Urinary incontinence affects millions of American men and women. Help is available. You don’t have to suffer in silence.
If you notice a few drops of urine dribbling out when you laugh, cough or even sneeze, you may need to consult a general practitioner as these could be symptoms of urinary incontinence, or loss of voluntary control over one’s urination. In some cases there may be a total loss of urine from the urinary bladder while in other cases there could be partial leakage too. Most commonly seen in elderly males and females, this is a condition that could cause great embarrassment and mental agony. As the person loses control over his or her urination, it drips into his inner clothes without his knowledge and this causes stains, bad smells as well as embarrassment to the person in question. This problem can prevent the person from socializing as he\she is always preoccupied with the thought that the urine might leak out and others may come to know about his or her condition. As this is a problem that often affects the elderly, it could cause severe mental agony and sometimes elderly persons may even develop depression because of it.
Causes of incontinence
Some cases of incontinence are temporary and often, these instances are caused by an external or lifestyle factor. Drinking alcohol, caffeinated beverages, or too much of any fluid can cause a temporary loss of bladder control. Some medications — such as blood pressure drugs, muscle relaxants, sedatives, and some heart medicines — may also lead to a short spell of incontinence. A urinary tract infection may also lead to instances of incontinence.
Other causes of incontinence include:
Aging: As you age, your bladder muscles becomes weaker and incontinence becomes more likely. Any issues with your blood vessels will make this situation worse.
Vaginal delivery or surgery in the pelvis: Any damage caused to your pelvic floor muscles can lead to incontinence, since these muscles support your bladder. In some cases, they can be damaged or weakened by surgery—usually during a procedure to remove the uterus—or during childbirth.
Enlarged prostate: In nearly all men, the prostate gland enlarges with age. It is common for men to experience some incontinence as a result.
Cancer and stones: Prostate cancer in men, or bladder cancer in men or women can cause incontinence. In some cases, the cancer’s treatment will cause incontinence as a side-effect. A tumor, whether malignant or benign, can also cause incontinence by blocking the usual flow of urine. Kidney or bladder stones can also have the same effect, say experts.
Evaluation of the man or woman with incontinence
The condition is determined after a person records regular urine leakages. Diagnosis of urinary incontinence may involve a physical exam, an ultrasound, urodynamic testing and tests including cystoscopy, urinalysis and a bladder stress test. Sometimes, I may ask the person to keep a bladder diary.
Prevention
Although it is not always possible to prevent UI, one can lower its risk by practicing Kegel exercises, especially during pregnancy, following a healthy high-fiber diet, maintaining a healthy weight and avoiding caffeine and acidic foods.
Treatment of this condition
Most cases of urinary incontinence can be treated with lifestyle changes and bladder training exercises but medication and other coping strategies like use of diapers (that can absorb the excess urine) are also used if the problem is due to urgency or mixed incontinence. There are a few effective ways to put an end to your battle with incontinence, such as –
• Drink fluids in moderation
• Empty the bladder completely
• Lose weight
• Avoid drinking tea and coffee
• Stop drinking alcohol
• Treat digestive problems
• Read labels on medications
• Apart from these, there is a therapy to improve the symptoms of frequency, nocturia, urgency, and urge incontinence.
Treatment options also include anticholinergics, antispasmodic agents, and tricyclic antidepressants (Tofranil). Pharmacologic therapy for stress incontinence and an overactive bladder may be most effective when combined with a pelvic exercise regimen.
Some surgical procedures like tape or sling procedures, bladder suspension, urethral bulking agents, artificial urinary sphincter in men with incontinence after prostate surgery and other surgical procedures are available as treatment.
Bottom Line: Men and women who suffer from incontinence don’t have to suffer in silence and wear diapers. Help is available. See your doctor to discuss an evaluation and treatment options.
Dr. Neil Baum's Urology Blog 