Urinary Incontinence

Urinary Incontinence Overview

The involuntary leakage of urine is known as urinary incontinence. It denotes urinating when one does not wish to. The urinary sphincter’s control is either lost or weakened. Urinary incontinence is a common issue that affects a large number of people.

The intensity might range from occasionally leaking pee when you cough or sneeze to having an intense urge to urinate all of a sudden that keeps you from using the restroom in time.

Urinary Incontinence Symptoms

  • Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
  • Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as a neurological disorder or diabetes.
  • Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
  • Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
  • Mixed incontinence. You experience more than one type of urinary incontinence — most often this refers to a combination of stress incontinence and urge incontinence.

Urinary Incontinence Causes

Incontinence can be a chronic condition or a transient issue brought on by a vaginal or urinary tract infection (UTI), constipation, or certain medications.

Chronic incontinence has several common causes, including: 

  • overactive bladder muscles
  • weakened muscles in the pelvic floor
  • damage to the nerves that control bladder function
  • other bladder conditions, such as interstitial cystitis (chronic bladder inflammation), a condition or limitation that makes it challenging to use the restroom quickly
  • complications following surgery
  • obstruction
  • neurological conditions like Parkinson’s disease, multiple sclerosis, or stroke
  • For men, benign prostatic hyperplasia (BPH), an enlarged prostate, and prostate cancer
  • for women: hysterectomy, menopause, pregnancy, childbirth

Urinary Incontinence Complications

Chronic urinary incontinence complications include:

  • Skin conditions. Skin that is constantly wet can develop sores, rashes, and skin infections.
  • infection of the urinary tract. Your risk of recurrent urinary tract infections rises with incontinence.
  • effects on your private life. Your social, professional, and personal relationships may be impacted by urinary incontinence.

Urinary Incontinence Diagnostics

Your doctor will conduct a physical examination and inquire about your past health in order to determine the cause of your urinary incontinence.

Your doctor will inquire as to what you drink and how much. You’ll also be questioned about how much, how frequently, and how much of your urine leaks. If you record these details using a bladder diary for three or four days prior to your appointment with your doctor, it might be simpler for you to respond to questions.

To assist in determining the cause of UI, your healthcare provider might order one or more tests.

  • Urinalysis can check for diabetes, kidney disease, or bladder infections in your urine.
  • Blood tests can reveal a chemical imbalance in your body or issues with how well your kidneys function.
  • Urodynamic testing, which includes electromyography, examines how well the bladder, urethra, and sphincters—components of the urinary tract—are storing and releasing urine.
    During a cystoscopy, a long, thin instrument called a cystoscope is used to look inside the urethra and bladder.
    Imaging tests can be used to take images of the interior of the body, including the nervous system and urinary tract.

Urinary Incontinence Treatment

Sling surgery
Sling surgery is the method of choice for treating stress incontinence in women. A strip of material is inserted between the vagina and urethra during sling surgery by working through the vagina. The surgeon may decide to use a biologic graft created from human or animal tissue or a synthetic mesh, a screen-like material that supports weakened or damaged tissue.

The male sling is a procedure also used to treat stress incontinence in men. Mesh is inserted under the urethra to lift and support the urethra and sphincter muscles.

Artificial urinary sphincter
An artificial urinary sphincter, which helps keep the urethra closed to prevent leaks, can be implanted to treat stress incontinence in male patients.

Blockage removal surgery
Surgery to remove the blockage can be used to treat overflow incontinence brought on by a blocked urethra or another urethral condition.

Men with enlarged prostates may experience obstruction of the bladder outlet. Your doctor may recommend surgery, including minimally invasive surgery, to remove enlarged prostate tissue or widen the urethra if other treatments are ineffective.

Bladder augmentation, or bladder enlargement
Your doctor might advise surgery to enlarge your bladder if nerve damage is the root cause of UI. This procedure might increase the amount of urine your bladder can hold, but it might also make it harder for you to empty it, necessitating the use of a catheter