Urinary Incontinence (Leaking urine)
Familiar with the term “laughed till you peed”? Well, in some women this can be a big concern and quite embarrassing as well! You will be afraid to laugh, cough or even sneeze!! Some may leak a few drops of urine while running or coughing whereas others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Which category are you in? Wearing pads during THAT time of the month is considered uncomfortable, and now with this leaking issue?? What should you do?
What is urinary incontinence?
Urinary incontinence is the loss of bladder control, or leaking urine.
Urine is made by the kidneys and stored in the bladder. The bladder has muscles that tighten when you need to urinate. When the bladder muscles tighten, urine is forced out of your bladder through a tube called the urethra. At the same time, sphincter muscles around the urethra relax to let the urine out of your body.
Incontinence will occur if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. Urine may escape with less pressure than usual if the muscles are damaged, causing a change in the position of the bladder.
Incontinence can be caused by everyday habits, underlying medical conditions or physical problems. Did you know, urinary incontinence affects twice as many women as men.
SO, why us women?
This is because reproductive health events that take place in women, like pregnancy, childbirth, and menopause, do affect the bladder, urethra, and other muscles that support these organs.
The pelvic floor muscles that support the bladder, urethra, uterus (womb), and bowels may become weaker or damaged as we age and with a number of pregnancies. So, when these muscles that support the urinary tract become weak, the muscles in the urinary tract must work extra hard to hold urine until you are ready to unleash them. This extra stress or pressure on the bladder and urethra can cause urinary incontinence or leakage.
Types of incontinence
1. Stress incontinence.
This is the most common type of incontinence. This typically affects younger women. Stress incontinence happens when there is stress or pressure on the bladder. Stress incontinence can happen when weak pelvic floor muscles put pressure on the bladder and urethra by making them work harder. With stress incontinence, everyday actions that use the pelvic floor muscles, such as coughing, sneezing, or laughing, can cause you to leak urine. Sudden movements and physical activity can also cause you to leak urine. In many cases, this type of incontinence can be treated.
2. Urge incontinence.
With urge incontinence, urine leakage usually happens after a strong, sudden urge to urinate but you may not be able to hold it before you can get to a bathroom. Some women with urge incontinence are able to get to a bathroom in time but feel the urge to urinate more than eight times a day. This is also known as “overactive bladder.” Urge incontinence is more common in older women.It can happen when you don’t expect it, such as during sleep, after drinking water, or when you hear or touch running water.
Many women with urinary incontinence have both stress and urge incontinence. This is called “mixed” incontinence.
How to treat Urinary incontinence?
Should you drink less water to reduce the leak? No. Many people with urinary incontinence think the less they drink, the less urine leaks out. This is not healthy especially when you need fluids for good health. Do note that alcohol and caffeine can irritate or stress the bladder and this may worsen the urinary incontinence.
Treating urinary incontinence can start at home. Simple steps may give you big benefits.
These steps may include:
- Doing Kegel exercises.
Kegel exercise has been around for a very long time. Many women would know this exercise but won’t do it in a proper manner. This exercise strengthens your pelvic floor muscles. However, some women have urinary symptoms because the pelvic floor muscles are always tightened, so this exercise may not be much of a benefit.
- Training your bladder.
Controlling an overactive bladder or urge incontinence by going to the bathroom at set times. Some may find this hard in the beginning but you will make progress. Write down on how frequently you go to the toilet, then slowly add about 15 minutes between bathroom visits.
Remember to urinate each time, even if you don’t have the urge. By increasing the amount of time between visits, you will train the bladder to hold more urine before it signals the need to go again.
How to diagnose?
You may need to do other tests such as:
- Urine test.
Your urine sample will be sent to the lab. This is to rule out any form of infection or other causes of incontinence.
- Ultrasound.
This scan is done to have a look at your kidneys, bladder, and urethra. We, doctors, will look for anything unusual that may be causing urinary incontinence.
- Bladder stress test.
You will need to cough or bear down as if pushing during childbirth(reminiscing those moments) as the doctor watches for any loss of urine.
- Cystoscopy.
If needed, the doctor will insert a thin tube with a tiny camera into your urethra and bladder to look for any damaged tissue. This is usually done in hospitals and some patients may need sedation.
I have done everything mentioned above but there is still no improvement to my urge incontinence, what else can I do?
Here are some other medical options that can be done:
1. Medicines.
Some medications can be given to help relax the bladder muscle and increase the amount of urine your bladder can hold. However, not many may benefit from this and some can even have side effects such as dry mouth.
2. Vaginal rejuvenation with platelet rich plasma (PRP)
Platelet Rich Plasma Therapy uses cells taken from a patient’s blood on the day of treatment, to rejuvenate vaginal and vulval tissues. Platelet-rich plasma is injected around the opening of the urethra, to help treat women who experience stress incontinence and urge incontinence. It can also help with many other conditions, particularly those affecting the vulva and vagina.
3. Surgery.
Methods mentioned above are useful in patients with mild to moderate incontinence. If you have severe incontinence, you may be referred to a hospital and will be recommended for surgery to help increase the amount of urine your bladder can hold.
Prevention
Preventing urinary incontinence isn’t always possible, but you can take steps to lower your risk:
- Practice Kegels daily
- Stay at a healthy weight
- Eat foods with fiber to help prevent constipation, reducing stress to your lower abdomen.
When to see a doctor?
You may feel uncomfortable discussing incontinence with your doctor. But if incontinence is frequent or is affecting your quality of life, it’s important to seek medical advice because urinary incontinence may:
- Indicate a more-serious underlying condition
- Cause you to restrict your activities and limit your social interactions
- Increase the risk of falls in older adults as they rush to the toilet
Talk to us and we will go through this together!
