Urinary Incontinence

Losing urine accidentally, known as urinary incontinence, is more common in women than in men, although it can take place in either men or women, and at any age.  The Mayo Clinic in the United States lists six basic types of urinary incontinence:

• Stress incontinence is typically seen in women after menopause, pregnancy, childbirth, pelvic surgery, or pelvic radiation treatment. It takes place with sneezing, coughing, laughing, or lifting.
• Urge incontinence is also typically seen in women after menopause, childbirth, or pelvic trauma. It can also occur as part of the picture of Parkinson’s disease or multiple sclerosis.
• Mixed incontinence includes both stress and urge incontinence.
• Overflow incontinence consists of frequent small amounts of urination due to incomplete bladder emptying. It is sometimes confused with stress incontinence. Causes include enlarged prostate or neurological damage due to diabetes, Parkinson’s disease, spinal cord injury, or multiple sclerosis.
• Reflex, or spastic bladder, incontinence takes place when the bladder fills and an involuntary reflex causes it to empty, usually from injury to the spinal cord above an area of the cord known as thoracic 12, at the lower end of the chest.
• Functional incontinence is associated with immobility, mental impairment, dementia, or head injury.

A wide array of treatments is available for treating incontinence, and types of treatment are prescribed depending upon the diagnosis. Stress and urge incontinence can be treated with Kegel exercises, which are effective, non-invasive, and do not risk the side effects of medications. Kegel exercises can be performed anywhere, with little effort. First locate the muscle used to hold back urine, and contract them for 10 seconds, then relax for 10 seconds. Repeat 10 to 15 times. The University of Chicago School of Medicine suggests performing 3 sets of exercises per day. One nursing instructor at Rio Hondo College in Whittier, California, suggests performing a Kegel exercise while waiting for a red light to turn green. Patients who do not find relief from incontinence using this exercise should see their physicians for prescription medications or surgery.

Benign prostatic hypertrophy (BPH), or enlarged prostate, is common after the age of 50. According to the National Institutes of Health in Bethesda, United States, the condition affects half of men between 51 and 60 years of age and up to 90% of men over 80. In May 2020, the journal Frontiers in Pharmacology published a summation of treatments available for BPH. The first is ‘watchful waiting”, followed by medications to stop overgrowth of prostate tissue. The third step is surgical intervention.

High blood sugar levels in diabetes can harm the entire body by damaging the blood levels that carry oxygen and nutrients to all the organs. High blood sugar is also toxic to the nervous system. Keeping fasting blood sugar levels under 100 mg/dL can help to prevent incontinence caused by nerve damage.

In April 2018 the medical journal Neurourology and Urodynamics reported urinary incontinence in 26.7% of patients with early Parkinson’s disease, compared with 8.2% of control patients in good health. The authors recommend further research into treating incontinence in this population.

With incontinence caused by spinal cord injury or multiple sclerosis, catheterization may be used to empty the bladder, according to an article published in Topics in Spinal Cord Injury and Rehabilitation in the summer of 2019. Indwelling catheters, left in for long periods of time, are for patients who have difficulty inserting catheters and do not have adequate assistance. One-use catheters are less likely to cause bladder infection. Medications that cause the bladder to empty less frequently may also be prescribed, or surgery can enlarge the bladder or divert urine to the intestine. With careful diagnosis and treatment, urinary incontinence is a controllable problem.

If you or someone you care for is suffering from urinary incontinence, the first step toward solving the problem is to see your family physician. He or she will first need to take a history of how when the incontinence started, what other health problems have occurred alongside it, patient age and gender, medications taken, and family history. This will be followed by a physical examination. Sometimes the family doctor can prescribe simple exercises or medication, or he/she may want to refer you to a urologist for a more specialized workup.

A brand-new option for urinary incontinence improvement is available at Healthy Beings! EMSella is a machine designed to strengthen the pelvic floor (just like when you do Kegels) with little to no effort from you! Learn more about EMSella.