Treating And Managing Urinary Incontinence
Today, there are more treatments and ways to manage urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.
A combination of treatments may help you get better control of your bladder. Your doctor may suggest you try the following:
Types Of Urinary Incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. Its the most common type of bladder control problem in younger and middle-aged women. It also may begin later, around the time of menopause.
- Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimers disease, Parkinsons disease, multiple sclerosis, or stroke.
- Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
Treatments For Urinary Incontinence
Healthcare providers can help find the best treatment for urinary incontinence. There are many different options available such as:
If you have urinary incontinence, your provider might prescribe a catheter A balloon holds the tube inside your bladder. The catheter drains urine out of the bladder into a bag outside the body.
Urine drainage bags
If you have urinary incontinence, your provider might prescribe a urine drainage bag to help collect urine coming out of the bladder. You can hide it under clothing and strap it to your leg. Your doctor can help you find a urine drainage bag thats the right size for you and feels comfortable to wear.
Catheters for intermittent catheterization
Your doctor may recommend a catheter that you dont have to wear all the time. Instead, you or your healthcare provider can insert and remove clean catheters 3 to 5 times a day. This helps decrease the chance of infection.
Some providers may recommend that you use adult pads or adult diapers. These products help absorb urine leaking from the bladder, which helps protect your skin and clothes. You have the option of purchasing absorbent products that you throw away after each use, or you can purchase reusable products.
Some people who experience urinary incontinence may have concerns about getting to a toilet in time. Toilet substitutes like commodes can provide convenience and peace of mind.
Also Check: What Is An Intermittent Urinary Catheter
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.
Do Pelvic Floor Muscle Exercises
Strong pelvic floor muscles hold in urine better than weak muscles. You can strengthen your pelvic floor muscles by doing Kegel exercises. These exercises involve tightening and relaxing the muscles that control urine flow. Researchers found that women who received pelvic floor muscle training had fewer leaks per day than women who didnt receive training.6 You should not do pelvic floor exercises while youre urinating.
Men can also benefit from pelvic floor muscle exercises. Strengthening these muscles may help a man leak urine less often, especially dribbling after urination.
A health care professional, such as a physical therapist trained in pelvic floor therapy, can help you get the most out of your Kegel exercises by helping you improve your core muscle strength. Your core includes your torso muscles, especially the lower back, pelvic floor muscles, and abdomen. These muscles keep your pelvis lined up with your spine, which helps with good posture and balance. Your physical therapist can show you how to do some exercises during daily activities, such as riding in a car or sitting at a desk.
You dont need special equipment for Kegel exercises. However, if you are unsure whether you are doing the exercises correctly, you can learn how to perform Kegel exercises properly by using biofeedback, electrical stimulation, or both. Biofeedback uses special sensors to measure muscle contractions that control urination.
Incontinence In Alzheimer’s Disease
People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. These tips may help:
- Avoid drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
- Keep hallways clear and the bathroom clutter-free, with a light on at all times.
- Provide regular bathroom breaks.
- Use underwear that is easy to get on and off, and absorbent briefs or underwear for trips away from home.
Visit Alzheimers Disease: Common Medical Problems for more tips.
What Causes Urinary Incontinence
Common causes include:
- aging while not an inevitable result of aging, incontinence is particularly common in older people
- changes in body function that result from diseases, use of medications, and/or the onset of an illness
- a urinary tract infection
- pregnancy and childbirth, or after the hormonal changes of menopause, because of weakened pelvic muscles
- being overweight, which boosts pressure on the bladder and the muscles that control it
- nerve damage from spinal cord injuries, diabetes, Parkinsons disease, and multiple sclerosis
- overactive bladder
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When To Seek Medical Help
Any instance of incontinence is reason to seek medical help. It may be a symptom of a more serious condition that needs to be treated.
Even if the underlying cause isnt serious, incontinence can be a major disruption in your life. Its important to get an accurate diagnosis and discuss treatment options with a healthcare professional.
In some cases, incontinence can be a sign of a medical emergency.
You should seek immediate medical attention if you lose control of your bladder and experience any of the following symptoms:
- trouble speaking or walking
Urinary incontinence and treatment for urinary incontinence may result in complications, depending on the cause.
These complications may include:
- Urinary tract infections. UTIs can be caused by wet undergarments against the skin. This may create an environment where bacteria can grow.
- Kidney damage. In some cases where the flow of urine is obstructed, you may experience kidney trouble or kidney failure.
- Cellulitis. This skin infection is caused by bacteria and may cause swelling and pain.
- Medication side effects. Medications used to control urinary incontinence may cause side effects, depending on the medication. Side effects may include dry mouth, nausea, hypertension, or others.
- Catheter side effects. If you have a catheter placed, you may experience side effects such as infection and trauma.
- Mental health side effects. Urinary incontinence may cause feelings of anxiety, depression, or social isolation.
Surgical Treatments For Incontinence
Currently there are several different surgical options for incontinence. However, these treatments are often only recommended if medication and behavioral modifications have not been effective. Different procedures are used for women and men.
The most common surgical treatments for incontinence in women are:
- Retropubic Suspension: If the bladder falls out of place due to a weakening of the vaginal wall, this procedure can be used to situate the bladder back in the correct position. One or more incisions are made in the lower part of the abdomen. Surgical instruments are inserted through the cut, allowing for the bladder, part of the vaginal wall, and the urethra to be sutured to the pelvic bones and ligaments. This raises the urethra and the bladder.
- Pubovaingal Fascial Sling: In this procedure, a material known as fascia is placed around the neck of the bladder to stop urine from involuntarily leaking.
