At ALMU, we understand the impact that incontinence can have on your daily life. Our goal is to help you regain bladder control and improve your quality of life.
Normal urination involves emptying the bladder when the desire to urinate occurs, at which point the bladder contracts and urine flows out of the body. Once the bladder is empty, the muscles contract and urination stops. People with incontinence experience a disruption in this process, which results in a loss of bladder control.
Causes of Incontinence
Incontinence is often caused by a urinary tract infection or weak muscles in the urinary tract. Some medications may cause weak bladder muscles, therefore causing urinary incontinence. Weak muscles may prevent the closing off of the urethra, and performing certain activities may cause urine to leak.
In some cases, urinary incontinence may be a symptom of a bladder or pelvic floor disorder.
Weak Pelvic Muscles
Weak pelvic floor muscles, which support the bladder and urethra, can lead to urine leakage. This can occur due to aging, prostate surgery, or certain medical conditions.
Enlarged prostate (benign prostatic hyperplasia) or prostate cancer can cause urinary symptoms, including incontinence. Treatments such as surgery or radiation therapy may also contribute to urinary leakage.
Nerve damage or neurological disorders, such as spinal cord injuries, stroke, Parkinson’s Disease and multiple sclerosis, can disrupt the signals between the bladder and brain, leading to incontinence.
Urinary Tract Infection
The urinary tract includes the bladder and the urethra, and a bacterial infection can develop in either of these areas. Symptoms of a urinary tract infection include burning when urinating, frequent urge to urinate, pelvic pain and fever.
Certain medications may affect bladder control and cause urinary incontinence. It is important to discuss any medications you are taking with your healthcare provider.
Symptoms of Incontinence
In addition to leaking urine, people with incontinence may also experience the following symptoms:
- Strong desire to urinate
- Pelvic pressure
- Frequent urination
- Painful urination
A symptom of incontinence may also be bed-wetting or nocturia.
Types of Incontinence
There are three main types of urinary incontinence.
Urge incontinence is most common and involves urine leakage that occurs after a sudden urge to urinate because the muscle wall of the bladder is overactive.
Stress incontinence is urine leakage that occurs after an activity such as coughing, laughing or sneezing places pressure on the bladder.
Overflow incontinence occurs as the result of an inactive bladder muscle that does not completely empty the bladder after urination.
Diagnosis of Incontinence
Patients exhibiting the symptoms of incontinence should see their doctor to determine the cause, type and severity of their condition. Doctors can diagnose urinary incontinence through a series of tests and an evaluation of the patient‘s medical history. Patients may also be asked to keep a bladder or urination diary to record the frequency and circumstances of their urination. To determine the cause and severity of your incontinence, our urologists will conduct a thorough evaluation, which may include:
- Medical History: A detailed discussion of your symptoms, medical conditions, and medications will help us understand the potential causes of your incontinence.
- Physical Examination: Our urologists will perform a physical examination, including a prostate examination, to assess any physical abnormalities that may contribute to your incontinence.
- Urinalysis: A urine sample will be analyzed to check for signs of infection or other abnormalities.
- Bladder Testing: Specialized tests may be conducted to evaluate the function of your bladder and urethra. These tests measure factors such as urine flow rate, bladder capacity, and pressure changes during urination.
- Imaging Studies: In some cases, imaging tests such as ultrasound or cystoscopy may be recommended to examine the urinary tract and identify any structural abnormalities.
Treatment of Incontinence
There are many different treatment options available for patients with urinary incontinence, depending on the severity of their condition. Conservative treatments are often effective, and may include the following:
- Lifestyle Modifications: Our team will provide guidance on lifestyle changes that can improve bladder control, such as fluid management, dietary adjustments, and techniques to strengthen pelvic floor muscles.
- Medications: Depending on the underlying cause of your incontinence, medications may be prescribed to help control bladder spasms, reduce urinary urgency, or improve muscle function.
- Behavioral Therapies: Bladder training techniques, such as scheduled voiding and urge suppression techniques, can help you regain control over your bladder.
- Pelvic Floor Exercises: Our urologists can teach you how to perform Kegel exercises, which strengthen the pelvic floor muscles and improve bladder control.
- Medical Devices: In some cases, the use of medical devices such as penile clamps or external catheters may be recommended to manage urinary leakage.
Surgical Interventions: For severe cases of incontinence that do not respond to conservative treatments, surgical options may be considered. These may include:
- Male sling
- Mini-Jupette performed at the time of penile implant surgery
- Proact periurethral balloons
- Artificial urinary sphincter
Prevention of Incontinence
While not all cases of incontinence can be prevented, the following tips may help in managing and controlling symptoms:
- Maintain a healthy weight and engage in regular physical activity.
- Avoid smoking, as it can irritate the bladder and contribute to incontinence.
- Avoiding caffeine, alcohol, spicy foods, citrus, and constipation.
- Practice good fluid management by drinking adequate amounts of water and voiding every 2-4 hours.
- Kegel exercises.