What is urinary incontinence?
Urinary Incontinence, also known as bladder leakage, is a common occurrence that affects approximately 200 million people around the world – mostly women.
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In fact, 26% of women between the ages of 30 and 59 have problems with urine leakage. 1 Leakage typically occurs when pelvic muscles and tissue have weakened, causing the bladder and urethra to shift out of their normal position.
The symptoms of urinary incontinence can range from leaking urine when you laugh, cough, sneeze or run to having a sudden need to urinate. Other major symptoms include increased frequency, urgency, or pain during urination.
Urinary incontinence can be caused by common triggers such as certain foods, drinks and medications. It can also be caused by bladder infections, or in some cases, more serious conditions such as bladder or pelvic cancer.
There are several types of Urinary Incontinence, including:
- Stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
- Urge incontinence – when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
- Overflow incontinence (chronic urinary retention) – when you're unable to fully empty your bladder, which causes frequent leaking
- Total incontinence – when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
It's also possible to have a mixture of both stress and urge urinary incontinence. 2
Factors influencing urinary incontinence are varied, and can include age, gender, race, and family history. Pregnancy is a major factor in female urinary incontinence, with a vaginal delivery (especially operative or if you pushed for more than one hour) being an important precursor. Hysterectomy can also lead to urinary incontinence after the procedure.
Other common causes or urinary incontinence by diagnosis:
- Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
- Urge incontinence is usually the result of over activity of the detrusor muscles, which control the bladder.
- Overflow incontinence is often caused by an obstruction or blockage to your bladder, which prevents it emptying fully.
- Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a bladder fistula. 2
There are contributing lifestyle factors that can also increase one's risk for urinary incontinence. These factors include physical activity, smoking, obesity, diet, diabetes, hypertension (high blood pressure), and chronic constipation. Many of these can be managed with lifestyle adjustments that will help provide relief.
At Retreat Doctors’ Hospital, we develop customized treatment programs in order to address your unique concerns. Treatments are tailored to your individualized needs and can range from medications, to physical therapy to other behavioral modifications that can significantly reduce your symptoms and improve your overall health. In most cases, bladder control can improve through the following:
- Exercise – our team will help you find the right exercises to help strengthen your pelvic floor muscles and gain greater control over your lower abdominals and pelvic floor.
- Physical Therapy – a licensed physical therapist can lead you through bladder training and relaxation techniques to help reduce or eliminate your symptoms. Using the bathroom frequently as well as stress can make leaking or pain worse. Our team will help you to modify your daily habits and instruct you through breathing, postures and relaxation techniques to regain control of your bladder.
- Biofeedback- often used in combination with frequent exercises and physical therapy to help you target the right muscle group. Biofeedback involves an injection of Botox into the bladder, causing it to expand, increase storage capacity and decrease urgency.
- Sling and suspension - uses a small piece of woven polypropylene that’s placed under the urethra to improve bladder support and stop leakage. It’s a minimally invasive procedure.
- InterStimTM implantation - uses a neuro-stimulator that works like a pacemaker. It is implanted beneath the skin of the buttocks, and an electrode is then inserted next to the sacral nerves in order to regulate your urge “to go.”
- Botox® or collagen injections - used to relax the bladder, causing it to expand, increasing storage capacity.
- Urethral dilation - opens up or enlarges a urethra that has narrowed and is restricting urine flow. This is performed by inserting tiny tubes that stretch open the urethra.
- Sacral Nerve Simulation - a small implanted device delivers electrical stimulation of the nerves affecting the bladder to manage the urge to urinate.
For more information about Urinary Incontinence and the Center for Urological Health at Retreat Doctors' Hospital, please contact Cathy Frank, NP, at Catherine.Frank@hcahealthcare.com or (804) 200-1840.
- Muller N. What Americans understand and how they are affected by bladder control problems: highlights of recent nationwide consumer research. Urologic Nursing. 2005:25(2):109-115.