- Suburethral Sling: This procedure involves placing a sling under the urethra to support the neck of the bladder and prevent leakage.
- Tension-Free Vaginal Tape : TVT is a mesh that is placed around the neck of the urethra to provide additional support and stop urine from leaking.
The most common surgical treatments for incontinence in men are:
- Male Sling: The male sling involves placing a strip of material underneath the urethra to stop the urethra from opening involuntarily.
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What Is Pelvic Organ Prolapse
“Prolapse” refers to a descending or drooping of organs. Pelvic organ prolapse refers to the prolapse or drooping of any of the pelvic floor organs, including the:
- Pelvic organ cancers
- Surgical removal of the uterus
Genetics may also play a role in pelvic organ prolapse. Connective tissues may be weaker in some women, perhaps placing them more at risk.
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In fact, pregnancy and vaginal delivery are often responsible. Uterine or vaginal wall prolapse can also play a part.
If youre tired of wearing bulky pads or maybe even incontinence briefs, the best urinary incontinence treatments can help you regain your freedom.
Ill walk you through the 10 best urinary incontinence treatments. From convenient, non-invasive shorts to innovative pelvic floor exercisers, consider this your judgment-free guide to a leak-free life.
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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
What Can I Do About Urinary Incontinence
If you are a woman with stress incontinence, you can help control your condition by doing Kegel exercises to make the muscles around the neck of the bladder stronger. To do this exercise, you squeeze the muscles you use to control the flow of urine, hold for up to 10 seconds, then release. Aim to do three sets of ten each day.
The best way to handle urge incontinence is to use the bathroom on a regular schedule. This might be a half-hour after a meal, two to three times between meals, and before going to bed.
Special products and equipment are available. Absorbent underwear, which is no more bulky than normal underwear, can be worn easily under everyday clothing. Incontinence may be managed by routinely inserting a catheter into the urethra and collecting the urine in a container.
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How Do Urinary Incontinence Treatments Work
It depends on which one you buy. Weve included inner and outer electromagnetic devices here and those that provide biofeedback and let you train yourself. They all have the same purpose: strengthening your pelvic floor muscles.
Now technically, you can do this on your own by drawing in your pelvic floor muscles as if you were preventing yourself from urinating. Thats what these devices target.
Since age, exercise, and birth can all contribute to a weakened pelvic floor its incredibly common for folksespecially womento experience incontinence.
Using electromagnetic pulses from the outside or inside, incontinence treatment stimulates your pelvic floor area to tense and relax so you dont have to do it yourself.
If you choose a device that provides biofeedback, youll be led through exercises you perform on your own by drawing in your pelvic floor in a particular rhythm.
How Do I Do Kegel Exercises
Kegel exercises are a simple way to build strength in your pelvic floor muscles. These exercises are done by lifting, holding and then relaxing your pelvic floor muscles. You can find these muscles by stopping the flow of urine mid-stream while youre urinating. Only do this until you learn how to find the muscles stopping the flow of urine mid-stream isnt healthy over a long period of time.
When youre doing Kegel exercises, start small. Only hold it for a few second. Over time you can slowly work your way up to longer and longer stretches of holding the muscles tight.
Unlike other types of workouts, no one can tell when youre doing Kegel exercises. Aim to do several sets of Kegel exercises twice a day.
Causes Of Stress Incontinence
Stress incontinence occurs when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed .
Any sudden extra pressure on your bladder, such as laughing or sneezing, can then cause urine to leak out of your urethra.
Your urethra may not be able to stay closed if the muscles in your pelvis are weak or damaged, or your urethral sphincter is damaged.
These problems may be caused by:
- damage during childbirth, particularly if the child 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 in women or removal of the prostate gland in men
- neurological conditions, which affect the brain and spinal cord, such as Parkinsons disease or multiple sclerosis
- certain connective tissue disorders, such as Ehlers-Danlos syndrome
- certain medications
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.
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What Are The Signs And Symptoms Of Urinary Incontinence
Among the most common symptoms of UI are:
- inability to urinate, which can cause overflow incontinence
- progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying
- more frequent urination without a proven bladder infection
- needing to rush to the restroom or losing urine if you do not get to a toilet in time
- abnormal urination or changes related to stroke, spinal cord injury, or multiple sclerosis
- urine leakage that interferes with daily activities
- leakage of urine that starts or continues after surgery or childbirth
- leakage of urine that causes embarrassment or decreased quality of life
- frequent bladder infections
The symptoms of UI may resemble other conditions or health problems. Always see your health care provider for a diagnosis.
How Urinary Incontinence Is Treated
Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:
- lifestyle changes, such as losing weight and cutting down on caffeine and alcohol
- pelvic floor exercises taught by a specialist
- bladder training guided by a specialist
You may also benefit from the use of incontinence products, such as absorbent pads and hand-held urinals .
If you are still unable to manage your symptoms, medication may be recommended.
Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.
Surgical treatments for stress incontinence, such as tape or sling procedures, are used to reduce pressure on the bladder, or strengthen the muscles that control urination.
Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.
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When To Seek Medical Advice
See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.
This can also be the first step towards finding a way to effectively manage the problem.
The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.
Find out about diagnosing urinary incontinence.
Who Is At Risk For Urinary Incontinence
In adults, you are at higher risk of developing UI if you:
- Are female, especially after going through pregnancy, childbirth, and/or menopause
- Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
- Are a man with prostate problems
- Have certain health problems, such as diabetes, obesity, or long-lasting constipation
- Have a birth defect that affects the structure of your urinary tract
In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.
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