Incontinence

What are the symptoms or urinary incontinence?

• Frequent urination during the day and night
• Urgency of urination (rushing to go)
• Urgency with leakage (known as urge incontinence)
• Leaking on coughing and exertion (known as stress incontinence)

Types of urinary incontinence

• Stress incontinence – the most common form of incontinence in women. Physical movement such as coughing, sneezing and exercising can cause small amounts of urine to leak.
• Urge incontinence or overactive bladder – an uncontrollable urge to urinate or leaking large amounts of urine at unforeseen times including during sleep, after drinking a small amount of water, or even when you touch water or hear it running.
• Mixed incontinence – combination of stress and urge incontinence occurring together.
• Overflow incontinence – leaking small amounts of urine that the bladder hasn’t completely emptied. This could be due to nerve damage or an obstruction.
• Transient incontinence – leaking urine on a temporary basis due to a medical condition or infection that will go away once treated. It can be triggered by a urinary tract infection, medication, mental impairment, restricted mobility or severe constipation.

Diagnosis

Incontinence can be diagnosed by one of the following methods.

• Medical history
• Physical examination
• Fluid test – drinking plenty of fluids in order to test how much the bladder can hold and how well your bladder muscles function.
• Urinalysis – a urine sample is tested for signs of infection or other causes of incontinence.
• Urodynamics – a special technique is used to measure pressure in the bladder and the flow of urine.
• Stress test
• Blood tests – a blood sample is tested to assess kidney function and to investigate possible problems that may cause incontinence.
• Ultrasound – sound waves are used to take a picture of the kidneys, bladder and urethra, so any problems that could cause incontinence can be seen. Also residual urine can be estimated in a poorly emptying bladder.
• Cystoscopy – a thin tube with a tiny camera is placed inside the urethra to view the inside of the urethra and bladder to seek out possible abnormalities.

Non-medical treatment options

• Exercise – basic exercises that strengthen muscles around the bladder, called pelvic floor exercises, are able to help both men and women. Doing these exercises for a few minutes a day can help reduce or cure stress leakage especially when combined with weight loss in an overweight person.
• Electrical stimulation – brief doses of electrical stimulation are used to strengthen muscles in the lower pelvis. The strengthened muscles can aid in reducing both stress incontinence and urge incontinence.
• Biofeedback – a measuring device to make you more aware of your body’s functioning. A wire connected to an electrical patch is linked to a screen to show you when muscles contract, so you can learn to gain control over bladder muscles.
• Timed bladder training – this technique helps train your bladder to hold urine better. With bladder training you can change your bladder’s schedule for storing and emptying urine.
• Dryness aids – absorbent pads or underwear help, but are not a cure. Some people also use urinals beside their beds when they sleep if they suffer from urge incontinence.

Treatment options

• Implants or injections – substances are injected into tissues around the urethra. The implant adds bulk and helps the urethra stay closed.
• Surgery – this treatment is primarily used only after other treatments have been unsuccessful. There are different types of surgery available, including procedures that raise, or lift, the bladder up to a more normal position using a “sling” or other materials.
• Urethral inserts – small device is available that is place inside the urethra. You remove the device when you go to the toilet and then put it back into your urethra until you need to urinate again.
• Urine seals – small foam pads that you place over the opening of the urethra. The pad seals itself against your body, keeping you from leaking. Once you urinate, you remove the pad and throw it away then replace it with another pad.