Incontinence is a condition that means the involuntary loss of urine. This condition can occur for a number of reasons but is most commonly associated with the loss of urine when coughing, sneezing, or exercising or by the inability to hold urine when the urge to urinate occurs.
Both males and females are affected by incontinence, most typically as they get older.
There are several different types of incontinence which have been identified:
Stress incontinence: Activities such as laughing, coughing, and sneezing can cause urine to leak unexpectedly. This is most common in women and is often caused by physical changes occurring with and after pregnancy.
Urge incontinence: The bladder feels like it needs to be relieved immediately, regardless of how much urine is in the bladder. Symptoms include needing to urinate immediately (urgency), needing to urinate often (frequency), and having to get up at night to urinate (nocturia). Occurring in men and women, this condition is believed to be caused by bladder muscles contracting at the wrong times. This may be due to a disruption of signals between the bladder and the brain.
Mixed incontinence: When one person has both stress and urge incontinence, the condition is called mixed incontinence.
Overflow incontinence: Characterized by the retention of urine in the bladder after urinating, overflow incontinence is most common in men. Symptoms include dribbling of urine, urgency, hesitancy (waiting for the urine stream to begin), weak urine stream, straining to urinate, and urinating small amounts of urine at a time.
Dribbling incontinence: Dribbling urine immediately after urination is completed is called dribbling incontinence. This can occur in men and women.
Functional incontinence: When people are physically unable to make it to the bathroom in time due to a physical or mental condition, they are said to have functional incontinence.
Congenital incontinence: A child born with the bladder or ureter(s) out of place is said to have congenital incontinence.
Neuropathic incontinence: Problems affecting one or more nerves related to the bladder can cause different symptoms of incontinence. Abnormalities in the brain such as a stroke or a neurological disease can affect bladder function.
Traumatic incontinence: An injury to the pelvis, such as a fracture, or a complication of surgery can cause traumatic incontinence.
Treatment options for incontinence include behavioral, medical, and surgical therapies.
Behavioral
Behavioral techniques are often the first treatment of choice because they are noninvasive and have no side effects.
- Biofeedback- This involves retraining the bladder through pelvic muscle tightening and relaxing that is guided by a trained technologist.
- Timed voiding and bladder training. Keeping to a schedule for urinating may minimize your symptoms.
- Pelvic floor exercises. Kegel exercises help women strengthen muscles used during urination.
- Pelvic floor stimulation. Women can increase the tone of pelvic floor muscles by having a small probe inserted into the vagina or rectum that delivers painless electrical pulses.
- Weighted vaginal cone. For women, a cone-shaped weight is inserted into the vagina and exercises are performed to strengthen pelvic floor muscles.
- Pessary. This device is inserted into a woman's vagina to support the bladder and improve bladder control.
- Urethral plug. To block urine flow, a small tampon-like plug is inserted into the urethra.
- In some cases, catheterization may be used to drain urine from the bladder. In this medical procedure, a thin tube is inserted into the urethra and bladder to drain urine. Several medications are also used to medically treat incontinence.
- Anticholinergic or spasm-relieving drugs suppress bladder contraction and relax bladder muscles for those with urge incontinence.
- Tricyclic antidepressants such as Tofranil also have the above anticholinergic effects.
- Adrenergic agonists such as ProAmatine and pseudoephedrine (Sudafed) may increase internal sphincter tone in people with stress incontinence. These medications may have serious side effects, such as high blood pressure.
- Topical estrogen cream is sometimes prescribed to menopausal women to strengthen pelvic muscles.
- Alter bladder neck position
- Repair or support weakened pelvic floor muscles
- Remove a blockage
- Implant a "sling" around the urethra
- Implant a nerve stimulation device to increase awareness of need to urinate
- Inject collagen around the urethra to add bulk to the area and compress the urethra, thus increasing resistance to urine flow
- Enlarge the bladder by injecting an antispasmotic medication such as Botox into the bladder muscle.
There are plenty of businesses out there who sell a variety of products to help you deal with incontinence for every day normal activities. These products include briefs, disposable pads, seat/bed protection, swim ware and more.
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