal positions. The sudden, added pressure from coughing, sneezing, laughing or simple lifting can cause accidental loss of urine. The Monarc sling system helps to correct the conditions that cause stress urinary incontinence with a mesh sling that supports the urethra. A narrow strip of polypropylene mesh is surgically placed in your body to cradle your urethra and give it a point of support. The self-fixating mesh anchors itself to tissue and muscle in the space surrounding the urethra. As with most surgical procedures, potential adverse reactions may occur. Be sure to talk to your healthcare provider about all warnings and precautions.
It’s very likely that you or someone you know may be quietly coping with this potentially embarrassing problem. A treatment option could help to boost your self-confidence and even change your life. Find out today, contact Panhandle OBGYN.
(Some information provided by the Mayo Clinic).