Urinary incontinence and bladder control

Urinary incontinence is a sudden loss of bladder control. If you've had this experience, you know that it can cause not only embarrassment, but personal stress as well. There are several causes of urinary incontinence, including illness, previous surgeries, childbirth, infections, medications, and weight gain.

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Both men and women can experience urinary incontinence. Most people do not realize that urinary incontinence can be treated. The first step is to speak with your healthcare provider, who can help you determine the cause.

Causes

With urinary incontinence, you may permanently lose urination control, but this happens more often in some cases. Also, urinary incontinence can mean a small flow or leakage of urine, or it can mean that a significant amount of urine has been lost. Urinary incontinence can be temporary and reversible or permanent.

The most common reasons include :

The pregnancy

During pregnancy, some women experience urinary incontinence as a result of pressure exerted on the bladder by the expanding uterus that contains the developing baby. This problem is more noticeable later in pregnancy, but it can increase or decrease during pregnancy as the baby changes position as the pressure on the bladder changes. Incontinence of pregnancy usually resolves after delivery.

Birth

Multiple vaginal deliveries can also increase the risk of urinary incontinence later in life. Some women experience more severe urinary incontinence after delivery if nerves or muscles are damaged during delivery. In many cases, symptoms can go away even after an injury.

Stress urinary incontinence

Stress urinary incontinence can be caused by laughing, sneezing, coughing, or physical movements that put pressure on the lower abdomen, where the bladder is located. Most cases of stress urinary incontinence are due to a violation or weakening of the muscles of the pelvic floor or urethra, which control the flow of urine in both men and women.

In rare cases, stress urinary incontinence occurs when your bladder is too full of urine because it has been held in for too long, or because your bladder is not working as a result of diabetes or a stroke.

Bladder spasm

A bladder spasm is a sudden contraction (constriction) of the bladder that can lead to involuntary urination. There are several causes of bladder spasm, including stress, medication side effects, kidney or bladder stones, or too much caffeine. Health professionals call urine leakage from bladder spasms "irresistible urinary incontinence."

Overactive bladder

An overactive bladder is a tendency to feel a sudden urge to urinate or involuntary bladder spasms. (A person who repeatedly experiences bladder spasms may have an overactive bladder. ) An overactive bladder can be a symptom of several conditions, including infections and neurological conditions.

Diabetes

Diabetes can cause urinary incontinence , especially in patients with undiagnosed diabetes. Polydipsia (drinking more fluids) and polyuria (excessive urination) are some of the first signs of diabetes. Often times, the large volume of urine that diabetes produces can cause a person to lose urine control, especially while sleeping. Long-term, poorly controlled diabetes can cause irreversible damage to the bladder and cause urinary retention, leading to a total inability of the bladder to function.

Menopause

Menopause is often accompanied by urge and stress urinary incontinence. After menopause, vaginal tissue can thin out and affect surrounding structures, including the urethra. These changes can lead to urinary incontinence.

Enlarged prostate

The prostate is a walnut-sized gland located between the bladder and the urethra in men. As men age, the prostate enlarges, making it difficult for urine to drain and can cause urinary incontinence. An enlarged prostate can also be the result of benign prostatic hyperplasia or prostate cancer. It is important for men with urinary symptoms to be screened for prostate cancer by a doctor.

Neurological diseases

Multiple sclerosis , strokes, spinal diseases, and other neurological disorders affect the brain or spine. This can cause urinary incontinence due to inadequate control of the nerves that activate the muscles involved in urination, or due to a problem of decreased bladder sensitivity, leading to decreased awareness of the need to urinate. .

Dementia

Dementia is characterized by memory loss and cognitive problems. Often, people with dementia experience urinary incontinence due to a decreased feeling of fullness in the bladder or a decreased ability to control urinary muscles. Some people with dementia experience urinary incontinence due to behavioral changes, such as apathy (decreased interest in the world around them) or loss of social restraint (decreased interest in behaving according to social expectations) ( the disease of Parkinson's is another neurological disorder that sometimes occurs in association with urinary incontinence.)

