Causes of urinary incontinence in women

What is incontinence?

Incontinence can be described as unexpected and unintentional voiding of urine which is not controlled by the patient himself. It can be a distressing and embarrassing problem affecting quality of life and is more common in females. The urine may pass after sudden coughing, just before passing large amount of urine or while sexual activity and to females it comes inevitably with increasing age. 

What are the causes?

The root cause of incontinence is the imbalance between the bladder muscle function and closure of the bladder opening. This can result due to certain reasons like:

•          Excessive drinking of water.
•          Polyuria or excess urine production like in diabetes and some kidney disorders which increase urgency and frequency.
•          Caffeine and cola beverages are bladder stimulants.
•          Damage to the nerve supplying bladder muscle as in spinal cord injury, spina bifida and stroke, also leads to improper functioning of bladder.

What are the types of incontinence?

•          Stress incontinence

Occurs due to pressure on the weak bladder muscles and urine is passed while coughing, laughing or sneezing.

•          Urge incontinence

A sudden need to void urine without full bladder due to abnormal nerve signals, bladder spasm or inappropriate bladder contractions.

•          Overflow incontinence

Spilling of urine over and over again due to improper bladder emptying. This occurs when urethral opening is blocked by stones or nerve damage as in diabetes. 

•          Over active bladder

A woman may feel strong urge to urinate without prior warning, may frequently pass urine and may have to urinate often during the night also.

·         Functional incontinence

This occurs in functionally dependent wheel chair bound patients or those who suffer from medical illnesses like arthritis, Parkinson’s or alziemers disease. The urine is spilled during the excess time taken by the patient to reach the toilet seat or in clearing too many external obstacles.

·         Mixed incontinence

This may be a combination of both stress and urge incontinence.

·         Temporary

It is a transient kind of incontinence which subsides with time. This occurs in patients taking medications, urinary infections, severe constipation which pushes the urine with stools and severe cold which may trigger incontinence. 

Why are women more affected?

Women are known to be twice more affected than men. The reason contributes to pregnancy, childbirth and largely to menopause. Incidence of incontinence in women is highly related to obesity and prevalence of diabetes. Loss of estrogen during menopause tends to reduce the vaginal lining thereby resulting in stress incontinence. Women after uterus removal are also known to develop incontinence.

Treatment regimens

The bladder incontinence treatment must aim at reducing wetness, odor and gain essential urine control. A woman may use disposable absorbents and urethral inserts to control urine loss. Other methods are pelvic floor exercises which help gaining the voluntary control to some extent. Cessation of smoking and reduction of weight is helpful along with certain medications to calm the overactive bladder are essential components of urinary incontinence treatment.

Tips for coping with incontinence

•          Schedule visits to toilet
•          Urinate completely while deep breathing.
•          Distract yourself whenever there is an urge.
•          Practice bladder training time to time.
•          Continue exercises for bladder control.