What Is Urinary Incontinence
Urinary incontinence is a loss of control over urination. Urine leaks before you are able to get to a toilet.
Normally, kidneys make urine that travels through tubes into the bladder. The bladder is a balloon-shaped structure with walls of muscle. The muscular walls are relaxed until the bladder fills up. The underside of the bladder is supported by pelvic floor muscles.
When the bladder is full, the walls of the bladder are stretched. That signals the muscular walls to squeeze down, causing an urge to urinate. When you are ready to urinate, the muscular walls squeeze down harder, and another tube opens up that carries urine out of the bladder and into the outside world.
With the various types of urinary incontinence, this normal process gets disrupted.
One type of incontinence is stress incontinence. Your pelvic muscles are located beneath your bladder. Stress incontinence occurs when your pelvic muscles arent strong enough. They cannot withstand a stress or pressure pushing on the bladder.
When your pelvic muscles give way, they release their squeeze around the bottom of your bladder. As a result, urine can drain out.
Stress incontinence is common during:
- Some awkward body movements
Many women have urinary incontinence after childbirth. Pregnancy and childbirth can affect the conditioning of the pelvic muscles. They can also stretch and injure the pelvic nerves. Incontinence may last for a surprisingly long time after childbirth.
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.
Medications That Can Cause Or Worsen Incontinence
Ask your doctor if you think medicines may cause your incontinence.
If you are showing signs of urinary incontinence or if your incontinence problem seems to be getting worse, take stock of your medicine cabinet. Not for a new remedy, but to find overlooked causes of incontinence, or the explanation for your worsening symptoms.
Commonly recommended medications could be the cause of your incontinence, or at least contributing to them.
Medications affect people differently, so one person with incontinence may not notice worsening symptoms, while another person does.
If you suspect medications may be worsening or the cause of your urinary incontinence, describe your incontinence symptoms to your doctor and let him or her know about all the medicines you take, both prescription and over-the-counter. That way, your doctor can help determine whether these medicines should be adjusted or stopped, or if a treatment should be modified.
Here are the most common medicines that can worsen or cause urinary incontinence:
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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
Why Is Urinary Incontinence A Health Issue
Urinary incontinence is a very common problem in aging women . When women leak urine during exercise, sneezing, or coughing, doctors call this type of incontinence stress-related . When women have strong urges to urinate and have trouble holding urine until getting to the bathroom, they may have what is known as urgency incontinence . Although most women have one or the other type of incontinence, older women often have both types. Incontinence hurts women’s self-confidence, interferes with their ability to enjoy their favorite activities, and decreases the quality of their lives .
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Sleeping Pills And Incontinence
Only a small percent of people with incontinence have a problem with bed-wetting, according to Anger, who estimates that about 10% of patients with incontinence wet the bed. However, sleeping pills may pose a problem for those with incontinence at night.
“Sleeping pills can make things worse, because people don’t wake up ,” she says.
As an alternative, cut down on caffeine so you sleep better on your own, Anger suggests.
Sleep will come more easily if you keep a regular bedtime and wake-up schedule, according to the National Sleep Foundation. You can also develop a relaxing bedtime ritual, such as reading a book or listening to soothing music.
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
- 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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Some Medications For Type 2 Diabetes
The newer medications for type 2 diabetes, a class called sodium-glucose cotransporter-2 inhibitors work by increasing the amount of glucose or blood sugar your kidneys excrete and pass through urine, which takes fluid with it, says Varin. Some good news: There was a concern that SGLT2 inhibitors would also increase the risk of urinary tract infection , but newer research has failed to find that connection, suggests the February 2020 issue of Clinical Kidney Journal.
What Is The Bottom Line About This Health Issue
If you have trouble with leaking urine, know that you are not alone many women suffer from urinary incontinence. There is no shame in discussing this problem with your doctor or an incontinence professional . The real harm is in ignoring incontinence. Non-drug treatments, such as healthy lifestyle changes or pelvic floor exercises, should be the first choice. Once you start adopting healthy behaviors, sticking to these good habits will serve you well in the long run.
Currently there are no effective medications for women with stress incontinence. In contrast, women with urgency incontinence have good evidence that several medications can be helpful. There are eight drug choices available and women can make informed decisions with their doctors. We “urge” you to take into account the balance between benefits and harm for each of eight available drugs and to make informed treatment decisions after discussions with incontinence professionals.
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High Blood Pressure Medicine As A Cause Of Urinary Incontinence
Also called alpha-adrenergic antagonists, these medicines — including Cardura, Minipress, and Hytrin — work by dilating blood vessels to reduce your blood pressure.
In women, alpha blockers can relax the bladder. “So, if they cough or sneeze, they might lose urine,” says Rodney Appell, MD, director of the Baylor Continence Center at the Baylor College of Medicine, Houston.
