The Inconvenience of Incontinence
There are many causes of urinary incontinence such as drugs – some have a diuretic effect – carbonated drinks, caffeine, foods high in spice, sugar or acid especially as found in citrus drinks. This increases urine volume and stimulates the bladder, as does corn syrup, sedatives, heart or blood pressure meds, muscle relaxants, and large doses of vitamin B and C.
The cause of incontinence could be an underlying medical condition. The rectum and bladder share many of the same nerves. Compacted stool in the rectum tends to stimulate these nerves, causing an uptick in the urge to urinate.
A urinary tract infection, or UTI, irritates the bladder, causing strong urges to go and sometimes incontinence. A burning sensation and foul-smelling urine could mean an UTI. Other medical conditions could include a blockage in the urinary system and nerve and muscle problems.
Pregnancy, hormonal changes and the increased weight of the uterus can be a factor in incontinence. Menopause, when the level of estrogen starts to drop in a woman, could contribute to the deterioration of the pelvic floor muscles. Vaginal delivery of one or more babies could also be contributors to urinary incontinence. It can weaken the pelvic floor sling, causing the bladder, rectum, small intestine or uterus to push into the vagina. Such problems could be associated with urinary incontinence.
Risk factors for incontinence are age: Bladder and urethra muscles lose some of their elasticity and strength. Age also can reduce bladder size and increase chances of involuntary urine release. Women are more likely to be plagued by stress incontinence whereas men, because of prostate problems, are more likely to be besieged by urge and overflow incontinence.
Being overweight or obese increases abdominal pressure, weakening connections between muscles and causing leakage when sneezing or coughing. Neurological diseases and diabetes can also increase the risk of incontinence.
Urinary tract infections and skin problems like rashes, infections and sores from constantly wet skin are complications of urinary incontinence. Incontinence can also affect work, personal and social relationships. There are five types of urinary incontinence discussed here: stress, overflow, urge, functional and mixed incontinence.
Stress Incontinence
Stress incontinence is the involuntary release of urine when the body is in a position of putting physical pressure on the bladder. Examples include coughing, sneezing, sexual intercourse, laughing, vigorous exercise, lifting heavy objects or when bending over. It can involve a large leak or a few drops.
Both women and men are susceptible to stress incontinence, but women are two times more likely to fall victim to it. The most common causes of female stress incontinence are multiple pregnancies and childbirths. These stretch out the sphincter and pelvic muscles, weakening them.
For men, an enlarged prostate or surgery are common causes of stress incontinence. Because the prostate gland surrounds the urethra, surgery to remove an enlarged gland can weaken support for the urethra. Inflammation of the prostate gland could cause involuntary leakage. Other causes are obesity, constipation and diabetes.
Typically, treatment is a combination of medical treatment and behavioral changes such as not engaging in activities that cause leakage, like running or jumping. Losing weight, quitting smoking and reducing alcohol and caffeine intake may help – nicotine, alcohol and caffeine are all irritants. There are Kegel exercises and biofeedback that can teach the body what it feels like when the correct muscles are engaged. Electrical stimulation does the same without the feedback loop.
Medication like imipramine, an antidepressant, is used to reduce bladder contractions. The least invasive surgery is the injection of collagen directly into the urethra to strengthen the walls. A sling procedure on women provides more support to urethra and bladder by rebuilding the pelvic floor structure.
Overflow Incontinence
Overflow incontinence happens when the bladder is very full, and the sphincter muscle allows urine leakage. It usually occurs when flow is constricted from the bladder while exiting the body. The condition affects both men and women. In men causes can include BPH, or nonmalignant enlargement of the prostate gland, urethral narrowing, and the narrowing of the bladder outlet due to scarring or excess growth of muscle tissue.
Neurological causes may include diabetes-related bladder problems, a herniated lumbar disc, nerve problems and peripheral neuropathy.
Urge Incontinence
Because the bladder contracts at inappropriate times, the sufferer feels a sudden urge to pee. The cause may be a bacterial urinary tract infection. The urethra, bladder, uterus and kidney can become infected as well.
Bladder neck obstruction is just that -- the bladder neck is blocked by abnormalities, preventing it from opening completely. This condition is more common in men who are 50 and older. There’s also overactive bladder, a chronic condition in which the urge to urinate comes on suddenly, regardless of bladder volume.
Bladder stones are crystallized minerals formed as the result of incomplete bladder emptying where concentrated urine is left. Urinary tract infections, an enlarged prostate or bladder problems may be responsible for these stones. Men comprise 95 percent of sufferers. Treatment can include using a laser, mechanical or ultrasound device to break the stones into smaller, passable pieces. If that doesn’t work, surgery typically is the next step.
Functional Incontinence
Functional incontinence occurs when the patient cannot make it to the bathroom either because of physical or mental incapacities. Examples are Alzheimer’s patients, dementia sufferers, and those with poor mobility or poor dexterity. Contributors to this kind of incontinence include diabetes, stool impaction, tobacco use, obesity and some antidepressants.
There is one acute condition associated with functional incontinence, and that is cauda equine syndrome. This happens due to lumbar disc herniation, spinal tumors, infection or inflammation and may be accompanied by groin numbness and loss of strength or sensation in the lower extremities. Treatment within 48 hours is imperative to relieve dangerous pressure on the tail end of the spinal cord.
Mixed Incontinence
This condition is a combination of urge and stress incontinence. The bladder is overactive, and the urethra is underactive. It can involve a sudden loss of urine control with no warning. With physical activity, there may be mild to moderate stress incontinence. Treatment addresses the most distressing aspect of leakage first.
With any of these symptoms of incontinence, it is advisable to see a health care provider because they could be signs of a more serious medical condition. Treatment simply may be a matter of getting in great urinary tract shape with adherence to exercises that will strengthen the pelvic organ girdle. So go ahead and laugh as heartily as your sense of humor allows.