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Wednesday, 02 April 2014 00:00

Managing Your Urinary Incontinence

What Is Urinary Incontinence?

Urinary incontinence is the uncontrollable loss of urine. It is very common, especially in women. Up to 60% of women have incontinence.

What Are the Causes of Urinary Incontinence?

The two most common types are stress incontinence and urge incontinence. Stress incontinence is losing urine in a spurt or gush with certain activities (e.g., coughing, sneezing, lifting, exercising). It can be caused by childbirth or growing older. Urge incontinence is losing urine on the way to the bathroom. It can be caused by drugs, caffeine, alcohol, or growing older. Many bladder problems worsen during menopause.

What Are the Symptoms of Urinary Incontinence?

In very mild incontinence, a small amount of urine sometimes leaks (dribbles) during a cough or sneeze, or on the way to the bathroom. In mild to moderate incontinence, urine leaks daily and/or a pad is needed for protection. In severe incontinence, urine soaks a pad several times each day. Incontinence may limit daily activities.

How Is Urinary Incontinence Diagnosed?

Diagnosis involves taking a medical history, x-rays, blood tests, urinalysis, and other tests to see how the bladder works. These tests, called urodynamic tests, measure pressure in the bladder, urine flow, and the amount of urine left in the bladder after urination.

How Is Urinary Incontinence Treated?

Strengthening pelvic floor muscles is usually the first step in managing stress incontinence. Tightening these muscles is called a Kegel exercise. If Kegel exercises do not help, special physical therapy may improve bladder control. This therapy includes biofeedback and electrical stimulation.

Special devices, called pessaries, are also available to treat stress incontinence. These devices can be used to support organs such as the bladder. Sometimes pessaries are useful when urine is lost only during certain activities, such as jogging, aerobics, and horseback riding.

The first step in treating urge incontinence is usually training the bladder to empty (void) at certain times. The goal is for 3 hours to pass before the need to void during the daytime without any leaking. Sometimes medicines can help with bladder training. These drugs may cause dry mouth or eyes but are generally well tolerated. Various operations can also be used for stress incontinence. Specialists such as gynecologists or urologists do these operations.

DOs and DON’Ts in Managing Urinary Incontinence:

  • DO your Kegel exercises as directed.
  • DO take your medicine as directed.
  • DON’T drink lots of liquids containing caffeine (e.g., coffee, black tea, sodas). Caffeine can make the kidneys produce more urine faster than normal. Both stress and urge incontinence will get worse, and you will void more often.
  • DON’T drink excessive amounts of alcohol. Alcohol is also a diuretic.
  • DON’T drink large amounts of fluids during the day or at one time.
  • DON’T drink liquids after 7 to 8 pm if you get up more than twice during the night to urinate.

For more information, see the attachments below.

 

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