Urinary Incontinence 2018-02-19T17:30:28+00:00

GYNECOLOGY

Urinary Incontinence

The Latin word “incontinentum” means “not holding together.” Urinary incontinence is a loss of the control of your bladder. It is caused when your muscles are not able to hold your bladder under control. Bladder control problems happen for a variety of reasons to a broad range of people. Involuntary urination is another name for urinary incontinence. The muscle most affected by urinary incontinence is your urinary sphincter. The urinary sphincter is in charge of holding urine in the bladder.

Anyone can have urinary incontinence, but the most common group is older people, and among that group, females. Out of the 25 million older adults that are affected by urinary incontinence, nearly 80% of them are women. Pregnancy, childbirth, and menopause are the major reasons for the greater prevalence of urinary incontinence among women. About 1 in 4 women between the ages of 18-24 experiences incontinence.

Kinds of Urinary Incontinence

There are six main types of urinary incontinence. You can think of these as occurring on a spectrum of incontinence, beginning with the most functional version of incontinence and ending with the least functional version.

  • Stress Incontinence: This is the most common type of urinary incontinence, especially with women and girls who have had children or gone through menopause. Stress, in this case, refers to the physical pressure instead of mental or emotional stress. Your bladder and muscles involved in urinary control may urinate involuntarily when placed under sudden extra pressure. The pressure that may trigger stress incontinence may be a sudden cough, sneezing, laughing, lifting heavy things, or exercising. The amount of urine that comes out depends on how full your bladder is and how affected your muscles are.
  • Urge Incontinence: Also known as effort incontinence or reflex incontinence. This is the second most prevalent type of urinary incontinence. In this case, your bladder is either unstable or overactive. The detrusor muscles (the muscles controlling the muscular wall of your bladder that causes urinary urgency) will trigger an urge to urinate that can’t be stopped when they contract suddenly and involuntarily. You will accidentally lose a lot of urine for no apparent reason while at the same time feeling a sudden urge to urinate. Regardless of what you try to do when you feel the urge to urinate you have a very short time before your urine is released. Sometimes, the urge to urinate is caused by a sudden change in position, the sound of rain or running water, or even sex. If you have this type of incontinence, it is likely that you have to urinate frequently. Urge incontinence usually occurs because of damage to the nerves of your bladder, nervous system, or muscles themselves.
  • Mixed Incontinence: This type of incontinence is diagnosed when you have a combination of stress incontinence and urge incontinence.
  • Overflow Incontinence: This type of incontinence is more common in men that have prostate gland issues, a damaged bladder, or a blocked urethra. If you have an enlarged prostate, you may only manage to urinate in small amounts that are like trickles, yet you have to go frequently and never feel like your bladder is truly emptied. Because (for one reason or another) you can’t empty your bladder, you will frequently (or in some cases constantly) be dribbling urine.
  • Functional Incontinence: This type of incontinence is named “functional,” because the person who is incontinent is aware that they have a need to urinate, but they can’t make it to the bathroom in time due to a mobility problem. If you have a disability where you have poor dexterity (ex. can’t get your pants down in time), if you suffer from confusion, dementia, poor eyesight, poor mobility, depression, or anxiety, you are an example of someone with functional incontinence. The amount of urine lost may be large. Difficulties thinking, moving, and communicating all contribute to preventing you from reaching a toilet. Functional incontinence is the most prevalent in elderly people and in nursing homes. Functional incontinence is also known to happen to the everyday person. If you are on a long trip without a bathroom and there is no other option but to wet yourself, that is what your body will eventually do.
  • Gross Total Incontinence: This type of incontinence involves either leaking out urine on a continuous basis (all day and night) or periodically and uncontrollably releasing large amounts of urine. Your bladder is unable to store urine, due to either a congenital problem, an injury to your spinal cord or urinary system or possibly because of a fistula.

Non-Surgical Options for Urinary Incontinence

InTone

Surgical Options for Urinary Incontinence

  • Electrical stimulation
  • Retropubic suspension
  • Tension-free vaginal tape (TVT) surgery
  • Urethral Sling
  • Urethral bulking
  • Minimally invasive bladder repair

Risk Factors

Urinary incontinence has been linked to the different behaviors and traits. The older you are, the greater your risk of developing urinary incontinence. Diabetes is linked to urinary incontinence. Being female puts you at greater risk for urinary incontinence, because of giving birth, menopause, etc. Kidney disease is a congenital condition associated with incontinence. Obese and overweight people are more likely to have incontinence issues because the increased pressure on their bladder and surrounding muscles weakens the muscles and makes leaks more likely. Smoking causes a chronic cough, which is a trigger for developing urinary incontinence.

Dealing with urinary incontinence can be difficult. You may need help from another person with your toilet and hygiene needs. Or you may benefit from artificial and disposable underwear. Talk with your doctor about your issues with incontinence.

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