Bladder incontinence among women

Urinary incontinence

A sudden and involuntary loss of urine is commonly termed as incontinence. This is more prevalent among females and can often be a depressing situation which affects their quality of life. Being unavoidable with advancing age, the passage of urine may take place with sudden coughing, full bladder or in between sexual intercourse.

What are the causes?

The incontinence is found to be the outcome of basic in coordination between bladder muscle, detrusor and contraction of bladder opening. This results when the bladder is stimulated as in excessive caffeine, tobacco or cola intake, or when the nerve supplying bladder is damaged like in spinal cord injury or stroke patients. In addition to this, drinking huge amounts of water or production of excess urine in diabetic and renal disorder patients, there is a much more increase in urgency and frequency to void.

Classification of incontinence

The type of incontinence is directly related to the bladder incontinence treatment one must undergo. The incontinence is broadly classified into following:

•          Urge incontinence – occurs when there are hampered nerve signals leading to sudden bladder contraction making the patient feel a sudden urge to urinate.

•          Stress incontinence – Occurs during stressful physical activities like laughing, coughing or sneezing.

•          Overactive bladder – Bladder contractions are too much and there is an increased urge to void during night also.

•          Overflow incontinence – Occurs when stones in the bladder block the opening or there is a nerve disorder resulting in leaking of urine for long time.

•          Transient – It occurs temporarily when patient is on medications like diuretics or in cases of urinary tract infections.

•          Functional incontinence – Time taken to overcome too many hurdles, slowness in gait like in Parkinson’s, wheelchair bound patients mostly spill the urine while reaching the toilet seat.

•          Mixed – A combination of stress and urge incontinence.

Why are women more affected than men?

The incontinence problem is found twice as common in females as compared to males. The primary reason is pregnancy and delivery, while the secondary reason attributes to menopause. The enlargement of vaginal opening during childbirth results in incontinence. As the menopause approaches, the vaginal tissues are broken down due to loss of estrogen. Other reasons are post hysterectomy, obesity and high incidence of diabetes among women.

What are the management options?

The immediate goal of bladder incontinence treatment is developing a voluntary control over passing the urine, reduce wetness and reduce odor. There are certain urethral inserts a woman may use or substitute with disposable absorbent pads to prevent spillage. Kegel exercises are beneficial in improving tone of pelvic floor muscles. Topical medications and anticholinergic slow down the abnormal contractions while secondary prevention by smoking cessation and weight control are helpful too.  

Living with incontinence

•          Empty the bladder completely.
•          Time your toilet visits.
•          When there is an unwanted urge, indulge in any other activity.
•          Practice exercises for effective bladder control.