Nighttime Voiding And Incontinence
Nighttime voiding and incontinence are major problems in the older population. Women who have nocturia more than twice a night or experience nighttime bed-wetting may benefit from fluid restriction and the elimination of caffeine-containing beverages from their diet in the evening. Patients should restrict fluids after dinnertime so they can sleep uninterrupted through the night. In some cases, DDAVP can be used to decrease nighttime urine production and help reduce nocturia however use caution regarding the risk of hyponatremia, especially in elderly patients.
Finally, individuals who develop edema of the lower extremities during the day experience nighttime voiding because excess fluid from lower extremities returns to the heart when the person is in a recumbent position. This problem may be handled with a behavior technique, support hose, and/or medications.
Advise these individuals to elevate their lower extremities several hours during the late afternoon or evening to stimulate a natural diuresis and limit the amount of edema present at bedtime. Support hose or intermittent sequential compression devices used briefly at the end of the day can reduce lower extremity edema and minimize night time diuresis, thus improving sleep.
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.
7 Things You Should Always Discuss with Your Gynecologist
When it comes to sexual and reproductive health, it can be hard to know whats normal and what may be a sign of a potential health problem. Even if you feel embarrassed about certain issues, your gynecologist has seen and heard it all and is there to help you, not to pass judgment.
What Are The Treatment Options For Women With Stress Urinary Incontinence
Women have both non-surgical and surgical options to treat SUI.
Not every woman with SUI will need surgery. Some factors you should consider before deciding whether to undergo surgery include:
- the severity of your SUI symptoms and their effect on your daily activities
- your desire for future pregnancy as vaginal delivery can cause recurrence of SUI symptoms, which could require future surgery
NONSURGICAL TREATMENT OPTIONS
Examples of nonsurgical treatment options for SUI include:
- Pelvic Floor Exercises: A type of exercise to strengthen the pelvic floor by contracting and relaxing the muscles that surround the opening of the urethra, vagina, and rectum. These exercises, commonly referred to as Kegel exercises, improve the muscles strength and function and may help to hold urine in the bladder longer.
- Pessary: A removable device that is inserted into the vagina against the vaginal wall and urethra to support the bladder neck. This helps reposition the urethra to reduce SUI.
- Transurethral Bulking Agents: Collagen injections around the urethra that make the space around the urethra thicker, thus helping to control urine leakage. The effects may not be permanent.
- Behavioral Modification: This includes avoiding activities that trigger episodes of leaking.
SURGICAL TREATMENT OPTIONS
Surgical mesh in the form of a âslingâ is permanently implanted to support the urethra or bladder neck in order to correct SUI. This is commonly referred to as a âsling procedure.â
When To See A Doctor For Your Uti
If your symptoms persist beyond a few days with no sign of improvement, or if your infection keeps recurring, its best to see a doctor. While many home remedies may ease symptoms if they persist your doctor will be able to determine the cause and prescribe a course of antibiotics that should help take care of your UTI right away and prevent it from leading to a worsening condition or infection.
Have you tried any of the above natural remedies for UTIs, or other home treatments to treat your urinary tract infection? Tell us about them in the comments below!
Recommended Reading: Can I Take Azo Urinary Pain Relief While Pregnant
How Can You Tell Dog Incontinence From Inappropriate Elimination
Other conditions can look like incontinence in dogs but may be caused by a different issue. Most of the following instances of inappropriate elimination are voluntary urinations in which the pet is aware, but loses control.
Submissive or excitement urination: This is a voluntary urination that has a behavioral component. Submissive urination often involves a small amount of urine and only happens when your dog is near a person or excited about an event.
Lack of proper house-training: Some dogs have not been consistently and positively trained to eliminate in appropriate spots. This can look like a normal amount of urine, and it tends to happen near a door or somewhere away from where your dog eats, sleeps, and plays.
Cognitive changes: Older pets can experience cognitive changes that alter their ability to recognize appropriate places to urinate. You will find a normal amount of urine in any place throughout the house.
Pain: Pain can lead to inappropriate elimination as well, as some pets find it difficult to posture or physically move to the correct location. Sometimes this can look like your dog is dripping urine as they try to make their way outside.
Medications For Urinary Incontinence
If medications are used, this is usually in combination with other techniques or exercises.
The following medications are prescribed to treat urinary incontinence:
- Anticholinergics calm overactive bladders and may help patients with urge incontinence.