Pelvic organ prolapse

Prolapse is when one or more pelvic organs deviate from their normal position. In women, prolapse can be seen on vaginal examination, when parts of the bladder or other organs are visible as bumps or hernias on the vaginal wall. These changes can cause not only urinary incontinence, but also urinary retention, constant pressure, and painful intercourse.

Loss of consciousness

People who pass out as a result of a medical condition such as seizures, heart attacks, strokes, drug overdoses, head injuries, or any other health problem may lose urine control while unconscious .

Operation

Sometimes surgical procedures can damage structures that are involved in normal urinary function. This can be an unavoidable process, for example when a cancerous tumor is removed, or it can be the result of anatomical changes as a result of surgery .

In men, surgery to remove the prostate for an enlarged prostate or prostatectomy (removal of the prostate) for cancer can cause urinary incontinence. In women, hysterectomy can cause urinary incontinence. In men and women, procedures performed on the back or spinal cord can damage nerves and cause urinary incontinence as a side effect.

Cancer

Cancer in the pelvic area can affect the ability to control urine. Cancers and tumors that affect urination include bladder cancer, prostate cancer, or uterine cancer, which are adjacent organs, or can be cancer from another area of the body, such as the lungs or chest, that has spread to or around the the urinary bubble .

Neuropathy

Neuropathy is a disorder of the nerves. There are several causes of neuropathy, the most common of which are diabetic neuropathy and alcoholic neuropathy. Neuropathy can make the nerves that control urination less efficient, leading to urinary incontinence .

Diuretics

There are many foods, beverages, and medications that cause the body to overproduce urine. The best known is caffeine, which is naturally found in beverages such as coffee, tea, and cocoa. Certain medications can also cause excessive urine production. For example, many medications used to treat high blood pressure are diuretics. Taking a diuretic does not necessarily lead to urinary incontinence, but it can increase the likelihood, especially if you have another cause of urinary incontinence.

Urinary tract infection

A urinary tract infection (UTI) is an infection that affects the kidneys, ureters, bladder, or urethra. UTIs can occur in both men and women and are treated with antibiotics. The infection can irritate the bladder and cause urinary symptoms, including urinary incontinence. Once the infection is gone, the urinary tract symptoms usually go away. In some cases, recurrent infections in patients can lead to a chronic overactive bladder.

Watch out

Behavioral changes, including diet and exercise, can help some people regain bladder control if done regularly. In some cases, medications may be prescribed in addition to these strategies.

The most common therapeutic and supportive techniques include:

  • Bladder training includes a structured urination schedule.
  • Pelvic muscle training teaches you how to contract and relax the Kegel muscles to better control the flow of urine. This is especially helpful for women who have lost bladder control after pregnancy or for men who have had their prostate removed.
  • Changing your fluid intake limits the amount of fluids you drink, as well as any beverages that have a diuretic effect. These include caffeinated beverages (coffee, tea, cola) or alcoholic beverages that not only stimulate urination, but can also irritate the bladder. Restricting fluids two to three hours before bedtime can reduce bed-wetting.
  • Neuromodulation of the sacral nerve is equivalent to a bladder pacemaker. This is a minimally invasive procedure in which a small wire connected to a battery is implanted to relieve symptoms of an overactive bladder or to help the bladder empty better if urine is retained.
  • A pessary is a small block that your doctor inserts into your vagina. It can be used for postmenopausal women with bladder control problems, prolapsed bladder, or prolapse.
  • Devices for male urinary incontinence: Male stress urinary incontinence that has not received medical treatment can be treated with sphincter surgery or a male sling. Both procedures are minimally invasive surgeries performed by urologists.
  • Fillers are substances, such as collagen, that can be injected around the urethra to increase the volume of the urethra. Women may only need local anesthesia for this procedure, while men may need general or regional anesthesia.
  • A suburethral sling is a minimally invasive surgical procedure designed to increase compression of the urethra in women. It is most often used to treat stress urinary incontinence.

Get the word of drug information

Whatever your experience with urinary incontinence, you should seek medical attention. Usually your doctor can find the cause, and treatment can help you avoid symptoms, significantly improving your quality of life.

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