Incontinence is defined as a condition when urine leaks involuntarily when a person laughs, sneezes, or lifts weights. This is mostly seen in women and not very uncommon. The ability of the bladder to control the opening is lost when the muscles supporting it lose strength for various reasons. Three major factors that contribute to incontinence in women and weakening of pelvic floor muscles are:
- Age
- Pregnancy
- Vaginal Childbirth
- Menopause or low levels of estrogen production
There can be other causes such as injury or trauma or a past surgery that has scarred pelvic floor muscles resulting in incontinence.
What are the different types of incontinence?
Depending on what causes urine leakage, Urinary Incontinence is classified into different types.
- Stress Urinary Incontinence. If the urine leak happens when there is the stress laid on the abdomen / pelvic muscles, that is called Stress Urinary Incontinence. The stress can be due to laughing, jumping, sneezing, or even lifting weights.
- Urge Incontinence (Over Active Bladder). You will often feel the urge to urinate but by the time you make it to the restroom, you would have leaked urine. Urge Incontinence is usually caused by an OverActive Bladder due to which you end up visiting the restroom more often than normal.
- Overflow Incontinence. When you are not able to empty your bladder completely, urine tends to leak at times. Small amounts of urine keep leaking instead of one big urge to visit the restroom. This type of incontinence is more common in people suffering from multiple sclerosis, stroke or diabetes. Men with larger prostate may also see this happening.
- Mixed Incontinence. When a person is suffering from two different types of incontinence such as Stress Urinary Incontinence and an OverActive Bladder, he/she is said to have mixed incontinence.
What causes incontinence?
Incontinence can be caused due to various reasons from Urinary Tract Infections, Vaginal Infection, constipation, etc. But such incontinence wouldn’t last long. Chronic incontinence can be due to any or some of the following reasons:
- Weakening of bladder muscles caused due to pregnancy and/or vaginal child birth. When a woman gets pregnant, the growing foetus occupies a lot of space putting a lot of pressure on the pelvic floor muscles. Though the body of a woman is so beautifully designed that the muscles and tissues around the womb get stretched, they often tear. Especially when giving birth vaginally, the trauma-induced and the extent of tear of pelvic muscles is so big that they often don’t get back to their original shape or strength after delivery. (Unless the woman works on her abdominal area to strengthen the muscles). The amount of trauma and tear can only be experienced than explained in words.
- Overactive bladder muscles cause compression of the bladder often causing the urine to leak.
- Nerve damage. When the communication between the bladder muscles and brain isn’t proper due to any reason (any kind of nerve or spine damage), bladder muscles are often out of control resulting in urine leakage.
- Enlarged Prostate. Men with an enlarged prostate often suffer from urine incontinence.
- Arthritis slows you down from reaching the toilet on time.
- Pelvic Organ Prolapse. Again, due to the weakening of pelvic floor muscles, any organ that is supported by the pelvic muscles such as the uterus, vagina, rectum, the bladder can fall down from their place. When any of the prolapses of the pelvic organs, it also affects the normal behavior or functionality of the other surrounding organs resulting in incontinence.
How is Urinary Incontinence diagnosed?
After listening to the symptoms of your problem, your urologist will start with a physical exam where he/she will check for any obvious reasons in your pelvis region that might be causing it. In the case of men, the size of the prostate will be checked. Your doctor may get urine tests or blood tests done and may also test your ability to empty your bladder (Urodynamic testing).
Your doctor may give you a pad to keep it in place that can hold the leaked urine. This can give your doctor an idea of how much urine is being leaked during a certain time.
How you can treat incontinence?
Certain types of incontinences may not be treatable completely. Certain lifestyle changes and some hygiene routines can help you alleviate symptoms and improve the quality of your life.
- Emptying the bladder regularly, say every one hour or one and half hours. Irrespective of whether your bladder signals you or not, you will need to follow this routine and as time passes, you can increase the urination window until things get back to normal.
- Emptying the bladder before traveling out or before a workout session can help.
- Avoid lifting heavy objects or lifting objects wrongly. The right way of lifting objects is by putting the weight on your legs but not on the abdomen or on your lower back.
- Kegels Kegels and Kegels. We can’t stress enough the importance of doing Kegels exercise every day after delivering a baby. This helps in strengthening of right pelvic muscles and can get rid of incontinence completely.
- Managing weight if you are obese or overweight. Being overweight is also another major cause of incontinence. The excess body weight lays stress on your lower body causing the muscles to weaken. A healthy diet and regular workout can take you a long way in combating incontinence.
In case if you are not able to manage incontinence with any of these practices, then there are certain medical procedures (given below) your doctor may suggest to get rid of the problem:
- Using bulking agents
- Botox treatment
- Neuromodulation techniques
- Sling procedures using synthetic materials or your own tissue.
- Artificial urethral sphincter.
If you are suffering from leakage of urine after childbirth, remember that you are not alone and you need not be ashamed of it. Many women have and many have overcome it with proper lifestyle changes and working on strengthening their pelvic muscles. Should you need any advice from our urologist on any of your incontinence or prolapse-related conditions, you can write to us or call us for an appointment with our expert urologists in Chennai.
References:
https://www.nia.nih.gov/health/urinary-incontinence-older-adults
https://my.clevelandclinic.org/health/diseases/17596-urinary-incontinence
