How Is Urinary Incontinence Diagnosed
For people with urinary incontinence, it is important to consult a health care provider. In many cases, patients will then be referred to an urogynecologist or urologist, a doctor who specializes in diseases of the urinary tract. Urinary incontinence is diagnosed with a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples.
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What Are The Symptoms Of Urinary Incontinence
The following are common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:
Needing to rush to the restroom and/or losing urine if you do not get to the restroom in time
Urine leakage with movements or exercise
Leakage of urine that prevents activities
Urine leakage with coughing, sneezing or laughing
Leakage of urine that began or continued after surgery
Leakage of urine that causes embarrassment
Constant feeling of wetness without sensation of urine leakage
Feeling of incomplete bladder emptying
The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
Bladder And Bowel Dysfunction
Patients often complain of urinary urgency, frequency, hesitancy, and incontinence. Incontinence can occur in the setting of a tonically contracted bladder that is incapable of filling completely or with a denervated distended bladder that overflows. It is often not possible to determine the nature of bladder dysfunction by history. Measurement of the volume of postvoiding residual urine, either by catheterization, by ultrasound, or by urodynamic studies, is essential for distinguishing between a spastic and denervated bladder. Bladder dyssynergia, an impairment of sphincter and detrusor coordination, is also a cause of hesitancy and incomplete voiding. Patients with urinary retention are susceptible to urinary tract infections, and such infections may trigger MS relapses by stimulating the immune system.
Bowel dysfunction is common in MS and is presumably caused by spinal cord plaques. Chronic constipation can worsen spasticity. Incontinence occurs either as a consequence of sphincter dysfunction or from bowel spasticity and fecal urgency.
Stanley R. Pillemer, in, 2008
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I’m Peeing More As I Age Am I Normal
Thirty percent of women ages 40-50 have an overactive bladder: more bathroom breaks during the day, urgent trips waking you up at night. According to womens specialist Dr. Kirtly Parker Jones, there are a few reasons for an overactive bladder, but this is normal. Find out what could be causing your frequent trips to the bathroom and how to reduce your need to go.
Today, we’re talking with Dr. Kirtly Parker Jones. She’s the expert on all things woman. Dr. Jones, the scenario is you’re 40, 50, you’re getting up there in the numbers and for whatever reason, you’re just starting to pee more. You’re starting to wake up more in the night, you’re starting to take a little more breaks during the day. What’s going on? Are you normal?
Symptoms Of Frequent Or Painful Urination
Frequent or painful urination can be a symptom of a variety of health conditions requiring treatment.
Symptoms of frequent urination that call for a visit to the physician as soon as possible include:
- Pain in the lower abdomen, side or groin
- Painful urination
- Blood in the urine, or red or dark brown urine. This can be a dangerous sign and should always be evaluated.
- A powerful urge to urinate
- Difficulty urinating, or trouble emptying the bladder completely
- Discharge from the vagina or penis
- Loss of bladder control.
People should see a physician when urinary frequency increases with no obvious cause , especially if other symptoms are present.
Symptoms accompanying painful urination requiring medical attention are:
- Painful urination lasting more than one day
- Discharge from the penis or vagina
- Blood in the urine
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When To See A Healthcare Provider
If the need to frequently urinate lasts for a prolonged period of time or gets worse, you may need to see a healthcare provider. They can examine to check for inflammation or signs of infection, as well as a urine analysis, ultrasound, and other tests.
Depending on the cause of your frequent urination, you may need to seek the assistance of your healthcare provider. Some natural healthcare providers recommend estrogen creams that lower the risk of UTIs in post-menopausal women.
Spinal Cord Diseases And Injuries
Bladder problems are common among multiple sclerosis patients and include urgency of urination, an overactive bladder, and a bladder that does not fully empty. Diet modifications and nerve stimulation procedures may be able to help patients control these issues. Other neurological conditions are closely associated with frequent urination in women too, especially if a spinal cord injury is involved. In healthy women, messages are sent from the bladder to the brain when the bladder is full. But with a spinal cord disease or injury, these messages may not be sent or received.
