Related Conditions And Causes Of Urinary Incontinence
Fecal incontinence is light to moderate bowel leakage due to diarrhea, constipation, or muscle or nerve damage.
As described in the section above on causes of urinary incontinence, common conditions may contribute to chronic urinary incontinence, including: urinary tract infection , constipation, interstitial cystitis or other bladder conditions, nerve damage that affects bladder control, side effects from a prior surgery, and neurological disorders.
What Causes Urinary Urgency And Frequency
- A urinary tract injury or infection , or a chronic bladder infection
- Infection in your urethra, or urine leaking from your urethra
- A nerve problem, or radiation treatment for cancer
- A medical condition, such as bladder cancer, diabetes, or a stroke
- Anxiety
- In women, pregnancy, menopause, or a vaginal infection
- In men, prostate infections, swelling, or enlargement
How Are Urinary Urgency And Frequency Issues Diagnosed
There are several ways urinary disorders may be diagnosed. In pelvic therapy, we take a thorough history from you that includes your bladder and bowel habits as well as what you eat and drink each day. We also review any testing that has been done by other providers. In addition, our physical exam allows us to determine whether you have pelvic muscle tension that may be causing or contributing to your urgency or frequency.
Again, if these symptoms are new it is wise to see a PCP or urologist to rule out an underlying infection prior to beginning pelvic therapy. In some cases, your specialist may decide that more detailed testing is necessary. Cystoscopies , ultrasounds of the kidneys and bladder, and urodynamic tests are commonly used procedures if a urologist determines more extensive testing is necessary.
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What Causes Frequent Urination In Women
Factors like age, habits, medical conditions and certain life circumstances can all cause you to spend too much time in the bathroom. Sometimes frequent urination can be normal and temporary for example, if youre pregnant. In other cases, its a symptom of another health condition and may require a treatment plan with your doctor. Here are 12 common causes for frequent urination in women:
What Are The Complications Of Urge Incontinence
Urge incontinence can affect your mental health. Some people with severe urge incontinence may be afraid to go out in public. They may worry about being too far from a restroom for fear of an accident. These worries may increase your risk of anxiety and depression.
Because urge incontinence causes you to leak a lot of urine, you may want to wear adult diapers or absorbent urinary pads until treatments take effect. Unfortunately, constant exposure to urine can lead to skin rashes and sores.
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Preventing Frequent Or Painful Urination
Whenever possible, physicians treat frequent or painful urination by determining what underlying problem is causing the symptoms, and treating that problem. For example:
- If diabetes is the cause of a persons frequent urination, the physician will work with the patient to control blood sugar to minimize the urinary issue.
- If a mans frequent urination is due to benign prostatic hyperplasia or prostatitis, the physician will treat that issue to relieve urinary symptoms.
- For women who have painful or frequent urination due to urinary tract infections, the physician will prescribe antibiotics or suggest other treatments to eliminate the infection.
Sometimes, behavioral treatments may also help alleviate symptoms of painful or frequent urination. These are activities the patient can do to minimize or eliminate symptoms for conditions such as OAB. Behavioral treatments might include:
What Are The Specific Symptoms Of Overactive Bladder
Overactive bladder represents a collection of symptoms that can include:
- Urinary urgency: This is a failure to be able to postpone the need to urinate. When you feel you need to urinate, you have a limited amount of time to get to a bathroom.
- Frequency of urination: People who experience this symptom need to urinate very often. Typically its an increase in the number of times you urinate compared to what you previously experienced.
- Urge incontinence: In this case, there can be a leakage of urine when you get the urge to urinate.
- Nocturia: This symptom is characterized by the need to get up and urinate at least two times each night.
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What Are Some Of The Different Types Of Urinary Incontinence
The following are some of the different types of urinary incontinence:
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Urgency incontinence: This is the inability to hold urine long enough to reach a restroom. It can be associated with having to urinate often and feeling a strong, sudden urge to urinate. It can be a separate condition, but it may also be an indication of other diseases or conditions that would also warrant medical attention.
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Stress incontinence: This is the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects or performing other body movements that put pressure on the bladder.
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Functional incontinence: This is urine leakage due to a difficulty reaching a restroom in time because of physical conditions, such as arthritis, injury or other disabilities.
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Overflow incontinence. Leakage occurs when the quantity of urine produced exceeds the bladders capacity to hold it.
Diet Stress And Caffeine
Environmental and dietary causes of constant urge to urinate are also important. High caffeine intake from drinking a few cups of coffee a day can cause frequent urination and can predispose people to overactive bladder. Limiting caffeine intake often improved symptoms if they are provoked by caffeine intake.
Stress and anxiety can provoke a constant urge to urinate in some people. Typically symptoms are temporary and occur only in situations that cause high anxiety.
Some patients drink abnormal amounts of fluid that causes a constant urge to urinate.
If dietary and environmental reasons do not apply to you or changing them does not improve your condition, then you require further evaluation. Please contact us to schedule an appointment with our top urologist in NYC.
