What You Can Do
To get ready for your appointment, it helps to:
- Be aware of any pre-appointment restrictions, such as restricting your diet
- Write down your symptoms, including how often you urinate, nighttime bladder activity and episodes of incontinence
- Make a list of all your medications, vitamins and supplements, including doses and how often you take the medication
- Write down key medical information, including other conditions you may have
- Ask a relative or friend to accompany you, to help you remember what the doctor says
- Take a notebook or electronic device with you, and use it to note important information during your visit
- Write down questions to ask your doctor
For urinary incontinence, some basic questions to ask your doctor include:
- Whats the most likely cause of my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is my urinary incontinence temporary?
- What treatments are available?
- Should I anticipate any side effects of the treatment?
- Is there a generic alternative to the medicine youre prescribing for me?
- I have other health conditions. How can I best manage these conditions together?
Dont hesitate to ask other questions during your appointment as they occur to you.
Causes Of Stress Incontinence
Stress incontinence is when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed. Your urethra is the tube that urine passes through to leave the body.
Any sudden extra pressure on your bladder, such as laughing or sneezing, can cause urine to leak out of your urethra if you have stress incontinence.
Your urethra may not be able to stay closed if the muscles in your pelvis are weak or damaged, or if your urethral sphincter the ring of muscle that keeps the urethra closed is damaged.
Problems with these muscles may be caused by:
- damage during childbirth particularly if your baby was born vaginally, rather than by caesarean section
- increased pressure on your tummy for example, because you are pregnant or obese
- damage to the bladder or nearby area during surgery such as the removal of the womb , or removal of the prostate gland
- neurological conditions that affect the brain and spinal cord, such as Parkinson’s disease or multiple sclerosis
- certain connective tissue disorders such as Ehlers-Danlos syndrome
- certain medicines
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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 Are Some Of The Different Types Of Urinary Incontinence
The following are some of the different types of urinary incontinence:
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.
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.
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.
Overflow incontinence. Leakage occurs when the quantity of urine produced exceeds the bladders capacity to hold it.
We Heard You Incontinence Affects Men Too Heres What You Need To Know
As men age, the simple act of urinating can get complicated. Prostate surgery often leaves men vulnerable to leakage when they cough, sneeze, or just rise from a chair. Or the bladder may become impatient, suddenly demanding that you find a bathroom right now. Thousands of years ago, it was not as much of an issue, observes Dr. Anurag Das, a urologist at Harvard-affiliated Beth Israel Deaconess Medical Center. There were lots of trees, and you could just find one and go.
But tricky bladders can be whipped into shape. The first step is a careful assessment of what triggers those difficult moments. Often your doctor can suggest helpful strategies and possibly medication to improve urinary control.
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Fast Facts On Urinary Incontinence
- Urinary incontinence is more common in females than in males.
- There are a number of reasons why urinary incontinence can occur.
- Obesity and smoking are both risk factors for urinary incontinence.
Urinary incontinence is when a person cannot prevent urine from leaking out.
It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity.
The chances of it happening increase with age.
Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.
Treatment will depend on several factors, such as the type of incontinence, the patients age, general health, and their mental state.
When To See A Health Care Provider And What To Expect
Talk to your health care provider if you have urinary incontinence or any signs of a bladder problem, such as:
- Needing to urinate more frequently or suddenly
- Cloudy urine
- Urinating eight or more times in one day
- Passing only small amounts of urine after strong urges to urinate
- Trouble starting or having a weak stream while urinating
Your doctor may recommend urodynamic testing and perform the following to try to figure out what might be causing your bladder problem:
- Give you a physical exam and take your medical history.
- Ask about your symptoms and the medications you take.
- Take urine and blood samples.
- Examine the inside of your bladder using a cystoscope a long, thin tube that slides up into the bladder through the urethra. This is usually done by a urinary specialist.
- Fill the bladder with warm fluid and use a cystoscope to check how much fluid your bladder can hold before leaking.
- Order or perform a bladder ultrasound to see if you are fully emptying your bladder with each void.
- Ask you to keep a daily diary of when you urinate and when you leak urine. Your primary care doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.
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Weakening Of The Pelvic Floor Muscles And Urethral Sphincter
Weakening of the pelvic floor muscles may occur as a result of trauma of vaginal childbirth, disease process affecting the brain and spinal cord such as multiple sclerosis, Parkinsons disease, diabetes mellitus and stroke birth defects, injuries from an accident usually with fracture of the pelvic bones, or a consequence of medications or after surgery such as removal of the prostate gland.
How Is Urinary Incontinence Treated
You and your doctor or nurse will work together to create a treatment plan. You may start with steps you can take at home. If these steps do not improve your symptoms, your doctor or nurse may recommend other treatments depending on whether you have stress incontinence or urge incontinence or both.
Be patient as you work with your doctor or nurse on a treatment plan. It may take a month or longer for different treatments to begin working.
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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.
Menopause And Old Age
Changes which occur with the menopause in women and natural aging process in the urinary bladder, urethra and pelvic floor muscles and sphincters may contribute to incontinence by interfering with the normal process of urination. For example, the natural enlargement of the prostate gland as men age or the presence of a prolapsed vagina or uterus that is common in old women may cause obstruction or abnormal descent of the urethra. The progressive decrease of estrogen after the menopause and aging which women experience, CAN lead to weakness of the pelvic floor muscles and sphincters.
