Urinary incontinence 17th June WCW – world continence week

Urinary incontinence

17th June WCW – world continence week

Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. But particularly common in woman “of a certain age”

Here we take a closer look at it, and how to prevent it

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 pee, 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 cannot 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.

When to seek medical advice

See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.

This can also be the first step towards finding a way to effectively manage the problem.

Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis.

The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.

Causes of urinary incontinence

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 overactivity of the detrusor muscles, which control the bladder.

Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.

Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area (fistula).

Certain things can increase the chances of urinary incontinence, including:

• pregnancy and vaginal birth
• obesity
• a family history of incontinence
• increasing age – although incontinence is not an inevitable part of ageing

Treating urinary incontinence

Non-surgical treatments

Initially, a GP may suggest some simple measures to see if they help improve your symptoms.

These may include:

• lifestyle changes such as losing weight and cutting down on caffeine and alcohol
• pelvic floor exercises, where you strengthen your pelvic floor muscles by squeezing them
• bladder training, where you learn ways to wait longer between needing to urinate and passing urine

You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals. Medicine may be recommended if you're still unable to manage your symptoms.

What are pelvic floor exercises?

Pelvic floor exercises strengthen the muscles around your bladder, bottom, and vagina or penis. Everyone can benefit from doing pelvic floor exercises.

Find your pelvic floor muscles

You can feel your pelvic floor muscles if you try to stop the flow of urine when you go to the toilet.

It's not recommended that you regularly stop the flow of urine midstream as it can be harmful to your bladder.

Pelvic floor exercises

To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10 to 15 times.

Do not hold your breath or tighten your stomach, bottom or thigh muscles at the same time.

When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds.

Every week, you can add more squeezes, but be careful not to overdo it, and always have a rest between sets of squeezes.

After a few months, you should start to notice results. You should keep doing the exercises, even when you notice they're starting to work.

Surgical treatments

Surgery may also be considered. The procedures that are suitable for you will depend on the type of incontinence you have.

Surgical treatment for stress incontinence, such as a sling procedure, is used to reduce pressure on the bladder or strengthen the muscles that control urination.

Surgery to treat urge incontinence includes enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Preventing urinary incontinence

It's not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it happening.

These include:

• maintaining a healthy weight
• avoiding or cutting down on alcohol
• staying active – in particular, ensuring that your pelvic floor muscles are strong

Healthy weight

Being obese can increase your risk of urinary incontinence. You may be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating.

Drinking habits

Depending on your particular bladder problem, a GP can advise you about the amount of fluids you should drink.

If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder.

The recommended weekly limit for alcohol consumption is 14 units.

A unit of alcohol is roughly half a pint of normal strength lager or a single measure (25ml) of spirits.

If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day.