Urinary Incontinence In Women: What You Need To Know
Urinary incontinence is the accidental loss of urine.
Over 25 million adult Americans experience temporary or chronic urinary incontinence.
This condition can occur at any age, but it is more common in women over the age of 50.
There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.
Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.
What Is The Treatment For Urinary Incontinence
Specific treatment for urinary incontinence will be determined by your doctor based on:
Your age, overall health and medical history
Type of incontinence and extent of the disease
Your tolerance for specific medications, procedures or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Bladder training: Teaches people to resist the urge to void and gradually expand the intervals between voiding.
Toileting assistance: Uses routine or scheduled toileting, habit training schedules and prompted voiding to empty the bladder regularly to prevent leaking.
Diet modifications: Eliminating bladder irritants, such as caffeine, alcohol and citrus fruits.
Pelvic muscle rehabilitation :
Kegel exercises: Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence.
Biofeedback: Used with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.
Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles.
Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions.
Consult your doctor with questions regarding the management and treatment of urinary incontinence.
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Tips To Keep Your Bladder Healthy
- Live a healthy lifestyle
- Avoid constipation
- Do pelvic floor muscle exercises
- Use the bathroom often and when needed
- Take enough time to fully empty the bladder when urinating
- Be in a relaxed position while urinating
- Wipe from front to back
- Urinate after sex
- Wear cotton underwear and loose-fitting clothes
If you would like to meet with a knowledgeable doctor, consider contacting Womens Health Arizona. As Arizonas largest ObGyn group, were trained and solely dedicated to delivering the best ObGyn experience in convenient and comfortable settings around Phoenix.
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What Is Urinary Urgency
Urinary urgency is sometimes also referred to as frequent urination. This is not a condition on its own. Instead, urinary urgency is rather considered a symptom. Several conditions may lead to the development of urinary urgency as a symptom.
The main sign of urinary urgency tends to be a consistent urge to urinate. The patient may feel that their bladder is not emptying completely. The patient will feel like they have to urinate again shortly after urinating.
There are times were urinary urgency would not cause serious problems. In such a case, a few simple remedies and strategies may be used as treatment options. The patient will usually be able to continue with their daily life like they normally do.
This is not always the case, however. In certain scenarios, urinary urgency can be a more disruptive symptom. The patient may find that it greatly interferes with their ability to continue with their daily routine.
In more severe cases, urinary urgency may also lead to psychological complications. Anxiety is a common issue linked to urinary urgency. The patient may have anxious feelings when they visit a shop or when they are about to enter a meeting. They will be unsure if they will be able to make it through a specific event. The anxiety may be even greater when a bathroom is not close to the patient during such an event.
Types Of Urinary Urgency
Urinary urgency is a general term that is used to describe a frequent or consistent urge to urinate. There are different types of urinary urgency that patients should take note of.
We share a quick overview of the specific types of urinary urgency below. Patients should consider the specific symptoms they experience. This will help them determine the type of urinary urgency they may have.
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Symptoms Of Stress Incontinence
Common in Women
Stress incontinence occurs when pelvic floor muscles weaken. The condition is the most common type of urinary incontinence in young women. Stress incontinence is the second most common type in older women. Activities like exercise, walking, stretching, bending, laughing, coughing, sneezing, or lifting place strain on weakened pelvic floor muscles, and that leads to leaks. Any activity that increases physical strain on pelvic floor muscles may lead to stress incontinence–even sex. The amount that leaks varies. It may be a few drops or up to a tablespoon or more, depending on severity.
Some studies suggest 24% to 45% of women over the age of 30 suffer from stress incontinence. If you suffer from urinary incontinence, you are definitely not alone. Weakness in not just the pelvic floor muscles, but also in the urethral sphincter often plays a role in this type of urinary incontinence.
How Do I Do Kegel Exercises
To do Kegels:
If you are uncomfortable or uncertain about doing Kegel exercises on your own, a doctor or nurse can also teach you how to do Kegels. A pelvic floor physical therapist or other specialist may also be available in your area to help teach you how to strengthen these muscles.
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When Should You Seek Help
You should seek medical help when you first notice a weak urine stream. In addition, if you seem to fit the symptoms when you research slow urine flow in females, you should seek help.
Even though most cases of a weak urinary stream can become less severe in time, seeking treatment can prevent other related issues.
Slow, inconsistent, and low-pressure urine are all examples of a weak urine stream. Therefore, if this applies to you, consider seeking a urinary incontinence treatment in Fort Lauderdale to help treat your problem.
What Is Urinary Urgency And Frequency
Urinary urgency and frequency is a condition that increases how strongly or how often you need to urinate. The condition may also be called urgency-frequency syndrome. Urinary urgency means you feel such a strong need to urinate that you have trouble waiting. You may also feel discomfort in your bladder. Urinary frequency means you need to urinate many times during the day. This may also be called increased daytime frequency. You may be woken from sleep by the need to urinate. Urgency and frequency often happen together, but you may only have one.
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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.
Should I Drink Less Water Or Other Fluids If I Have Urinary Incontinence
No. Many people with urinary incontinence think they need to drink less to reduce how much urine leaks out. But you need fluids, especially water, for good health.
Women need 91 ounces of fluids a day from food and drinks.11 Getting enough fluids helps keep your kidneys and bladder healthy, prevents urinary tract infections, and prevents constipation, which may make urinary incontinence worse.
After age 60, people are less likely to get enough water, putting them at risk for dehydration and conditions that make urinary incontinence worse.12
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Causes Of Urinary Incontinence
Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
Find out more about the causes of urinary incontinence.