- Topical estrogen may reinforce tissue in the urethra and vaginal areas and lessen some of the symptoms.
- Imipramine is a tricyclic antidepressant.
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.
Recommended Reading: Azo Urinary Pain Relief Pill
Vaginal Devices Used To Treat Sui:
So, if your pelvic floor muscles are feeble and you are female, an embedded vaginal gadget may forestall spills. Models are tampons, overthecounter pessaries, and custom-fitted pessaries. These gadgets regularly press against the mass of the vagina and the urethra. The pressing factor helps reposition and back up the urethra. It prompts fewer holes with insignificant danger. There are various sorts of gadgets women can utilize, which include:
Surgical Treatments For Pop
Women with symptomatic POP often benefit from surgical treatment in the setting of severe prolapse, failure of conservative therapy, or when definitive management is desired. It is estimated that by age 80, 30% of the women with POP will have undergone at least one reconstructive surgery.59 The choice of a primary POP repair is affected by many patients and surgical factors, including age, POP stage, medical comorbidities such as obesity, and desire for future sexual activity.1 The most common surgical approaches for POP treatment will be reviewed here, including both native-tissue and mesh-based repairs. An evaluation of treatment efficacy, trends, controversies, and opportunities for further research for each repair method is also outlined.
Recommended Reading: Does Stress Cause Stomach Pain
Don’t Miss: Bard Urinary Drainage Bag With Anti Reflux Dome
What Causes Incontinence
There are many different reasons that you could experience incontinence. These causes can vary depending on if youre a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term medical conditions. When you experience leakage issues because of a chronic condition, its usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually dont go away. Incontinence may have to be managed over time as a symptom of your chronic condition.
Temporary or short-term causes of incontinence can include:
- Urinary tract infections : An infection inside your urinary tract can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
- Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
- Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
- Beverages: There are certain drinks like coffee and alcohol that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
- Constipation: Chronic constipation can cause you to have bladder control issues.
Do The Right Exercises
High-impact exercise and sit-ups put pressure on your pelvic floor muscles and can increase leaks.
To strengthen your pelvic floor to relieve symptoms, replace high-impact exercise, such as jogging and aerobics, with strengthening exercise, such as pilates.
Pilates strengthens your core muscles, which is beneficial for stress incontinence.
You May Like: Physical Therapy For Urinary Problems
Urinary Incontinence: Causes Treatment And Self
A person suffering from urinary incontinence is unable to control the bladder. Urine leakage happens when a person sneezes, coughs, laughs or while exercising. This is more common in obese women.
A sudden reaction causes the person to either lose complete control over the bladder or just partially. People with urinary incontinence should make trips to the bathroom more often to avoid losing sudden control.
A person suffering from urinary incontinence lives in a continuous state of anxiety and embarrassment. It affects ones mental health, and quality of life and restricts activities. Many start wearing pads or diapers due to fear of leakage or passing urine.
Urinary incontinence can be caused by an underlying health condition. Hence, a person must seek medical guidance for the problem.
Weekend muscles of the urinary bladder
Urinary tract infection
Not being able to empty the bladder
Emptying bladder on time, especially before physical activities like heavy workouts
Change in lifestyle and diet
Avoiding alcohol and caffeinated drinks
Stress and anger management
Addressing psychosomatic problems
Treatment and management
Sujok Therapy: This is of immense help in managing the problem. The picture shows point that you can press, massage or apply seeds on. This will improve blood circulation. Advanced Sujok helps in balancing energy.
Urinary Incontinence In Older Adults
Urinary incontinence means a person leaks urine by accident. While it may happen to anyone, urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled. Talk to your healthcare provider about what you can do.
What happens in the body to cause bladder control problems? The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder dont work the way they should, urine can leak. Incontinence typically occurs if the muscles relax without warning.
Clinical Management Of Urinary Incontinence In Women
This is a corrected version of the article that appeared in print.
LAUREN HERSH, MD, and BROOKE SALZMAN, MD, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
Am Fam Physician. 2013 May 1 87:634-640.
Patient information: A handout on this topic is available at .
Urinary incontinence, defined as the involuntary leakage of urine, affects 20 million persons nationwide. 1 Estimations of prevalence range from 3 to 55 percent, depending on the definition and the population.2 Within nursing homes, 60 to 70 percent of patients experience the disorder.3 These estimates are thought to be conservative, because at least one-half of patients do not report incontinence to a physician.4
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Conservative therapies should be the first-line treatment for stress and urge urinary incontinence.
|Clinical recommendation||Evidence rating||References|
Pharmacologic interventions should be used as an adjunct to behavioral therapies for refractory urge incontinence.