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Causes Of Frequent Urination
Frequent urination can be a symptom of many different problems from kidney disease to simply drinking too much fluid. When frequent urination is accompanied by fever, an urgent need to urinate, and pain or discomfort in the abdomen, you may have a urinary tract infection. Other possible causes of frequent urination include:
Diabetes. Frequent urination with an abnormally large amount of urine is often an early symptom of both type 1 and type 2 diabetes as the body tries to rid itself of unused glucose through the urine.
Pregnancy. From the early weeks of pregnancy the growing uterus places pressure on the bladder, causing frequent urination.
Prostate problems. An enlarged prostate can press against the urethra and block the flow of urine. This causes the bladder wall to become irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
Interstitial cystitis. This condition of unknown cause is characterized by pain in the bladder and pelvic region. Often, symptoms include an urgent and/or frequent need to urinate.
Diuretic use. These medications that are used to treat high blood pressure or fluid buildup work in the kidney and flush excess fluid from the body, causing frequent urination.
Stroke or other neurological diseases. Damage to nerves that supply the bladder can lead to problems with bladder function, including frequent and sudden urges to urinate.
Urinary Tract Kidney And Bladder Infections
One of the most common causes of frequent urination is a urinary tract infection, or UTI. More than half of women experience one or more UTIs in their lifetimes, many of which occur by a woman’s early 20s. UTIs are commonly caused by bacteria getting into the urinary tract from sexual intercourse or improper wiping while using the toilet. However, the frequent burning urination associated with a UTI can also occur during pregnancy, in women with immune system disorders, and from simply holding the bladder for a prolonged period of time. A specific type of UTI is a kidney infection that develops in the bladder or urethra and moves to the kidneys. If you are taking antibiotics for a UTI but your symptoms are not improving, you may have a kidney infection. Accompanying symptoms include nausea, vomiting, and blood in the urine. Most bladder infections are caused by bacteria, and these are a type of UTI. Bacteria can enter the bladder through stool and from other areas of skin through the urethra. Because women’s urethras are shorter than men’s, females are more prone to bladder infections and experience frequent urination.
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What Is Frequent Urination In Women
On average, a female bladder can hold up around 500 milliliters of liquid, but the urge to urinate might settle when the bladder is filled with 200 to 350 milliliters of fluid. In some cases, frequent urination in women might be a result of having a small bladder, especially if the person had previously undergone certain surgical procedures, experienced specific urologic problems, or underwent radiation.
Experts say that you may have an overactive bladder when you visit the bathroom on over eight occasions every day. Women urinating at night at the same pace may also have a too active bladder, but it might also point to another different condition. Sometimes, the cause of frequent urination in women could be traced back to an infection. In these cases, the symptoms may subside when the infection manages to clear up.
Diagnosis And Physical Examination
Patients presenting with pure urinary urgency and frequency symptoms must initially be evaluated by a urologist for a complete workup of their voiding dysfunction, including postvoid residuals and urodynamic testing. Men should have a thorough prostate examination. As with urinary incontinence, a thorough evaluation of patients with urinary frequency and urgency includes a full medical history and physical examination to assess for medical or neurogenic causes. A complete neurologic examination with special attention to the sacral neuronal pathways from S1 to S4 as well as the assessment of perineal sensation, bulbocavernosus reflex, rectal sphincter tone, and ability to contract the anal sphincter should be performed in the presence of any neurologic symptoms. Diagnosis of overactive PFMs can be made during a musculoskeletal pelvic floor examination. Externally, minimal movement of the perineal body when patients are asked to do voluntary PFM contraction or relaxation should lead the examiner to consider a hypertonic state. On the internal assessment, attention is focused on the stiffness and length of the levator ani muscles. Patients are likely to have shortened levator ani muscles that feel weak when tested for strength. These patients often have pain in the PFMs as a result of chronic hypertonicity. Again, minimal movement of the muscles during the internal part of the examination will help to diagnose high tone or overactive PFM dysfunction.
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Risk Factors For Urinary Incontinence
The following factors may put you at higher risk for developing UI.
Being female Women experience stress incontinence twice as often as men. Men, on the other hand, are at greater risk for urge and overflow incontinence.
Advancing age As we get older, our bladder and urinary sphincter muscles often weaken, which may result in frequent and unexpected urges to urinate. Even though incontinence is more common in older people, it is not considered a normal part of aging.
Excess body fat Extra body fat increases the pressure on the bladder and can lead to urine leakage during exercise or when coughing or sneezing.
Other chronic diseases Vascular disease, kidney disease, diabetes, prostate cancer, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, and other conditions may increase the risk of urinary incontinence
Smoking A chronic smoker’s cough can trigger or aggravate stress incontinence by putting pressure on the urinary sphincter.
High-impact sports While sports don’t cause incontinence, running, jumping, and other activities that create sudden pressure on the bladder can lead to occasional episodes of incontinence during sports activities.
