Urinary Incontinence

 

Urinary incontinence refers to involuntary leakage of urine when you do not want it to occur.  The accidental loss of urine can occur at any time. Urinary incontinence affects men and women and is fairly common.  Urinary incontinence or urinary leakage can negatively affect the quality of life, causes embarrassment, job loss, social difficulties and depression.

 

The causes of urinary incontinence are different in men and women.  Symptoms of urinary incontinence include leakage of urine wet underwear, underwear that smells of urine.  It is fairly simple to determine if you have urinary incontinence however some elderly men and women with mild-to-moderate dementia may not be aware or concerned that they have urinary leakage.  Often it takes family members or caretakers to bring this issue to medical attention for evaluation and treatment.

 

Urinary incontinence is more common in younger women than in younger man.  However as men get older more men develop urinary incontinence.

 

The causes of urinary incontinence in women include weak pelvic floor muscles, overactive bladder, neurogenic bladder, and small capacity bladder.  occasionally overflow incontinence occurs in women when the bladder cannot hold urine anymore.

 

The causes of urinary incontinence in men include overactive bladder neurogenic bladder poorly functioning bladder with overflow urinary incontinence as well as weak urinary sphincter they can occur after prostatic or urethral surgery.

 

Types of incontinence:

 

Stress incontinence: leakage of urine with stress or an increase in abdominal pressure with activities such as coughing, sneezing, laughing, or exercise

 

Urge incontinence:  loss of urine after feeling a strong urge or need to urinate

 

Overflow incontinence: dripping of urine out of a bladder that is already filled to its capacity

 

Mixed incontinence: combination of other types of incontinence

 

 

 

A number of studies can be done to better understand the type of incontinence you have and what may be causing it. These studies include:

 

  • Physical exam: thorough exam of the entire body to look for signs of underlying medical problems that may contribute to incontinence

  • Urinalysis: the urine is tested for evidence of infection, blood, or other contributing causes

  • Ultrasound:  acoustic waves are used to better visualize the kidneys, ureters, bladder, and prostate

  • Cystoscopy:  camera is placed inside the urethra and bladder to visualize the lining of these organs: This allows the physician to diagnose tumors, stones, inflammation, or fistulas of the bladder / urethra.

 

Treatment:

 

There are different ways to treat urinary incontinence depending on the type and cause of leakage. The most conservative treatment is behavioral modification. Often decreasing the amount of fluid you are drinking may decrease the amount of leakage.

 

Treating underlying medical problems such as diabetes or an enlarged prostate is also useful in treating incontinence.

 

Physical therapy can be helpful for those with stress incontinence. A physical therapist can teach you the proper exercises to strengthen the pelvic floor muscles and thus eliminate or decrease the amount of leakage. Other options include injection of a bulking agent into the urethra or surgical placement of mesh (aka sling) under the urethra to give you more support.  There are many medications available by prescription to help relax the bladder and eliminate urge incontinence. Injection of Botulinum toxin into the bladder is another treatment option for urge incontinence.

 

Call SW11Medical Centre to make an appointment with our urologist to further discuss the best treatment option for you.

 

 

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