Urinary incontinence, also known as bladder weakness, is estimated to affect around 200 million people all over the world. It causes leaking of urine by accident such as spilling of few drops of urine when sneezing or after passing urine due to poor control over bladder. The prevalence of urinary incontinence increases with age and it is seen to affect more women than men. A 2017 study revealed that urinary incontinence affects around 17% of women in the age group of 40 – 59 years and 23% of women between 60 – 79 years of age. The common factors that put a woman at risk of urinary incontinence include age, constipation, obesity, surgery, vaginal deliveries and chronic respiratory illnesses. Here’s more about this common bladder control problem you need to know.
What Causes Urinary Incontinence in Women?
The urine gets stored in the urinary bladder. During urination, the muscles present in the urinary bladder tighten which causes urine to pass to a tube known as the urethra. During the same time, the muscles in the urethra relax to collect urine and pass the urine out of the body. So if there is any problem in the urinary bladder or if the muscles in the bladder or urethra fail to function properly, urine can leak which leads to urinary incontinence.
There are various factors that can lead to urinary incontinence right from urinary tract infection and constipation to use of certain medicines.
Age: As you age, the risk of suffering from urinary incontinence is high because with age the pelvic floor muscles weaken.
Coughing and sneezing: When you sneeze or cough, there is an added pressure on the urinary bladder which in the case of weak bladder leads to urinary incontinence.
Physical strain: Certain activities that strain the body such as lifting heavy weights can strain the pelvic floor muscles increasing the risk of incontinence.
Pregnancy: Women during and after their pregnancy will also be more prone to bladder incontinence due the stress of the baby pressing down on the bladder.
Diseases: Certain health problems such as diabetes and multiple sclerosis can damage to the nerves which control the bladder function leading to urinary incontinence.
What are the types Of Urinary Incontinence?
There are different types of incontinence seen in both women and men. Here are the common ones:
Stress incontinence: If any pressure on the bladder causes urine leakage then it is known as stress incontinence. It could be due to coughing, sneezing, laughing, exercising, or lifting heavy weights. Although seen in younger and middle-aged women, it is common in menopausal women.
Urge incontinence: If you feel an urge to urinate but can’t hold it enough till you reach a washroom, then it is termed as urge incontinence. It is commonly seen in people suffering from diabetes, Alzheimer’s disease, and multiple sclerosis.
Overflow incontinence: It is when small amounts of urine gets leaked from the bladder that is always full. Although common in men with prostate problems, women with diabetes and spinal cord injuries can also experience this condition.
Total incontinence: This happens when the bladder fails to store urine even in minute amounts leading to frequent leaking and constant passing of the urine.
Urinary Incontinence: When Should You Seek Advice?
Most people suffering from urinary incontinence feel embarrassed to speak up about their condition at a doctor’s clinic. But this should not be the case, as incontinence is a common problem and can be treated effectively. If you feel uncomfortable or delay the diagnosis of the condition, then there are high chances that your condition might worsen and you may not have access to effective treatment options. Hence, do consult your doctor to diagnose and treat the condition at the earliest. The doctor who specializes in the diagnosis and treatment of urinary tract infection and problems is known as a urologist.
After a quick review of your medical history and medications you are taking, your doctor may ask about any recent surgery or injury to know about your overall health. Post this, your doctor may order a few tests to know the cause of the condition. This includes urinalysis (blood and urine tests) and tests to know how well your bladder is functioning (also known as post-void residual measurement). You may also be asked to maintain a diary to keep track of when you urinate, how much you urinate, how often you urinate and when you leak.
There are various treatment options available to treat urinary incontinence, however it depends on the type of incontinence, its severity, and how it fits your lifestyle. The treatment approach ranges from lifestyle measures to medicines and surgery to manage the condition. Here’s a quick sneak peek into the common treatment options.
Pelvic exercises also known as kegel exercises can help the bladder muscles to become strong and thus, aid in proper functioning of the muscles during urination.
Bladder control training such as timed voiding. In this, you are required to urinate on a set schedule, for example, every hour. This time gap can be slowly extended based on your response and control.
Lifestyle changes include quitting smoking, losing weight, cutting down on caffeinated beverages and avoiding lifting heavy objects to ease the pressure on the bladder.
Medicines may also prove significantly helpful. They work either by allowing emptying the bladder more fully during urination or aiding in tightening the bladder tighten muscles thereby lessening the leakage.
Surgery to keep the urethra closed or the use of medical devices such as a urethral insert or a pessary (a stiff ring inserted) into the vagina to prevent leakage.
Nerve stimulation, which sends mild electric current to the nerves around the bladder, is also used to control urinary incontinence.
The use of absorbent pads such as adult diapers and protective undergarments is also recommended as it helps to ease the discomfort and inconvenience of leaking urine.
Urinary incontinence can be treated and managed effectively with proper support and consultation from your doctor. Do not hesitate to reach out to your doctor and get it diagnosed early to lead a happy life.
(The article is reviewed by Dr. Swati Mishra, Medical Editor)
1. Biswas B, Bhattacharyya A, Dasgupta A, et al. Urinary Incontinence, Its Risk Factors, and Quality of Life: A Study among Women Aged 50 Years and above in a Rural Health Facility of West Bengal. J Midlife Health. 2017 Jul-Sep;8(3):130-136. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625577/
2. Urinary Incontinence in Older Adults. National Institute on Ageing. National Institute of Health U.S. Available from: https://www.nia.nih.gov/health/urinary-incontinence-older-adults