Urinary incontinence

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Managing Urinary Incontinence

Thursday, December 26th, 2013

Urinary incontinence refers to the loss of bladder control and is a very common problem. Unfortunately, it is also a very embarrassing problem for many women, and so they often just live with it rather than discussing it with their doctors – which is too bad, because there are effective treatments available, and some of them are very simple.

Urinary incontinence can be mild or severe, ranging from the occasional leak upon sneezing or coughing to having such strong, sudden urges to urinate that you can’t make it to the toilet in time. If incontinence is affecting your day to day activities, please don’t hesitate to talk to your doctor about it. He or she has heard it before, and some simple medical treatment or even just lifestyle changes in some cases can make a huge difference. There are several different types of urinary incontinence, for example:

Stress Incontinence: Leaking urine when pressure is exerted on the bladder, such as through laughing, sneezing, coughing, or heavy lifting. Childbirth and menopause often result in stress incontinence. Obesity is a very common culprit.

Urge Incontinence: An intense and sudden need to urinate. Women with this type of incontinence often experience involuntary loss of urine and “not making it” to the toilet in time. The bladder contracts and in some cases the woman has only a matter of seconds to reach a restroom. This type of incontinence can be caused by a variety of health problems such as UTIs (urinary tract infections), stroke, Parkinson’s or Alzheimer’s disease, and multiple sclerosis. 

Overflow Incontinence: Women who have trouble emptying their bladders completely may experience overflow incontinence, or the frequent or constant leaking of urine. A women with this type of incontinence may not be able to empty her bladder and may be able to produce only a weak stream of urine; typically, this is caused by some type of damage to the bladder – for example, nerve damage caused by multiple sclerosis or diabetes.

There are also cases where women experience more than one type of incontinence. To be sure, it can feel embarrassing to tell your doctor you are having a problem with incontinence. But this is a much better option than suffering in silence. For starters, incontinence may be a symptom of a more serious problem. It can also seriously affect your quality of life, especially if you are restricting your activities and limiting social interactions.

What Causes Urinary Incontinence?

Incontinence can be temporary or permanent, mild or severe. It can be caused by a number of different things. Sometimes, temporary incontinence or isolated incidents can be caused by alcohol, caffeine, or over-hydration; it can also be caused by a UTI and in this case, it goes away as soon as the infection is treated.

When incontinence is persistent, it may be caused by an underlying physical condition or problem, such as an undiagnosed urinary tract infection , pregnancy, hysterectomy, neurological disorders, or obstruction of the urinary tract by a stone or tumor.  The most common reason is just aging and not pregnancy or the mode of delivery.   As stated here back in May, nuns have the same prevalence of urinary incontinence as mothers.


See Your Doctor for a Solution

Often, women with urinary incontinence are most comfortable talking to their gynecologists first. In most cases, your gynecologist can help you with this problem; in certain cases, he or she may need to refer you to a urogynecologist or other specialist. When you go to your appointment to discuss your problem, be prepared with some information that your doctor is sure to ask you for. For example, your symptoms in detail and a list of all medications you take (including vitamins). Also write down questions you have so you don’t forget them once you are in the doctor’s office.

The type of treatment recommended will depend on your individual symptoms and the type of incontinence you are experiencing. Your doctor will most likely suggest the least invasive treatments first, and often, these are quite effective. He or she may suggest that you try certain techniques such as bladder training, double voiding, diet and fluid management, or Kegel exercises.

If these are not effective, there are medications available that can help. There are also medical devices such as urethral inserts and pessaries that can be helpful. Sometimes, urinary continence may require surgical treatment.

To reduce your risk of developing urinary incontinence or to prevent yours from worsening, maintain a healthy weight, do regular Kegel exercises, don’t smoke, and avoid foods known to irritate the bladder such as caffeine and alcohol. You will almost certainly be glad that you talked to your doctor about your incontinence. Go make your appointment now and you’ll be one step closer to relief.

– Yvonne S. Thornton, M. D., M. P. H.

Risk Factors For Urinary Incontinence

Thursday, May 23rd, 2013

There can be a lot of embarrassment associated with urinary stress incontinence, and a lot of women may feel like they can’t talk about it with anybody—even their doctor. However, those women should know that there is nothing to be ashamed of. It’s a fact of life that many women will have to deal with throughout their lives, whether it is after pregnancy, the result of aging, or due to any other number of causes.  In fact, with this study you can see just how many risk factors there are for UI. Moreover, UI (urinary incontinence) is not something to be ashamed of because it is the particular structure of women’s bodies that causes it to be so prevalent in the female gender.  It is also not related to the mode of delivery, i.e., cesarean vs. vaginal delivery.  Nuns have the same prevalence of urinary incontinence as mothers.

UI doesn’t necessarily mean you can’t hold it in at all—it simply means that there may be times or situations where women experience a little leakage, or there may be times when they are unable to “hold it” completely until they reach a restroom. Women may experience UI when they laugh or sneeze, or they might simply find the need to wear a panty liner throughout the day. It is a myth that there is nothing that can be done for UI.

The first and most important step in dealing with this issue is to speak with your doctor and specifically a urogynecologist. This is absolutely necessary, as there may be medical causes for sudden UI. If there are no medical causes, there might be other causes for UI, such as smoking.  If the cause is something like obesity, simply losing some excess weight can help. Your doctor can also recommend exercises that can help strengthen the pelvic wall and reduce UI. In extreme cases, your doctor may even recommend surgery to treat urinary incontinence. However, nothing can be done if patients are unwilling to speak to their doctor about the problem. Communication is always the first step in treating any issue.

– Yvonne S. Thornton, M. D., M. P. H.

Urinary incontinence? Help is available

Tuesday, October 4th, 2011

Many women are too embarrassed to talk to their doctors about urinary incontinence—which means that they may be suffering needlessly for a common complaint that often has an easy fix.

You’d probably be surprised to learn that about half of all adult women share this problem.

What’s behind urinary incontinence? There are several possibilities, including certain medications, but the two most common culprits are the loss of pelvic floor muscle tone, causing stress incontinence (urine escapes during activities such as exercise, laughing, or coughing), and over-active bladder (you feel the need to “go” more often than normal).

Stress incontinence can often be successfully treated with pelvic floor strengthening techniques called Kegel exercises. These exercises are remarkably simple to do, once you have the hang of it, and you can do them anywhere: sitting in traffic, watching TV, even at your desk.

If incontinence is brought on by an over-active bladder, different re-training exercises, including biofeedback and behavioral therapy, may be helpful. And there are several medicines that your doctor may prescribe, depending on the underlying causes.

What’s most important to know is that help is available, and not just in the Depends aisle of your pharmacy. Remember that you’re not alone in dealing with incontinence. Chances are good that about half of the women you know are dealing with some form of this disorder.

Don’t let embarrassment keep you from discussing this all-too-common issue with your doctor.

– Yvonne S. Thornton, MD, MPH