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Frequent Urination In Women
UTIs are more common in people with a vagina than people with a penis. People with a vagina are at a greater risk because the female urethra is shorter. Bacteria have less distance to travel before they can infect the urinary tract and cause symptoms.
UTI risk factors for people with a vagina include:
- vaginal irritation and inflammation
- improper wiping after using the restroom, which will expose the urethra to E. coli
- sexual intercourse, which can introduce bacteria into the urinary tract
Other conditions that can lead to frequent urination include:
Whats considered a normal urinary frequency can vary by person. Some people naturally need to go more or less often than others. That said, experts typically consider urinating at least 8 times a day to be frequent urination.
Any other symptoms you have will depend on the cause of your frequent urination.
Frequent Urination In Women: Treatment Options
Fortunately, there are several treatment options for frequent urination. Every patients first step is to schedule an appointment with their healthcare provider to establish a proper diagnosis. Most probably, the doctor will recommend undergoing a urinalysis in order to rule out hematuria or infections.
Once the proper diagnosis has been made, the doctor will recommend the best course of action. Sometimes, they may be lifestyle changes, like tapering your fluid intake, cutting down on alcohol, spicy foods, and caffeine. Experts may also recommend certain performing different pelvic floor exercises. If these dont help, other medical interventions may be needed.
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What Is Overactive Bladder
Overactive bladder syndrome is characterized by the occurrence of urinary urgency which is a sudden compelling desire to urinate that is difficult to postpone. It is usually accompanied by frequent urination and nocturia . It is also commonly accompanied by urgency incontinence, where urine is accidently lost with urgency. This commonly manifests as the inability to get to the bathroom on time once urgency starts. OAB is quite common and affects about 11-16% of adults to varying degrees. Although it is common, that does not mean that a person who is affected by OAB should simply live with the condition, as many do. For some OAB can have a profound effect on quality of life causing disruptions at work, curtailing of social activities, reduction of sexual intimacy, and interfere with sleep. However, it is important to know that there are effective treatments for the symptoms of OAB.
There are other conditions such as urinary tract infections , polyps or tumors in the bladder, and excessive drinking of fluids that can cause similar symptoms and these conditions should be ruled out by your health care provider before embarking on OAB treatment.
Monitor Your Fluid Intake
Pay attention to your fluid intake throughout the day and night. You may want to keep a diary to track the total amount of fluid you drink. Make sure you include all beverages, like tea, and not just water.
Avoid drinking too much water as you get closer to nighttime, so you can get some rest instead of visiting the bathroom at night.
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Other Symptoms To Watch Out For That Are Similar To Frequent Urination
If your frequent urination is accompanied by other symptoms, youll want to make an appointment or go to urgent care as soon as you can to get started on a treatment plan and make sure you arent experiencing a more serious condition. Some of these symptoms include:
- Painful urination
- Feeling like you still have to pee even after peeing
- Smelly or cloudy urine
Finding The Right Care
Pelvic pain is a lot more common than people think, Prechel said. In Julies case, the prolonged sitting on a bike seat led to a lot of compression on her pudendal nerve. This caused pain and muscle tightness. This can also happen to men and women who spend a lot of time in the car, or who sit at a desk for work all day.
Prechel also saw patients who were experiencing pelvic pain for other reasons, including childbirth, hip or back injuries, or abdominal surgeries. She said people often live in unnecessary pain due to the sensitive nature of the injury and the treatment.
There are several physical therapists in our system who do this type of therapy for both men and women. We all respect peoples modesty, she said.Once the issue was identified, Julie and Mary began working together on a plan to relieve her pain.
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Trigger Point Therapy Brings Relief
The doctors at Pelvic Rehabilitation Medicine take a different approach to treating nonrelaxing pelvic floor disorder and other dysfunctions, targeting the trigger points themselves with ultrasound guided trigger point injections to relax muscles and relieve pain. Ultrasound is a safe and noninvasive imaging technique that helps doctors target the precise location of a trigger point. Patients typically receive a series of injections to resolve all the affected points in the muscles of the pelvic floor. This treatment approach for men with urologic chronic pelvic pain has shown great promise.