Bladder Structure And Function
The bladder, urethra and urinary sphincters work in concert to store urine at low pressure and to void voluntarily at socially convenient or appropriate times. The detrusor muscle and internal urethral sphincter are predominantly smooth muscle, whereas the external urethral sphincter and pelvic floor muscles are predominantly striated muscle. The bladder lumen is lined with epithelial cells and the basement membrane that protect the underlying detrusor muscle from toxins contained in the urine and enable communication with neural cells that coordinate storage and voiding phases .
Anatomy and histology of the female bladder
The sympathetic nervous system predominates during the storage phase and maintains continence through the paravertebral ganglia, the hypogastric nerves and hypogastric plexus. The parasympathetic system coordinates the voiding phase, through the sacral plexus and pelvic nerves . Afferent signals from the urothelium and bladder wall are transmitted through to the thalamus the balance between storage and voiding is maintained by the central pontine micturition centre . The neurotransmitters responsible for execution of these commands are acetylcholine and noradrenaline.
Neurological control of the urinary bladder
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When To Contact A Health Care Provider
Needing to relieve the bladder more often than usual for just a day may not be a major cause for concern. But if the urge to pee frequently persists for multiple days or is accompanied by other symptoms, it is likely time to seek medical care.
These are some of the symptoms to watch for when you have frequent urination. If any of these symptoms are present, contact your doctor to have the issue checked out and to determine the reasons for excessive urination.
- Back pain
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According to the Urology Care Foundation, women are at greater risk for UI than men because they have a shorter urethra than men. As a result, any weakness or damage to the urethra in a woman is more likely to cause urinary incontinence. This is because there is less muscle keeping the urine in your bladder until you are ready to urinate.
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What Increases Your Risk
Sometimes several things combine to cause urinary incontinence. For example, a woman may have had multiple childbirths, be older, and have a severe cough because of chronic bronchitis or smoking. All of these might contribute to her incontinence problem.
Physical conditions that make urinary incontinence more likely include:
- Pregnancy and vaginal delivery.
Medicines and foods that may make urinary incontinence worse include:
- Caffeinated and carbonated drinks, such as coffee, tea, and soda pop.
- Alcohol drinks.
- Prescription medicines that increase urine production or relax the bladder .
Kegel Exercises For Women
Strengthening pelvic floor muscles can reduce or even cure symptoms of stress incontinence. Kegel exercises target the muscles that control the flow of a stream of urine. You need to do the routine regularly to attain and maintain maximum benefit. Kegel exercises are easy to do it just takes a little practice to make sure you’re concentrating your efforts on the right area.
How to Do Kegel Exercises
To perform Kegel exercises, contract the muscles you use to stop a stream of urine. Hold for 3 seconds and then release. Relax for 3 seconds. Work up to 3 sets of 10 Kegels. You can start performing these workouts while lying down. As you get stronger, you can do them while sitting or standing. If you’re having trouble isolating the correct muscles, a doctor, nurse, or physical therapist can help you with your technique.
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
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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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Urinary Incontinence In Women Facts
*Urinary incontinence in women facts medical author: Melissa Conrad Stöppler, MD
- The definition of urinary incontinence in women is the unintentional loss of urine.
- Urinary incontinence occurs more often in women than in men. Pregnancy, childbirth, and menopause may contribute to urinary incontinence in women.
- Weak bladder muscles, overactive bladder muscles, and nerve damage may also cause urinary incontinence in women.
- Urinary incontinence in women is common and treatable.
- There are different types of urinary incontinence in women, including stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, mixed incontinence, and transient incontinence.
- Diagnosis of urinary incontinence in women may involve a physical exam, an ultrasound, urodynamic testing, and tests including cystoscopy, urinalysis, and a bladder stress test. The doctor will also take a medical history and may recommend keeping a bladder diary.
- Treatment of urinary incontinence in women may include behavioral or nonpharmacologic treatments, like bladder training and Kegel exercises, medication, biofeedback, neuromodulation, surgery, catheterization, or a combination of these therapies.
- Research is ongoing to discover new and better treatments for urinary incontinence in women.
Electrical And Magnetic Stimulation
Electrical stimulation of the pelvic floor muscles with a vaginal or anal electrode can be used in women who cannot voluntarily contract pelvic floor muscles.13 This can be done at home and typically consists of two 15-minute sessions daily for 12 weeks. Medicare has approved its use in patients who have incontinence that does not respond to structured pelvic floor muscle exercise programs.
Extracorporeal magnetic innervation involves a series of treatments in which the patient sits, fully clothed, on a chair that generates a low-power magnetic field. Patients typically undergo two or three treatments per week for six to eight weeks. One early study showed this method to be most effective for women who have mild stress incontinence .39 A more recent study found it to be more effective than sham treatment for women who are unable to generate adequate pelvic floor muscle contractions.40
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Incontinence And Emotional Health
Quality of Life Issue
Incontinence can take a serious toll on quality of life. Women who are affected by it report more depression and limitations in sexual and social functioning than those who do not have the condition. Those who suffer from this health concern are more likely to rely on caregivers. Incontinence also has a negative effect on self-esteem. In general, it negatively affects a woman’s quality of life, the more she should seek aggressive treatment.
An Honest Conversation
Many women feel embarrassed about suffering from incontinence, but they need not. This is a common problem and you are not alone. Effective treatments are available. Be honest with your doctor. Do you avoid certain activities because of your symptoms? Does incontinence impair your work, sleep, sex life, or social functioning? Different interventions are available depending on how it impacts you. Speaking candidly with your doctor is the best way to identify treatments that are most appropriate for your situation.