Urinary Incontinence
(Loss of Bladder Control · Bladder Control Problems · Incontinence)
In this condition factsheet:
Diagnosing Urinary Incontinence
Assessment by a doctor is the first step in diagnosing urinary incontinence. Your doctor will review your history, perform a physical examination, and run laboratory tests. The doctor will also ask questions to determine whether the incontinence occurs only at night (nocturnal) or during both day and night, how much urine is lost, and what factors trigger it.
You may be asked to provide a list of medications you are taking and to keep a bladder diary (writing down the amount of fluid intake and urine output). This information will help your doctor figure out why you might be experiencing incontinence.
Tests for urine leakage with coughing and bending will help diagnose stress incontinence, while tests that measure the degree of bladder emptying will establish overflow incontinence.
In certain cases, more extensive bladder testing may be needed to determine the exact cause of the incontinence. Your doctor may also test your urine or blood to see if problems such as diabetes or infection are causing incontinence. A pelvic or rectal exam may also be performed.
Finding out the cause of the problem will help determine what treatments are given.
Treating and Preventing Urinary Incontinence
In most people, incontinence can be successfully treated. If medications (e.g., water pills, certain antidepressants) or medical conditions (e.g., diabetes, atrophic vaginitis) are the root of the problem, then the medications may be discontinued or changed, or the medical condition treated.
In people suffering from dementia or Alzheimer's disease, incontinence isn't always treatable. In these cases, wearing undergarments or using bedpans or urinary catheters (flexible tubes that allow for urination) can be helpful.
Treatment options depend on the type and cause of incontinence and include the following:
Kegel or pelvic floor exercises: These exercises are particularly helpful if you have stress incontinence, but may also provide some benefit for those with urge incontinence. They specifically target the muscles of the pelvic floor. By contracting the muscles that support the bladder, you strengthen and tighten the bladder outlet. Kegel exercises need to be done regularly and consistently to work. It may take up to 6 to 8 weeks to see results from Kegel exercises.
Bladder or behaviour training: This treatment may be useful if you have stress or urge incontinence – about 75% of people report some improvement. You learn to control urine output and toilet habits over a training period of weeks to months. Training depends on the type of incontinence, but it can consist of learning how to "hold on" for longer time periods before urinating, voiding at regular time intervals, and resisting the "urge to go."
Weight loss: being overweight or obese puts additional pressure on the abdomen, which can cause or worsen incontinence. Your health care provider may recommend you lose weight to help reduce urine leakage.
Combination of Kegel exercises and behaviour training: These two therapies are sometimes combined with biofeedback. Treatments like these require a high level of determination and commitment, but the result is often worth the effort.
Medications: When exercises and behaviour training don't work, doctors may offer medication treatment. Some medications prevent bladder contractions, while others help increase bladder capacity. It's not recommended that you self-medicate with over-the-counter medications – if you have symptoms of incontinence, it's best to see your doctor for appropriate medications.
There are several types of medications used to treat incontinence, including:
- antispasmodics (e.g., oxybutinin*, tolterodine, solifenacin, trospium) help increase the bladder's storage ability and decrease bladder spasms – this delays the urge to urinate
- mirabegron is another medication that is used in people with urge incontinence to help relax the bladder smooth muscles
- botox can be also used in urge incontinence
- alpha-blockers (e.g., terazosin, tamsulosin) can be used to help urine flow easier
- 5-alpha-reductase inhibitors (e.g., dutasteride, finasteride) can be used in men with BPH to reduce prostate size
Bladder surgery: surgery is the most effective treatment for those with stress incontinence. Overflow incontinence caused by an obstruction in the urinary tract or an enlarged prostate in men may also be treated with surgery. Different types of surgeries are available, and the doctor will determine which one is best for a specific case.
Other treatment options for urinary incontinence include pessaries, catheterization and electrical stimulation. Preventing constipation by eating a diet high in fiber can also help with symptoms.
Helpful tips for managing incontinence:
- Reduce intake of foods or beverages that increase urination or may irritate the bladder (e.g., coffee, tea, alcohol).
- Avoid or reduce smoking, as it can worsen existing urinary incontinence, or potentially increase your risk of developing urinary incontinence.
- Avoid or reduce high impact activities, especially if you are experiencing stress incontinence, until symptoms improve.
- Scheduled emptying of the bladder helps, in addition to emptying before you sleep.
- Drink small amounts of fluids regularly throughout the day, but limit fluid intake 2 to 3 hours before going to sleep.
- Empty the bladder completely when you urinate and try to give an extra push to get the last drops of urine out.
- Before using absorbent pads or adult diapers, talk to your doctor to make sure you are getting proper medical treatment.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Urinary-Incontinence
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