In simple terms, Urinary Incontinence means ‘Uncontrolled leakage of Urine’. In a healthy person (whether man or woman), urine doesn’t leak unless the person wants to empty his/her bladder. But in people who are having this medical condition, urine leaks out when they cough, laugh, sneeze or put pressure on their pelvis area such as when he/she lifts weights etc. This is because of weakened pelvis muscles and improper coordination between urethra and the urinary bladder.
Types of Urinary Incontinence are:
- Stress Urinary Incontinence (SUI)
- Over Active Bladder (OAB) / Urgency Urinary Incontinence
- Overflow Incontinence
- Mixed Incontinence
Stress Urinary Incontinence
This is one of the common types of Urinary Incontinence faced by 50% of women and 25% of men. (As per the statistics taken in the United States). As the pelvic floor muscles and tissues become weak (for various reasons), they cannot control the bladder and urethra, resulting in leakage. Usually, when a person wants to empty his/her bladder, the muscles and tissues around the bladder tighten to push out the urine and the muscles around the urethra become loose. If the bladder muscles don’t tighten properly or if the tissues around urethra doesn’t loosen and tighten like they should, it results in improper emptying of bladder and leakage.
Urgency Urinary Incontinence/Over Active Bladder (OAB)
This is a condition when a person feels the compulsion to empty his/her bladder frequently. Emptying of bladder always creates an emergency kind of situation for the person and he/she should run to the toilet. If they don’t immediately empty their bladder, urine starts leaking out. This happens with age or other medical conditions like diabetes, multiple sclerosis or stroke.
In some people, when their bladder is full, they try to empty it but they won’t be able to completely empty it. As the bladder gets full quickly (because of improper emptying), the excess urine starts leaking / overflowing. This condition is called Overflow Incontinence. This condition is more seen in women than in men. Possible causes are diabetes, neurological disorders, under-active bladder etc. In men with prostate problem, this condition may be seen.
When a person has SUI (Stress Urinary Incontinence) and an Over Active Bladder, such condition is called Mixed Incontinence. Basically, having more than one type of incontinence.
Causes of Incontinence
Most often Incontinence is a symptom of an underlying cause but not a problem by itself. Underlying health issues can be:
- UTI – Urinary Tract Infections
- Medicines taken for other medical conditions
- Multiple Sclerosis
- Enlarged prostate
- Childbirth or menopause. (Childbirth causes loosening of pelvic muscles and menopause also does the same but due to aging factor).
Diagnosis and Treatment of Urinary Incontinence
When you present yourself to a good urologist or gynaecologist, he/she will question you regarding the amount of fluids that you take in, your life style, your food habits, level of incontinence, frequency of visiting toilet etc. He/she may perform physical exam, test your urine sample for possible UTI, take an ultra sound report after emptying bladder. A stress test may also be performed by making you sneeze or cough. You will need to reveal your complete medical history and the medication that you might be currently on. Causes of UI can be several things to your pelvis area including the recent surgeries you may have undergone for other reasons in the pelvis area.
Treatment options start from suggesting life style changes to medications and finally, surgical option may be chosen by the gynaecologist depending on the problem and it’s severity.
Dr. Deepa Ganesh on Urinary Incontinence in women