Urinary Incontinence

Overview of Urinary Incontinence

Urinary Incontinence Meaning in Urdu

یہ بیماری کافی اضطراب کا باعث بن سکتی ہے کیوں کہ کسی بھی وقت پیشاب خارج ہو سکتا ہے۔ مثانے پر کنٹرول اگر کم یا بہت محدود ہو جائے تو اس بیماری کے خطرات میں اضافہ ہو جاتا ہے۔ اس بیماری کی شدت ہمیشہ ایک جیسی نہیں رہتی۔ اگر آپ اس بیماری کا شکار ہیں تو کھانستے یا چھینکتے وقت واش روم جانے سے پہلے آپ کا پیشاب خارج ہو سکتا ہے۔ اس مرض کا سامنا زیادہ تر بوڑھے افراد کو کرنا پڑتا ہے۔ اگر طرزِ زندگی میں تبدیلی لائے جائے اور متوازن غذا استعمال کیا جائے تو اس مرض کو کنٹرول کیا جا سکتا ہے۔

It's not a disease; it's a symptom of a medical condition. Urinary incontinence is the loss of bladder control. It is a common and often embarrassing problem. The severity depends on urine leakage when individuals cough or sneeze. This action is so sudden that a person can't go to the toilet on time.

In some cases, urinary incontinence influences your everyday activities. Therefore, do not hesitate to visit your doctor. For most individuals, a simple lifestyle change or restorative treatment can ease discomfort or treat urinary incontinence.

Signs and Symptoms of Urinary Incontinence

The major symptom of this condition is leakage of urine either in smaller, moderate, or larger amounts. But according to the type and condition, urinary incontinence varies.

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Types of Urinary Incontinence

Depending upon the various factors, urinary inconsistency is of the following types:

Stress Incontinence: When urine leaks after pressure exertion on your bladder by coughing, sneezing, laughing, exercising, or lifting something heavy.

Urge Incontinence: Sudden, intense, and involuntary contraction of the bladder that leads to the urgency of urine. It is caused by:

  • The sound of running water
  • Sudden change in position
  • Due to some infection or some neurological disorder 
  • Diabetes

Overflow Incontinence: In this type, the bladder cannot hold the urine or the bladder cannot be entirely empty itself producing a small amount of urinary leakage

Most commonly, it is caused by:

  • Prostate problems in men e.g. enlargement of the prostate gland may block the bladder.
  • A damaged bladder
  • Blocked urethra
  • Frequent dripping of urine (overflow incontinence)

Functional Incontinence: It is caused by physical or mental abnormalities that resist going to the toilet on time. There are some causes of functional incontinence may include:

Mixed Incontinence: Having issues with more than one type of urinary incontinence. The symptoms of this type of incontinence are the same as that of stress and urge incontinence types.

Causes of Urinary Incontinence

As you know urinary incontinence isn't a disease, it's a symptom of a medical condition such as urinary tract infection, constipation, etc. Therefore, there can be various causes of urinary inconsistency depending upon the condition of the person.

The Severity of Urinary Inconsistency

Depending upon the severity of the condition, urinary inconsistency is of the following two types:

  1. Temporary Urinary Incontinence

Temporary urinary incontinence occurs for a shorter period of time due to a few drinks, foods, and medications. 

Below are the possible agents which act as a good stimulator to increase the volume of urine such as: 

  • Alcohol
  • Caffeine
  • Carbonated drinks and sparkling water
  • Artificial sweeteners
  • Chocolate
  • Chili peppers
  • Spicy food, sugar, or acidic fruits, especially citrus fruits (orange)
  • Heart and blood pressure medications
  • Sedatives and muscle relaxants
  • The high amount of vitamin C doses

The highly treatable medical condition can also be the cause of Urinary incontinence such as:

  • Urinary Tract Infection: When the bladder gets irritated, it may cause a strong urge to urinate, and sometimes incontinence.
  • Constipation: The rectum is located near the bladder and attached to the same nerves of the bladder. Hard, compressed stool in the rectum produces overactivation in the nerves and increases urination.
  1. Persistent Urinary Incontinence

Several factors are involved in this type of incontinence that continues for a prolonged period of time.

  • Pregnancy: Hormonal changes and a heavyweight fetus can lead to stress incontinence during pregnancy
  • Childbirth: During a vaginal delivery, muscles become weak for bladder control and also damage the bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With the prolapse, the bladder, uterus, rectum, or small intestine can get pushed down from the usual position and produce lumps into the vagina. Such lumps can be associated with incontinence.
  • Age: With age, the bladder muscle can decrease the bladder's capacity to store urine. Also, it is another involuntary bladder contraction of the bladder.
  • Menopause: After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can increase incontinence.
  • Hysterectomy: In women, the bladder and uterus are connected together with muscles and ligaments of the same type. If the uterus is removed, it may also damage the supporting bladder or pelvic muscles which leads to urinary incontinence.
  • Prostatic Hyperplasia: It is the enlargement of the prostate gland that causes urinary incontinence. It is most common in men. 
  • Prostate Cancer: Stress incontinence or urge incontinence can be associated with untreated prostate cancer in men. But urinary incontinence can be a side effect of prostate cancer treatment.
  • Obstruction: Tumour in the urinary tract inhibits the normal flow of urine, leading to overflow incontinence.
  • Neurological Disorders: There are some neurological disorders that cause urinary inconsistency are Multiple sclerosis, Parkinson's disease, brain stroke, or brain tumor and a spinal injury can affect the nerve signals involved in bladder control, causing urinary incontinence.
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Risk Factors of Urinary Incontinence