It is important to note here that having incontinence in old age is NOT normal and needs consultation with a health care provider.
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When Should I See A Health Care Professional
See a health care professional if you have symptoms of a bladder problem, such as trouble urinating, a loss of bladder control, waking to use the bathroom, pelvic pain, or leaking urine.
Bladder problems can affect your quality of life and cause other health problems. Your health care professional may be able to treat your UI by recommending lifestyle changes or a change in medicine.
Surgical Treatments For Ui
Bladder control surgery to treat stress incontinence is available and works by giving more support to the urethra. The support keeps you from leaking when pressure is put on your bladder or your urethra, putting you in control of when its time to go. There are also procedures available to treat urge incontinence.
Our doctors will help to decide if a procedure or surgery is the best option for you and will walk you through how it works as well as answer any questions you may have.
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How Is Incontinence Treated
There are many different factors that your healthcare provider will consider when creating a treatment plan for your incontinence. The type of incontinence and the ways it affects your life are both big considerations. Your provider will also talk to you about the type of treatment you are most comfortable with. There are three main types of treatment you can explore for incontinence medications, lifestyle changes and surgery. Each option has pros and cons that your provider will discuss with you.
Medications to treat incontinence
There are quite a few medications that can reduce leakage. Some of these drugs stabilize the muscle contractions that cause problems with an overactive bladder. Other medications actually do the opposite thing relaxing muscles to allow your bladder to empty completely. Hormone replacement therapies can often involving replacing estrogen thats decreased during menopause may also help restore normal bladder function.
In many cases, medications can work very well to return normal function to the bladder. Your provider will carefully select a medication that matches your specific needs. Often, your provider will start you on a low dose of the medication and then increase it slowly. This is done to try and reduce your risks of side effects and to keep track of how well the medication is working to treat your incontinence.
Common medications that can be used to treat incontinence include:
Lifestyle changes to manage incontinence
What Are The Treatments For Urinary Incontinence
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
- Not smoking
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
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Antidepressants As A Cause Of Urinary Incontinence
Antidepressants can impair the contractility of the bladder, and that can worsen symptoms of overflow incontinence, in which the bladder cant empty completely. Other antidepressants may decrease your awareness of the need to void.
If you think your antidepressant is worsening your incontinence, talk to your doctor about switching to another medication.
Who Does Urinary Incontinence Affect
There are many different factors that may lead to one becoming incontinent, though its important to note that urinary incontinence can affect anyone males and females, young and old alike.
The condition is more prevalent in females than males nearly twice as common. This is partly due to the fact that things like pregnancy, childbirth, and menopause are unique to females and create extra pressure on the bladder and pelvic floor that can cause urinary incontinence.
Still, males are not totally off the hook. Issues with the prostate are largely to blame for incontinence in males, especially if the prostate has been removed.
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Surgery And Procedures For Urinary Incontinence
If other treatments for urinary incontinence are unsuccessful or unsuitable, surgery or other procedures may be recommended.
Before making a decision, discuss the risks and benefits with a specialist, as well as any possible alternative treatments.
If you are a woman and plan to have children, this will affect your decision, because the physical strain of pregnancy and childbirth can sometimes cause surgical treatments to fail. Therefore, you may wish to wait until you no longer want to have any more children before having surgery.
The various surgical treatments for urinary incontinence are outlined below.
Common Causes Of Urinary Incontinence
What causes urinary incontinence ? According to the Urology Care Foundation, a number of factors can increase your risk of suffering from incontinence, including age , weight, smoking, or even drinking too much alcohol or caffeine. Disease, illness, and other health conditions like cancer, kidney stones, diabetes, stroke, or high blood pressure can also be culprits.
Although anyone can experience accidental urine loss, Johns Hopkins Medicine notes its most common in women over the age of 50. Pregnancy, childbirth, or c-sections can put you at a higher risk, while those with prostate issues may also have a higher chance of experiencing UI. For some its a temporary issue, but for others its a problem that persists.
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Duration Of Urinary Incontinence
Most cases of UI are chronic, and will remain so until treated. Depending on the cause, however, not all UI cases are chronic. If the cause is temporary, such as a vaginal infection or a urinary tract infection, the UI will stop once the issue is addressed.
Managing Bladder Or Urinary Incontinence
Sometimes urinary incontinence can last a short time, depending on what’s causing it. But sometimes incontinence can be long-term and uncomfortable, making some everyday activities difficult to manage.
Your health care team will ask you questions to determine the type of bladder incontinence you might have. Then, you might need tests to verify the type and learn the cause of it which will help them know the best way to manage it.
- Pelvic floor muscle strengthening may be recommended. A physical therapist that specializes in pelvic floor muscle exercises can help. This might help muscle strength and bladder control get better by doing exercises that tighten and relax muscles that control the flow of urine.
- Bladder training canhelp manage how often you need to urinate throughout the day, by assigning certain time intervals to empty your bladder.