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Should I Be Worried If I Have These Conditions And Frequent Urination
If you ever have a symptom that is outside of whats normal for your body, reach out to your healthcare provider. In some cases, pregnancy, for example, frequent urination is completely normal and nothing to worry about. However, in some conditions, your caregiver may want to know if you are urinating much more than you typically do. Theres a very wide range of conditionswith varying levels of seriousnessthat could cause frequent urination. It is always safe to discuss your symptoms with your healthcare provider.
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When To Contact A Medical Professional
- You have fever, back or side pain, vomiting, or shaking chills
- You have increased thirst or appetite, fatigue, or sudden weight loss
Also call your provider if:
- You have urinary frequency or urgency, but you are not pregnant and you are not drinking large amounts of fluid.
- You have incontinence or you have changed your lifestyle because of your symptoms.
- You have bloody or cloudy urine.
- There is a discharge from the penis or vagina.
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What Treatments Should This Patient Be Offered
If investigations do not indicate another cause for the patients symptoms, guidelines recommend lifestyle modifications as first-line treatment of overactive bladder: total daily fluid intake of about 2 L/d, and reduced intake of caffeinated drinks because they can promote urinary urgency. Pelvic floor muscle training by an expert physiotherapist is also recommended by guidelines, especially if the patient is interested in nonpharmacologic therapy. Lifestyle modifications can be combined with second-line pharmacologic treatment, depending on symptom severity and patient preference. Guidelines recommend that pharmacologic treatment be prescribed if optimal improvement with conservative management has not been reached within 812 weeks after the start of treatment.
Non-antimuscarinic medications include mirabegron, tricyclic antidepressants and desmopressin. A systematic review supports the use of mirabegron, a novel 3 agonist specifically indicated for overactive bladder, because it causes relaxation of the detrusor muscle during bladder filling. The starting dose is 25 mg once daily, and the dose can be increased to 50 mg/d depending on effectiveness. Common adverse effects include headache and mild hypertension. These effects are no more likely than with antimuscarinic drugs however, mirabegron should not be prescribed to patients with severe uncontrolled hypertension.
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Who Experiences Frequent Urination
The need to urinate is something that everyone feels. This shared experience isnt always consistent though. Sometimes you may need to urinate much more often than what is typical for you. This can happen to anyone. Men, women, and children can all have this symptom. However, its more common at certain times in your life or when you have other conditions. Youre more likely to frequently urinate if youre:
- A middle-age or old adult.
- Pregnant.
Why Are You Peeing A Lot
Urinary frequency means you have to urinate often, which can interfere with your normal day-to-day life. Youre always on the lookout for a restroom and cannot go long periods of time without using the bathroom. You always need the aisle seat at the movies or on an airplane and have to make multiple pit stops on road trips.
At night it is difficult to sleep without being woken up multiple times by your bladder . You may even have to wear an adult diaper or pads for fear of wetting your clothes. The severity of urinary frequency can vary, but it can easily interfere with your quality of life.
Other symptoms include feeling the need to urgently urinate , having trouble holding urine in , having pelvic pain or pressure, or feeling like you can never fully empty your bladder.
Common causes of frequent urination include dietary factors, urinary tract infections, bladder conditions, or difficulty emptying your bladder.
Common treatment of frequent urination include:
- Healthy lifestyle changes
- Leakage of a small volume of urine immediately or shortly after urinating
- Feeling like bladder does not fully empty
The prostate gland in men helps produce semen, the fluid that contains sperm. Over many years, the cells of this gland can become enlarged . Fortunately, an enlarged prostate is not dangerous. Benign prostatic hypertrophy is not prostate cancer and does not increase the risk of prostate cancer.
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How Can Nerve Stimulation Help Overactive Bladder
There are several treatments that involve stimulating your nerves to help improve overactive bladder. Your nerves help communicate the message that your bladder needs to be emptied to your brain. By treating the nerves, your healthcare provider can improve your bladder control. Nerve stimulation is a reversible treatment that is considered when conservative treatments have not worked or have not been tolerated. Conservative treatments include behavioral therapies and medications.
There are several types of nerve stimulation treatments. These can include:
Health Conditions That Cause Urinary Urgency
Common causes of urgent urination include:
- Drinking an unusually high amount of liquid
- Drinking caffeinated or alcoholic beverages
- Diabetes
- Increased appetite or thirst
- Abnormal vaginal discharge
If urinary urgency persists and becomes more frequent, we recommend seeing a womens health specialist. Your healthcare provider will likely order diagnostic tests to determine the cause of the urinary urgency.
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How Is Urinary Urgency And Frequency Treated
Treatment will depend on the type and cause of your urination problems. You may need any of the following:
- Medicines may be given to relax your bladder and decrease urination. You may also need antibiotics if your symptoms are caused by a bacterial infection.
- Sacral nerve stimulation sends electrical signals to your sacral nerve through a small device implanted under your skin. Your sacral nerve controls your bladder, sphincter, and pelvic floor muscles.
- Botox injections into your bladder may help relax your bladder muscle to decrease urgency and frequency.
- Surgery may be done if all other treatments cannot help you control your bladder.