Factors that increase your risk of developing urinary incontinence include:

  • Women are more likely to suffer from urinary incontinence as compared to men
  • Males with prostate gland problems
  • Older people are affected more by urinary incontinence
  • Being overweight
  • Smoking
  • Family history
  • Other diseases such as neurological disorders or diabetes 

Health Complications of Urinary Inconsistence

These complications arise when urinary continence becomes chronic. These issues are:

Skin Problems: Most likely to develop on wet skin

  • Rashes
  • Skin infections 
  • Sores

Urinary Tract Infections: These infections may recur again and again to aggravate the severity of inflammation.

Disturbed Lifestyle: Urinary incontinence can disturb your social life, work, and personal relationships as well.

 

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Prevention

It is one of the preventable conditions. You can also minimize the risk of infections by adopting a healthy lifestyle. Here are some tips to help you prevent urinary inconsistency:

  • Maintain a healthy weight
  • Practice pelvic floor exercises
  • Avoid bladder irritants, such as caffeine, alcohol, and acidic foods.
  • Eat more fibre, which can prevent constipation(a cause of urinary incontinence)
  • Quit smoking
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Diagnosis

A urologist would firstly ask you about your medical history, and examine the patients of urinary incontinence on the basis of the following tests:

  • A Bladder Monitoring:  A urologist examines the patient's bladder condition and evaluates how much a patient can drink after urination, production of urination, and the number of episodes of incontinence.
  • Physical Examination:  A urologist may check the vagina and pelvic floor muscle strength. In males, they examine the male's rectum to get to know about the prostate gland enlargement.
  • Urinalysis: Analysis of urine is done to check if there is any infection or any other abnormality.
  • Blood Test: Various blood tests are also conducted to diagnose the cause of urinary inconsistency.
  • Post Void Residual (PVR) Measurement: To assess the quantity of urine left in the bladder after urination.
  • Pelvic Ultrasound: To diagnose the abnormalities through an image pelvic ultrasound is done.
  • Stress Test: This test is used to check the loss of urine after applying the sudden pressure.
  • Urodynamic Testing: This test is done to determine how much pressure the bladder and urinary sphincter muscle can hold.
  • Cystogram: This test is helpful in providing an X-ray image of the bladder.
  • Cystoscopy: This is done by inserting the thin tube with the lens into the urethra to view the urinary tract abnormalities.

Treatment of Urinary Incontinence | When to Consult a Doctor

A urologist may recommend treatment to their patients, on the basis of:

  • Type of urinary incontinence
  • The severity of your symptoms
  • Association of any underlying medical condition 

These markers will help a doctor decide which treatment must be chosen for incontinence patients whether it is conservative, medication, or surgical treatment.

  1. Conservative Treatment

It is the first line of treatment option that is used to treat acute urinary incontinence, in which surgery, or medicines are not involved. These include:

  • Lifestyle changes
  • Pelvic floor muscle training (Kegel exercises)
  • Bladder training

A urologist or general practitioner (GP) may suggest the patients do some simple changes in their lifestyle to improve the symptoms such as:

  • Less intake of caffeine such as tea, coffee, and cola
  • A lot of fluid intakes
  • Losing weight for obese people

Pelvic Floor Muscle Training: These pelvic floor muscles are used to control the flow of urine. It is surrounded by the bladder and urethra. Any damage or weakness in pelvic floor muscles may cause urinary incontinence that's why specific exercises of these muscles are highly recommended.

A physiotherapist will start pelvic floor muscle training to evaluate the contraction of muscles in patients, depending upon the intensity of urinary incontinence.

Generally, this therapy may include a minimum of 8 muscles at least thrice a day for at least 3 months. According to the research, pelvic floor muscle training can benefit most patients.

  • Electrical Stimulation: It is another effective therapy to contract the pelvic floor muscles through electric current. It is given to those patients who are unable to contract pelvic floor muscles completely.
  • Biofeedback: It is the patient's feedback to the physiotherapist regarding their training. 
  • Vaginal Cones: It helps to assist with pelvic floor muscle training by inserting small cones into the vagina. 

Bladder Training: It is the first line of treatment that is commonly suggested to those patients who are diagnosed with urge incontinence. 

If an individual has mixed urinary incontinence, then bladder and pelvic muscle training are recommended. The course will usually continue for at least 6 weeks.

  1. Medications

If the urinary consistency doesn't get cured by therapies or training, the doctor will prescribe medication. These medications may include:

  • Antidepressants e.g. Duloxetine is used for stress incontinence
  • Antimuscarinic e.g. oxybutynin, tolterodine and darifenacin
  1. Surgical Procedures

These procedures are suggested to those patients who are suffering from chronic urinary incontinence. Before giving any recommendation, a urologist or GP will go through their previous medical record.

 

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Last updated on Monday 28/11/2022

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