If you are a woman on an alpha blocker and you are experiencing urinary incontinence, Appell has this advice: “Go back to the internist who prescribed the alpha blocker and ask if there is something else you can be treated with.”
In men, these medications actually are prescribed to help with urination problems. In men with an enlarged prostate, a condition called benign prostatic hyperplasia, or BPH, alpha blockers can help relax the muscles in the bladder neck, letting urine flow more easily and improving symptoms of BPH.
What Causes Urinary Incontinence
Urinary incontinence is not an inevitable result of aging, but it is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications and/or the onset of an illness. Sometimes it is the first and only symptom of a urinary tract infection. Women are most likely to develop urinary incontinence during pregnancy and after childbirth, or after the hormonal changes of menopause.
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Beta Agonists For Bladder Problems
This class of medication, mirabegron , works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder . Mirabegron is the first drug in this category.
- How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
- Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
- Allergy to this drug
- Advanced kidney disease
What Do You Do If Your Medication Is Causing Incontinence
For many people, the first sign of urinary incontinence encourages them to stop taking the medication they were on. However, this is not always the best option for your health. If it is not possible to discontinue the medication you are taking, urinary incontinence may be managed with a variety of pharmacologic options.
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You May Be Able To Switch To A Comparable Medication With Fewer Unpleasant Side
- Make lifestyle changes such as avoiding liquids at least an hour before bed time and/or sex.
- Try double voiding to be sure your bladder is completely empty.
- Talk with your doctor about available medical interventions.
- Do Kegel exercises three times a day to strengthen your pelvic floor muscles. Find the muscle by interrupting your urine midstream or tightening the muscles that keep you from passing gas. Dont continue to stop your urine after you have identified the muscle. Doing so may increase your risk of a urinary tract infection. Contract the muscle for a few seconds, release and repeat. You can do Kegels anywhere discreetly so do them regularly for best results.
- Consider Mens Liberty. We offer a comfortable, skin-friendly alternative for worry free incontinence management. Our male external catheter keeps you dry 24/7 and is designed to maximize freedom to enjoy your normal activities without fear of accidents.
Certain medication can impact the ability of the bladder to hold or fully expel urine. If you notice symptoms that seem related to your medications keep a journal in advance of your doctor visit. Doing so can help your doctor get a full picture of the patterns and problems with your incontinence. The more information you can share the more useful the feedback you receive will be.
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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Home Remedies For Urinary Incontinence
Urinary incontinence can be described as the inability to control urination, leading to urine leakage or involuntary loss of urine.
It is a very common, and at times debilitating, urological disorder. According to the National Association for Continence , it affects about 25 million Americans.
Urinary incontinence can be divided into three main types:
- Urge incontinence occurs when an overactive or hyperactive bladder causes a sudden and intense urge to urinate causing involuntary loss of urine
- Stress incontinence occurs when physical activities like vigorous exercise, jumping, coughing, sneezing or even laughing put pressure on the bladder and it releases urine
- Overflow incontinence inability to completely empty the bladder, leading to frequent or constant dribbling of urine
Incontinence can be caused by a number of factors like age , weakened pelvic floor muscles due to surgery or childbirth, enlarged prostate, menopause, an overactive bladder, nerve damage, urinary stones, urinary tract infections and constipation.
Plus, certain foods, drinks and medications may stimulate your bladder and cause temporary incontinence.
It not only can cause discomfort and embarrassment, but can also be harmful if urine is left in the bladder creating a breeding ground for bacteria. Incontinence is not a disease in itself, but a symptom of an underlying condition or disorder.
Here are the top 10 home remedies for urinary incontinence.
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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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More On Drug Side Effects
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I’m sorry to say, however, that your aunt long ago reached the age where anticholinergic drugs should almost certainly be ruled out as a treatment option. In older patients, anticholinergics like the two your aunt has been prescribed can cause a wide range of adverse effects, including constipation , blurred vision, confusion and short-term memory problems, dizziness, anxiety, depression and hallucinations.
When considering how to treat urinary incontinence it’s important to remember two things. First, while the muscles in the bladder and urethra lose some of their strength as we get older , incontinence isn’t “normal” at any age. Second, urinary incontinence is a symptom, not a disease. Urge incontinence, for example, may be caused by:
I’d recommend that you work closely with your aunt’s physician or other health care provider to determine, if at all possible, what might be causing her incontinence. Smoking or being overweight can be contributing factors, for example.
While it’s not always possible to pinpoint a cause especially with very old patients I find that adjusting a patient’s medications often resolves or, at least, substantially lessens the problem. Some simple behavioral techniques including bladder training and scheduled toilet trips can help, too.
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