Urinary Incontinence

People with incontinence, the involuntary loss of bladder or bowel control, shouldn’t feel embarrassed or alone. It affects over 3.8 million people in Australia and 280,000 people in New Zealand. Urinary incontinence affects up to 13% of Australian men and up to 37% of Australian women. It’s important to understand that incontinence is not an inevitable part of aging, nor is it necessary to accept long-term incontinence after having children. Incontinence is not a disease. It is usually a symptom or side effect of another medical condition.

The following conditions (amongst others) can cause incontinence:

• Pregnancy
• Menopause
• Cystitis
• An enlarged prostate
• A urinary tract infection

There are different types of urinary incontinence all with different causes and symptoms. Urge Incontinence is one type and usually happens when you suddenly leak urine after feeling an urgent and immediate need to use the bathroom. This particular form of incontinence is more often found in the elderly and is caused by the bladder muscles being underactive or overactive. Stress Incontinence occurs when the pelvic floor muscles are weakened from an outside influence, like a cough or sneeze, which causes a small amount of urine to leak from the bladder. Stress incontinence is most commonly found in women and is often treated by pelvic floor exercises. Overflow Incontinence, the third type of urinary incontinence, is when you continuously leak small amounts of urine and you feel you never completely empty your bladder. It is sometimes caused by a blockage in the bladder or urethra.

Some people can manage their urinary incontinence without difficulty or professional help (especially when the syndrome is not severe). However, if you experience secondary symptoms (like blood in your urine) or if your incontinence causes you to start reducing social interactions and everyday activities, then a visit to your GP or your Urologist might be a good idea.

What causes urinary incontinence?

The severity of urinary incontinence can be pretty varied, from leaking urine when you laugh or lift a heavy object, to needing to go to the toilet so urgently you can’t get to the bathroom in time.

Urinary incontinence generally occurs when the pelvic floor muscles are weak or not working properly. The weak muscles cause the urethra (the tube that connects the bladder to the outside of the body) to not close properly and so urine may leak out. Excessive weight or pressure on the bladder can also cause urinary incontinence. This is an example of an underactive bladder.

On the other hand, an overactive bladder can also cause incontinence. If the sufferer’s bladder constricts too frequently it will leave the sufferer little or no time to get to the toilet. This might be the case if there is a blockage in the urethra or a problem with the nervous system that prevents the message about the full bladder from reaching the brain in time.

Urinary incontinence risk factors

There are certain risk factors that may increase your chances for suffering from urinary incontinence.
Some of these factors are:

• Obesity: Many studies have linked obesity to an increase of urinary incontinence. The extra weight puts additional pressure on the bladder and can cause leakages
• Smoking: Smoking indirectly increases the chances of incontinence because smokers often have a chronic cough that can put pressure on the bladder
• Pregnancy and life changes: As many women experience pregnancy, child-birth and menopause they tend to suffer from urinary incontinence more than men
• Ageing: People in the latter stages of their life are more likely to suffer from urinary incontinence. This is because the urethra and bladder lose muscle elasticity with age
• Excessive alcohol consumption: Alcohol can cause the muscles around the bladder to relax and a bladder leakage is more likely when this happens

Correct diagnosis can be difficult when it comes to urinary incontinence. To help with diagnosis, a person who is having bladder difficulties may be asked to keep a diary detailing how much fluid they consume, how often they go to the toilet and how many times they suffer from bladder loss during a specific period. An ultrasound or physical exam may also be performed where the doctor may check the strength of a women’s pelvic floor muscle or whether a man’s prostate is enlarged.

Treating urinary incontinence

There are several ways to treat urinary incontinence. What follows is a basic synopsis of the most commonly used incontinence treatments:

• Cutting down on excessive alcohol or caffeine
• Weight loss if the sufferer is obese
• Pelvic floor (Kegal) exercises can be performed to strengthen the muscles surrounding the bladder
• Delaying the time between feeling the urge to urinate and actually going to the toilet – this helps to strengthen the bladder and urethra
• Creating a timetable whereby the person afflicted with urinary incontinence goes to the bathroom at set times during the day, as opposed to waiting for the urge to occur
• Medication, corrective devices and surgery are also options although these treatments are most commonly used for extreme cases of urinary incontinence

Urinary incontinence can also bring with it secondary syndromes such as skin infections (usually due to the pelvic area being damp for extended periods) or urinary tract infections.

Living with urinary incontinence

The first thing you should know is that every type of urinary incontinence (Urge, Stress and Overflow) is manageable. It is also very common, with about 4% of all adults and 25% of all women over 40 having suffered from some kind of incontinence. Keeping this in mind, incontinence is something that you shouldn’t feel embarrassed about.

If you have a fairly mild case of incontinence, it is pretty simple to manage the syndrome without any outside help. The trick is to be prepared. You will probably need to carry incontinence products, usually in the form of absorbent guards or underwear specifically designed for urinary incontinence (Depend has a wide variety of great incontinence products For Him and For Her that you may like to take a look at). It is also a good idea to keep a change of clothes and underwear handy in case there is a mishap. Finally, performing pelvic floor exercises as part of a regular exercise routine might also help lessen the severity of your incontinence and improve the reliability of your bladder. Speak to your doctor about finding a routine that is right for you.