Some of us may remember the shame and embarrassment that came with wetting the bed in our younger years, so imagine how even more embarrassing it must be as an adult who is unable to control the urge to pee. Planning your life around the nearest bathroom is no fun. Unfortunately this is what urinary incontinence does and it is more common than you might think, especially amongst women.
The pelvic floor in women is made up of a group of muscles and tissues that form a sling to support the bladder, uterus, and colon. The urethra, the vagina, and the rectum all have passageways through the muscles of the pelvic floor. Therefore, any damage to or weakening of the pelvic muscles can cause issues with urination, bowel movements, and sexual functioning.
There are different types of urinary incontinence.
Stress incontinence refers to urine leaking from the bladder when an individual coughs, sneezes, or lifts a heavy object.
Urge incontinence occurs when a person experiences an intense, overwhelming need to pee. When this occurs, the bladder may involuntarily release urine.
Overflow incontinence happens when the bladder never fully empties and instead releases steady leaks of small amounts of urine.
Functional incontinence occurs when another medical issue prevents a person from making it to the bathroom on time.
Finally, mixed incontinence can include more than one type of incontinence issue.
Urinary incontinence may be temporary/transient or chronic, depending on the cause. Temporary conditions such as urinary tract infections, diuretic medications (water tablets), or constipation can cause short-term episodes of urinary incontinence.
Urinary incontinence that persists and affects daily life may have other causes. Many women experience incontinence during pregnancy as the weight of the fetus presses on the bladder. With age (and number of pregnancies in some cases), weakened pelvic muscles, involuntary contractions of the bladder, and changes in hormones can lead to incontinence. Physical blockages from tumors or calcified crystals in the bladder can also lead to leakage.
Also, disorders such as multiple sclerosis, Parkinson’s, or diabetes that affect nerves can cause incontinence.
Statistics show that more than 10% of the female population suffers from some variety of urinary incontinence, yet, like many issues around women’s health, this issue is not widely talked about. The fear of accidents and embarrassment keeps many women from sharing their struggles, even with health care professionals. As new treatments and better products become available, it is critical for women to feel comfortable enough to seek the help they need to deal with this health issue.
There are different management options for urinary incontinence.
Medication
Anticholinergic drugs are one class of medications that can treat urinary incontinence or the symptoms of an overactive bladder. These medications work by preventing contractions of the smooth muscles of the bladder. Meanwhile, the second class of medications beneficial for this condition is alpha blockers, which can help relax the bladder muscles in women, decreasing urine leakage. Additionally, the medication Myrbetriq (mirabegron) is a medication designed to increase the bladder capacity by relaxing bladder muscles and helping it to fill more completely. Some women may also achieve relief by using topical estrogen to restore urethra and vaginal tissues affected by hormone loss.
Behavioral changes
Some studies suggest that certain behavioral changes may improve bladder control. The first involves Kegel exercises to strengthen the pelvic floor. The second behavioral technique requires training your bladder by going to the restroom at set times each day.
Losing excess weight, quitting smoking, and treating constipation issues can also help to decrease the frequency and urgency of urination. Lastly, avoiding beverages that contain alcohol, caffeine, or carbonation can help to decrease bladder control issues. Limiting fluid intake at crucial times of the day can help to avoid distressing leaks.
Surgical Intervention
There are some types of surgery for urinary incontinence. Your physician may suggest surgically implanting a sling to support the urethra and prevent urine leakage.
A colposuspension is a surgical procedure in which a surgeon attaches the neck of the bladder to nearby structures in order to raise and support the urethra. In cases where neither of these procedures is appropriate, the doctor may recommend urethral bulking. This strategy involves injecting a bulking agent into the tissues around the urethra to narrow the opening and prevent leakage.
Medical Devices
The use of medical devices may help to prevent urinary leakage. A urethral insert is a plug that can be inserted into the urethra to prevent the flow of urine during times of heavy activity. This device can be messy to use and must be removed after a few hours of use. Meanwhile, a pessary is a device that can be inserted into the vagina to support the pelvic area. The device has to be fitted by a doctor. Some women find this device to be uncomfortable or irritating.
If the incontinence is caused by an overactive bladder, Botox treatments may provide relief. The Botox is injected by a physician into the bladder muscle. Botox then prevents the muscle from contracting and causing leaking, feelings of an intense need to urinate, and urinary frequency. Patients may notice results within two weeks of their first Botox injection. This result typically lasts six months until the next treatment. Side effects may include urinary tract infections, pain while urinating, and difficulty fully emptying the bladder.
Urinary incontinence can cause embarrassment which is understandable, however there is help available for those who speak up.