Nonrelaxing pelvic floor dysfunction and other problems related to the pelvic floor can cause pain, discomfort, and embarrassment. At Pelvic Rehabilitation Medicine, our doctors treat the whole person, not just a symptom and well work with you to find the relief your body has been looking for.
Weakened Pelvic Floor Muscles
Your pelvic floor muscles hold up many of the organs in your urinary system, including your bladder. If these muscles weaken, organs can slip slightly out of place and lead to more frequent urination. Vaginal childbirth is one way the pelvic floor muscles can become strained and start to lose their strength. Aging may also lead to pelvic floor muscles weakening.
If weakened pelvic floor muscles are causing your frequent urination, your primary care doctor or OB-GYN can work with you to understand your symptoms, make treatment recommendations and, if needed, connect you with a urogynecologist .
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What Should Be Included In The Physical Examination Of This Patient
According to the Canadian Urological Association, focused physical examination for overactive bladder includes abdominal and pelvic examination in women, as well as a basic neurologic examination. The pelvic exam includes assessment for vaginal prolapse and vaginal estrogen status, and a cough stress test for stress urinary incontinence .2 .
Why You Might Need To Urinate More
Here are eight reasons, according to Dr. Jaeger, that you may be running to the bathroom more often than youd like:
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Causes For An Overactive Bladder
There are people with neurologic problems, multiple sclerosis, and other conditions that can make kind of an overactive bladder and that’s what you see on the TV, it’s called overactive bladder.
The most common reason is we don’t know. So I call it idiot-pathic, instead of idiopathic, meaning it’s unknown, I call it idiot-pathic. And it has to do with an aging brain. And that is the kind of ability to calm your bladder that you had to learn at two so that you could be continent and not pee in your pants all the time.
As you get older, you lose some of that so your brain can say, “Oh, I think I want to pee and I want to pee now.” You can retrain your brain to say, “No, I really don’t. I just went two hours ago and I haven’t had anything to drink.” So mindfulness training actually works very well.
Diagnosing The Cause Of Frequent Urination
If urinary frequency interferes with your lifestyle or is accompanied by other symptoms such as fever, back or side pain, vomiting, chills, increased appetite or thirst, fatigue, bloody or cloudy urine, or a discharge from the penis or vagina, it’s important to see your doctor.
To diagnose the cause of frequent urination, your doctor will perform a physical exam and take a medical history, asking questions such as the following:
- Are you taking any medications?
- Are you experiencing other symptoms?
- Do you have the problem only during the day or also at night?
- Are you drinking more than usual?
- Is your urine darker or lighter than usual?
- Do you drink alcohol or caffeinated beverages?
Depending on the findings of the physical exam and medical history, your doctor may order tests, including:
Blood Tests. Routine blood test can check for kidney function, electrolytes, and blood sugars
Urinalysis. The microscopic examination of urine that also involves a number of tests to detect and measure various compounds that pass through the urine.
Cystometry. A test that measures the pressure inside of the bladder to see how well the bladder is working cystometry is done to determine if a muscle or nerve problem may be causing problems with how well the bladder holds or releases urine. Thereâs a broader term called urodynamics that includes tests such as cystometry, uroflowmetry, urethral pressure and others.
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Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder.
The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.
The reason your detrusor muscles contract too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- not drinking enough fluids this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity
Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched.
Your detrusor muscles may not fully contract if:
- there’s damage to your nerves for example, as a result of surgery to part of your bowel or a spinal cord injury
- you’re taking certain medicines
What Causes Urinary Frequency In Females
Other treatments address frequent urination rather than an underlying cause. These include the below.
- Kegel exercises: These regular daily exercises, which people often perform during pregnancy, can strengthen the muscles of the pelvis and urethra and support the bladder. For best results, perform Kegel exercises 1020 times per set, three times a day, for at least 48 weeks.
- Biofeedback therapy: A person combines this treatment with Kegel exercises to enable them to become more aware of how their body functions. This increased awareness can help them improve the control of their pelvic muscles.
- Bladder training: This involves training the bladder to hold urine longer.
- Monitoring fluid intake: This may reveal that drinking a lot at certain times is the main cause of frequent urination.
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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: