The inability to control urine flow is called urinary incontinence. This condition can range from an occasional leakage to a complete failure to hold any urine. People of any age can have incontinence, but it is more prevalent in women, especially those who have had children, and older adults. It is not a normal part of aging, but the muscles in the urinary tract become less efficient as we grow older—another reason to have regular exercise.
Incontinence is quite rare in children, except in severe urinary tract infections, spinal injuries and other neurological abnormalities. Occasional accidents in children up to age six years of age are not unusual. Nighttime incontinence is usually referred to as bedwetting or enuresis, which can be helped with medication. Occasionally in adolescent females, a slight leakage of urine may be associated with laughing, coughing or sneezing.
Two types of urinary incontinence are acute or abrupt, and persistent or chronic. Acute incontinence is generally a symptom of a new illness or condition such as bladder infection, inflammation of the prostate, urethra or vagina, and constipation. Side effects of some medications can result in acute urinary incontinence. Some examples are water pills, some antihypertensives, tranquilizers, antidepressants and antihistamines. This type of incontinence comes on suddenly and is often reversed when the condition that caused it is treated. Persistent incontinence comes on gradually, and lingers even though it can be managed.
Some of the risk factors and causes of urinary incontinence are childbirth, drinking large amounts of fluid especially coffee, excess weight, frequent constipation, chronic cough, smoking, alcohol, certain illnesses, some types of medicines or surgery, infection, bladder stones, low hormone levels after menopause, or an enlarged prostate gland.
The three main kinds of urinary incontinence are: stress incontinence: an involuntary loss of urine due to an increase in abdominal pressure from coughing, laughing, sneezing, straining or lifting, urge incontinence (also called hyperactive or irritable bladder): a sudden, strong urge to urinate where you may not hold it long enough to get to the bathroom, and overflow incontinence: when the bladder does not completely empty, as in certain disease conditions. There can also be a combination of types. Stress and urge incontinence (urgency) often occur together, especially in older women.
Some of the treatments are: bladder training (going to the bathroom according to the clock rather than waiting for the need to go, slowly making the time between urinations longer), pelvic floor muscle exercises called Kegel’s (pronounced kay-gulls) that tighten the muscles around the urethra, and medication. Estrogens can improve bladder function. Other medical treatments include drugs that decrease bladder contractions, These drugs may have side effects, such as dry mouth, dry eyes and constipation. Additional options including surgery may be recommended by your doctor, which may very well eliminate the problem, even though incontinence can often be greatly improved and sometimes even cured without surgery. Keep in mind that caffeinated beverages such as coffee and tea, spicy foods and alcohol can worsen the symptoms.
For most women who suffer from stress or urge incontinence, especially as a consequence of childbirth, Kegel exercises can be very effective. The exercises involve contracting and releasing the pelvic floor muscles. Most of the factors causing incontinence weaken these muscles, and Kegels can strengthen them. Obtain a brochure from your doctor, and do the exercise with other activities such as driving, watching television, or cooking, although some specialists feel five minutes twice a day until improvement, then 5 minutes three times a week is the best regimen. It’s important to learn exactly how to do these exercises, because squeezing the wrong muscles will be unproductive, and may be cause for abandoning the exercises. Be patient, as it may take a few months for improvement. They really work, and they have no side effects.
Incontinence need not be hopeless, so see your physician if you have any degree of this condition, even seemingly mild. Bladder control problems can usually be cured, treated, or adequately managed. The gynecologist and the urologist are the physicians most familiar with incontinence. These specialists will evaluate the causes and recommend several treatment approaches.