Urinary Incontinence & Bladder problems

Incontinence is defined as the involuntary loss of urine, severe enough to constitute a social or hygienic problem. While it is not life threatening, it can significantly effect quality of life when patients start avoiding activities such as exercise or social events. If you answer yes to any of the following questions you may be suffering from a form of urinary incontinence:

  • “Do you have trouble leaking urine when you cough, sneeze or exercise?”
  • “Do you have a severe urge to void?”
  • “Do you leak before you can actually make it to the bathroom?”
  • “When you go shopping, do you know where all the bathrooms are in the shopping mall?”

Urinary incontinence is very common, affecting nearly 13 million Americans. Approximately 10-35% of adults are incontinent. Women are more 2-3 times more likely to be incontinent than men. Childbirth, menopause, obesity, and smoking are risk factors. Caucasians are affected most, followed by Asians and Latin Americans, with African Americans with the least risk. People with certain conditions are also at increased risk including those with spinal cord injuries, history of stroke, multiple sclerosis or diabetes. Other factors that may worsen the condition, include certain medications and dietary habits, especially the intake of caffeine.

Two types of incontinence exist. Stress urinary incontinence occurs when involuntary leakage occurs with effort or exertion such as sneezing or coughing. Urinary urge incontinence is involuntary leakage accompanied or immediately preceded by urgency. However, both of these types can co-exist in mixed urinary incontinence.

Symptoms Include:

  • Frequent urination
  • Uncontrollable urge
  • Leakage when coughing or sneezing
  • Leakage when lifting
  • Getting up often at night to empty bladder

If you do suffer from any of the above symptoms, a visit to your physician can help improve your quality of life. First, a thorough review of one’s medical history, medications, previous surgeries, and diet will be performed. Then, an overall physical exam will help uncover any underlying medical diseases. Studies can be performed which can also rule out a urinary tract infection or stone. A voiding dairy is also useful to determine timing and frequency of bathroom activity and urinary leakage, in addition to quantity and types of intake. Urodynamic studies may then be recommended for studying the performance of the bladder.

When diagnosis of urinary incontinence is made, there are many non-surgical modalities for its treatment. First, includes adjusting one’s diet that would include a moderate intake of fluids and a decrease of caffeine intake. Kegel exercises are useful in strengthening pelvic floor muscles. Biofeedback and physical therapy are more directed methods at identifying and strengthening pelvic floor muscles. Pessaries, which mechanically correct bladder leakage, are also available. Also, depending on the type of incontinence, various types of medications are available that can alleviate the symptoms of urinary incontinence. Stress urinary incontinence may also be surgically corrected with an outpatient procedure such as a urethral sling.

So with the various non-surgical modalities for treatment of urinary incontinence available, anyone should feel comfortable discussing symptoms with their physicians so that proper treatment can be initiated and life can be enjoyed to its fullest.