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Urinary incontinence

Abraham Eisenstein, M.D. |
Incontinence is the loss of bladder or bowel control. Forutantely, it can be controled very well and you can have it and live quite a normal life.

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First, let's see how bladder works. It is a small bag surrounded by muscle. Urine is made in the kidneys and stored in the bladder until you are ready to pass water. Your brain controls your bladder by sending messages telling it when to hold on and when to empty.

A normal bladder empties 4 to 7 times each day, can hold 400 to 600ml of urine, can wake you up once or twice at night to pass water, empties completely each time you pass urine and does not leak urine. Now, what happens in the case of incontinence? There are many different types of incontinence, but we will focus here on the most common types.

Stress incontinence is leakage when you cough, sneeze, laugh or exercise. Notice here that even gentle exercise or a bit faster walk can cause leakage if you have stress incontinence. It is most usual in women and is caused by a weak bladder outlet and pelvic floor muscles. The bladder outlet in women is very close to the vagina. The pelvic muscles which support the bladder outlet, can be stretched and weakened during childbirth. After the menopause, the body stops producing the hormones that help keep vagina and bladder outlet healthy. All that can lead to stress incontinence. Men, in the other hand, may develop stress incontinence after a prostate operation.

Urge incontinence is a sudden urgent need to pass urine, but not being able to reach the toilet in time. You may also need to pass urine more often than usual and you may be woken several times at night. Urge incontinence can often be caused by an overactive bladder. Many people find that as they get older the bladder gives less warning and needs emptying more often. This is normal until it starts to cause incontinence. Then it is the time to seek help. The cause of an overactive bladder is often unknown and we simple can't connect it with some cause, so we can't say what to do to prevent it.

Overflow incontinence happens when the bladder does not empty completely. Urine builds up and in the end may overflow, often as a frequent dribbling leakage. The bladder may not empty completely for a number of reasons: there may be an obstruction such as an enlarged prostate gland, severe constipation may block the bladder outlet, diabetes can affect the health of the bladder, conditions such as multiple sclerosis, stroke or Parkinson’s disease may make the bladder less efficient while emptying.

You do a lot to make your incontinece - worse. Fizzy and alcoholic drinks may cause problems, and so might drinks containing caffeine such as tea, coffee, chocolate drinks and cola. Drinking too much fluid in the evenings can lead to waking several times in the night to pass urine. In the other hand, not drinking enough makes urine very concentrated and the bladder then becomes used to hold it very little.

Now, what can you do to make the condition better. First, drink normally, six to eight cups of liquid each day. If tea or coffee make your symptoms worse cut down on caffeine, eat plenty of fibre, and keep as active life as you can. Do pelvic exercises to make your muscles stronger. Eventually, they will be so strong that you will pass urine only every three to five hours and be able to wait until it is convenient for you.

Incontinence does not always respond completely to treatment, and that case there are a variety of pads, pants and other products available. You can buy many of them in pharmacies and supermarkets, but it is important to seek advice from your doctor before you buy them.

A thing to remember: incontinence can be reversed in many cases and with just a little attention your life can return to normal.


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