Urinary Incontinence overview

Urinary incontinence is the loss of ability to control urination. Incontinence may greatly affect the  quality of life by causing embarrassment, stigmatization, isolation, and depression. This disease is common in men after undergoing surgery for prostate cancer. Millions of women also suffer from urinary incontinence (UI). Some may experience urine loss during running, coughing or during exercise. A sudden urge to urinate followed by a loss of large amounts of urine may occur. Urine loss may also occur during sexual activity. UI is more common in women, occurring twice as often. Both men and women may become incontinent as a result of birth defects, stroke and aging. Incontinence results from weakening of the muscles, problems with the nerves controlling the release of urine.

  • Type of Urinary Incontinence
    • Transient – related to a certain condition. Cold, illness etc.
    • Urge – uncontrolled urination, causing loss of large amounts of urine
    • Overactive Bladder – Frequent urination and urgency
    • Overflow – leakage of small amounts of urine due to a full bladder
    • Functional – loss of urine due to disability, unable to reach a toilet on time. 

  • Diagnostic tests
    • Ultrasound
    • Bladder Stress Test – the doctor observes for the loss of urine while under stress. eg, coughing
    • Cystoscopy – Insertion of a camera into the urethra for a visual examination of internal structures.
    • Urodynamics – measures the flow and pressure of urine
    • Urine analysis/urine bacterial culture

  • Treatment

    • Bladder Training - Patients are trained to change voiding habits. Measures to alter changes in fluid intake are undertaken.. Bladder training involves timed voiding (every 2 to 3 h) while awake. Prompted voiding is used for cognitively impaired patients; they are asked about every 2 hours whether they need to void. A voiding diary helps establish how often and when voiding is indicated and whether patients can sense a full bladder. Patients are instructed to limit fluid intake at certain times (eg, before going out, 3 to 4 h before bedtime), to avoid fluids that irritate the bladder (eg, caffeine-containing fluids), and to drink 48 to 64 oz (1500 to 2000 mL) of fluid a day (concentrated urine irritates the bladder).
    • Kegel exercises – Pelvic muscle exercises help strengthen muscle that control urination. Patients learn to contract the pelvic muscles rather than the thigh or buttock muscles.
    • Drugs – Certain drugs are used to treat overactive bladder conditions. These drugs block the nerve signals causing frequent urination. Anticholinergics help to relax bladder muscles preventing spasms. Side effects may include dry mouth, blurred vision and constipation.