Did you know that more and more people are becoming incontinent yearly and there are ways it can be avoided? Incontinence is the involuntary leaking of urine be it when you are playing a game of squash or just happen to sneeze. It often happens after childbirth to women and to men as they get older. It is a topic that you should feel you can discuss freely with your health provider.
Older people are more likely to experience urinary incontinence due to age-related changes in the body, but people of any age can suffer from it. There’s no need to suffer in silence though. It is important to not be embarrassed or self conscious. Besides medication, incontinence can be treated a number of ways, from behavioral therapy to surgery.
There are four general types of urinary incontinence: stress, functional, urge and overflow. Stress incontinence occurs during certain activities like coughing, sneezing, laughing, or exercise whilst urge incontinence is a strong need to urinate followed by bladder contractions and loss of urine. In short you don’t have enough time to go to the bathroom after you get the urge.
The ability to hold urine is dependent on your anatomy functioning normally and consists of two stages. This is the filling and storage phase and the emptying phase. Normally, during the filling phase, the bladder begins to fill with urine from the kidneys and stretches to accommodate increasing amounts of urine. The first sensation to urinate happens when approximately about 1 cup of urine is stored. A healthy person will respond to this by getting the urge to urinate while the bladder still fills. Most people can hold about 350 to 550 ml but the ability to fill and store urine needs a normal sphincter (the circular muscles around the opening of the bladder) and a bladder muscle that expands properly.
The emptying phase needs the ability for this muscle to contract properly to force the urine out whilst your body relaxes the sphincter to let the urine leave. If any part here is not functioning properly incontinence can occur either temporarily or long term.
Temporary causes can be urinary tract infection, prostrate infections, constipation causing bladder pressure, side effects of diuretics, diabetes, pregnancy, weight gain, too much time in bed (if you have been ill), nervous reactions or medicines such as cough mixtures, antihistamines or antidepressants.
Long-term causes can be spinal injuries, urinary tract abnormalities, weakness of the sphincter after prostate surgery in men or vaginal surgery in women, neurological conditions after a stroke or multiple sclerosis, pelvic prolapse, enlarged prostrate, depression, Alzheimer’s, reactions to radiation or bladder cancer.
Treatments vary depending on the cause and type of incontinence but the most common is exercises to strengthen the muscles of your pelvic floor. These are following a schedule to go to the toilet at certain times, whether you need to go or not. In between those times you try to hold on. At first, you may need to schedule 1 hour intervals but these get longer and longer until you go every 3-4 hours without leaking.
Kegel exercises contract the pelvic floor muscles for 10 seconds, and then relax them for 10 seconds. You need to repeat this 10 times and do them about 3 times a day. You can do this any time, any place. One type of Kegel exercise is to stop the urine flow midstream on the toilet however you should not do this too often as it can tire out the muscles and that can worsen your incontinence. The second type is contracting the buttocks like when you need to use your bowels and there is no toilet around so you would have to wait. The third is contraction of the whole area from the front to back and holding for 10 seconds.
If you need help with this you can use machinery. Biofeedback and electrical stimulation can help you learn how to perform these exercises above. Biofeedback uses electrodes placed on the pelvic floor muscles, giving you feedback when they are contracted. Electrical stimulation uses low-voltage electric current to stimulate the pelvic floor muscles and there are machines you can use in your urologists office. Once you know what muscles to use you can practice without the machine.
In the meantime pads and undergarments are available to handle the leakage although they are not pleasant and it is better to start doing your pelvic floor exercises now to prevent incontinence when you are older. Other ways to help are to avoid constipation by increasing fibre in your diet, give up smoking to reduce coughing and bladder irritation as smoking increases your risk of bladder cancer, lose weight if you need to, avoid spicy foods, fizzy drinks, citrus juices, alcohol, coffee and watch your blood sugar levels.
If your symptoms are really bad you may need surgery or medication such as drugs that relax the bladder, increase its muscle tone or strengthen the sphincter. Sometimes they insert artificial sphincters and in extreme conditions a catheter can be used although this can increase your chances of infection.
Talk to your gynecologist, urologists or natural therapist about this condition. There are a number of herbs that can help with excess urination and hypnosis can help with urge incontinence however you should call an ambulance if you ever have incontinence with loss of bowel control, loss of consciousness, trouble walking or speaking and you should see your doctor if you are constipated more than a week, have dribbling urine, wet the bed, have pain or burning, blood in the urine, have the urge too often while only passing small amounts of urine, retain urine or if the incontinence persists despite your best efforts to treat it.
You may need to have a urine test, cystoscopy (inspection inside the bladder), and urodynamics study to measure the pressure and urine flow or other tests. It is important to get these tests done so you know what is happening and that you follow instructions to prevent further illness in that area as you get older.
