Involuntary loss of urine is called urinary incontinence. It is more common in women than in men due to pregnancy, child birth, menopause and structure of female urinary tract account for this difference. Some women may lose few drops of urine while running or coughing. Others may feel a strong urge to urinate just before losing a large amount of urine. Many experience both symptoms.

It can be prevented by doing pelvic floor muscle strengthening, by weight management, avoiding constipation, moderate intense physical activity.

Types of urinary incontinence:

 

 

• Stress incontinence: Leakage of small amounts of urine during physical movement like coughing, sneezing and exercising. Causes of stress incontinence are physical changes resulting from pregnancy, child birth and menopause. Child birth and other events injure the supports of bladder causing stress incontinence. It increases during menopause or a week before menstruation due to low estrogen level.
• Urge incontinence: It is the loss of urine for no apparent reason after suddenly feeling the need or urge to urinate. It is mainly caused due to inappropriate bladder contractions, abnormal nerve signals causing bladder spasms.
• Overflow incontinence: It occurs when the bladder does not empty properly causing it to spill over. It is caused mainly due to weak bladder muscles or blocked urethra. Diabetes also causes due to nerve damage causing weak bladder muscles.
• Mixed incontinence: If you have more than one type of urinary incontinence.
• Functional incontinence: It can occur due to physical or mental impairment which keeps them from making it to the toilet in time.
• Gross total incontinence: It is continuous leaking of urine, day and night, or periodic volumes of urine and uncontrollable leaking.
• Overactive bladder occurs when the abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Symptoms of overactive bladder are increased urinary frequency, urinary urgency, urge incontinence, nocturia (awaking at night to urinate).

Tests and diagnosis:

• Bladder stress test.
• Urine analysis and culture.
• Ultrasound.
• Cystoscopy

Causes of temporary urinary incontinence:

• Alcohol.
• Over hydration.
• Dehydration.
• Caffeine.
• Bladder irritation.
• Medications like sleeping pills, diuretics, antidepressants.
• Urinary tract infection.
• Constipation.

Causes of persistent urinary incontinence:

• Pregnancy and child birth.
• Changes with aging.
• Hysterectomy.
• Painful bladder syndrome.
• Obstruction due to stones or mass.
• Neurological disorders like multiple sclerosis.

When to seek a medical advice:

• If the urinary incontinence is associated with blood in urine.
• If it is causing you to restrict your activities and limit social interactions to avoid embarrassment.
• It may increase the risk of falls in older adults as they rush to make it to the toilet.

Treatment:

Behavioral techniques:

• Pelvic floor muscle exercises.
• Bladder training.
• Scheduled toilet trips.

• Fluid and diet management.

Medications:

• Ant cholinergic medications.
• Imipramine.
• Antibiotics if there is any infection.

Electrical stimulation.

Medical devices like urethral inserts or pessary.

Surgery.

Using absorbent pads and catheters.

Prevention:

• Maintain a healthy weight.
• Avoid smoking.
• Practice pelvic floor exercises.
• Avoid bladder irritants like coffee.
• Eat more fiber diet.
• Regular physical exercises.