Surgical therapy should be considered in women with stress incontinence that has not responded to less invasive treatment modalities.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Conservative therapies should be the first-line treatment for stress and urge urinary incontinence.
Classification of Urinary Incontinence in Women
Other Therapies For Urge Urinary Incontinence
Botulinum toxin. Botulinum toxin A , a powerful neurotoxin produced by the bacterium Clostridium botulinum, has been studied as therapy for idiopathic detrusor overactivity in a variety of patients, including those who did not respond to anti-cholinergic drugs. BTX-A prevents the release of acetylcholine at the neuromuscular junction. This effect, in turn, inhibits depolarization of the detrusor muscle, resulting in chemical denervation of the bladder. BTX-A is administered via a cystoscopic technique that is reported to be safe and well tolerated. The toxin is injected directly into the detrusor muscle. In clinical trials, the duration of response was typically 3 to 6 months. Intravesical injections of BTX-A in patients with OAB resulted in increased bladder capacity, increased bladder compliance, and improved quality of life.,
A study of onabotulinumtoxinA in patients with idiopathic UUI or OAB indicated that doses ranging from 100 U to 150 U were effective in managing the disorder. Adverse effects included UTIs and urinary retention.
Although clinical trials with BTX-A have not been robust, they suggest that this agent may offer potential benefits for patients with UUI. Further research is necessary to substantiate the usefulness of BTX-A in this population.
Are There Other Ways To Treat Incontinence
Yes. Medicines or medical devices can treat some types of urinary incontinence. For example, estrogen cream to put in the vagina can be helpful for some women who have mild stress incontinence. Several prescription medicines are available to treat urge incontinence. For men, prescription medicine is available to shrink the prostate and improve flow of urine through the prostate. Talk to your doctor about possible medicine options for your type of incontinence.
In some cases, surgery may be an option. Treatment depends on what type of urinary incontinence you have and what is causing it.
What To Expect From Your Doctor
Your doctor is likely to ask you a few questions, such as:
- When did you first begin experiencing symptoms, and how severe are they?
- Have your symptoms been continuous or occasional?
- What, if anything, seems to improve or worsen your symptoms?
- How often do you need to urinate?
- When do you leak urine?
- Do you have trouble emptying your bladder?
- Have you noticed blood in your urine?
- Do you smoke?
- How often do you drink alcohol and caffeinated beverages?
- How often do you eat spicy, sugary or acidic foods?
You May Like: Probiotics For Urinary Tract Infection
Who Gets Incontinence
Incontinence can happen to anyone. However, its more common in certain groups and at certain times in your life. Incontinence is much more common in women than in men. This is often related to pregnancy, childbirth and menopause. Each of these experiences can cause a womans pelvic support muscles to weaken over time.
Youre also more likely to experience incontinence as you get older. The muscles that support your pelvic organs can become weaker over time, causing you to experience leakage issues.
What The Doctor Does
Doctors first ask questions about the persons symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the incontinence and the tests that may need to be done.
Doctors ask questions about the circumstances of urine loss, including amount, time of day, and any precipitating factors . People are asked whether they can sense the need to urinate and, if so, whether the sensation is normal or comes with sudden urgency. Doctors may also ask the person to estimate the amount of urine leakage. Doctors will also ask whether the person has any additional problems with urination, such as pain or burning during urination, a frequent need to urinate, difficulty starting urination, or a weak urine stream.
Sometimes doctors may ask people to keep a record of their urination habits over a day or two. This record is called a voiding diary. Each time the person urinates, the volume and time are recorded. After an episode of incontinence, the person also records any related activities, especially eating, drinking, drug use, or sleep.
Although urodynamic testing is important, results do not always predict response to drug treatment or assess the relative importance of multiple causes.
Also Check: Natural Herbs For Urinary Tract Infection
Who Is Most At Risk
In addition to the causes mentioned above, there are some things that can increase your risk of developing urinary incontinence without directly being the cause of the problem. These are known as risk factors.
Some of the main risk factors for urinary incontinence include:
- family history there may be a genetic link to urinary incontinence, so you may be more at risk if other people in your family have experienced the problem
- increasing age urinary incontinence becomes more common as you reach middle age and is particularly common in people over 80
- having lower urinary tract symptoms a range of symptoms that affect the bladder and urethra