blog by HARTMANN to mark World Continence Wee
Introduction
If you or someone you love suffers from urinary incontinence, you already know that it can be a distressing and embarrassing condition. It can vary in severity, with some people experiencing occasional leakage when they sneeze or laugh, to others suffering from a complete and total loss of the control over their bladder and being unable to make it to the toilet in time.
In addition to the topic being taboo, people who suffer from urinary incontinence can also find themselves dealing with odour, skin rashes, leakage and social consequences.
Learning about urinary incontinence can help you understand what it is, what causes it, and how you can alleviate its symptoms.
What Is Urinary Incontinence?
Urinary incontinence is a condition that involves a weakening of control over the urinary sphincter resulting in involuntary leakage from the urethra. This causes an individual to urinate when they do not intend to do so. While many people think of urinary incontinence as affecting the elderly or pregnant women, it is a problem that affects a wide swathe of people across the population.
The NHS estimates that up to one-quarter to one-third of men and women across the UK experience some form of urinary incontinence. While it is more common in women, it is far from solely a ‘female problem,’ with up to ten per cent of men suffering from the condition at some point in their lives.
What Are the Signs and Symptoms of Urinary Incontinence?
Urinary incontinence more commonly occurs as individuals age, but it is important to remember that it isn’t an inevitable part of ageing. Even the most senior amongst us should seek help and medical guidance if urinary incontinence begins to affect their daily lives. A few easy lifestyle changes and/or non-invasive medical treatments can alleviate the problem. If you have any of the signs or symptoms listed below, you should seek medical treatment.
The main types of urinary incontinence and symptoms include:
| Stress incontinence | This form of incontinence is characterised by urine leaking out from your urethra when you cough, sneeze, laugh, lift a heavy object, or exercise too vigorously. |
| Urge incontinence | Urge incontinence is a sudden need to urinate, then followed by involuntary urination. This can often occur, including in the middle of the night. It can be caused by an infection, diabetes, or a neurologic disorder. |
| Overflow incontinence | With overflow incontinence, the bladder does not empty fully, and a continuous dribble of urine can escape. |
| Functional incontinence | Individuals with mental or physical disabilities can have a hard time with mobility and undoing their garments, and this can cause them to urinate before they make it to the toilet. |
| Mixed incontinence | Someone who suffers from mixed incontinence has more than one of the types of incontinence listed above. |
When Should You Seek Medical Advice?
Anyone who suffers from urinary incontinence should seek advice from their GP, as it can be a symptom of a more serious underlying condition. While you may feel embarrassed, remember that your GP has extensive experience dealing with this issue, and they will not judge you. In fact, they will be able to help you deal with the condition.
It is important to speak to a GP, as urinary incontinence can:
- Indicate that you have a more serious underlying condition. Catching these conditions early dramatically increases your chances of dealing with them successfully.
- Negatively affect your professional and social life, as you might become more likely to limit your activities.
- Increase your risks of falling, as you will likely rush to the toilet, this is especially concerning for older people.
What Causes Urinary Incontinence?
It’s always important to remember that urinary incontinence is not a disease unto itself. It is a symptom of a bigger problem. While this underlying problem can be a medical condition, it can also simply be a habit that you are not aware is harmful.
Here are some of the most common causes of temporary urinary incontinence:
| Medications | Certain blood pressure medications, muscle relaxants and sedatives can relax the urethra and/or cause the overproduction of urine. |
| Urinary Tract Infections | An infection can irritate your bladder lining, causing you to feel stronger than usual urges to urinate. |
| Pregnancy | As the foetus grows and begins to press on the organs, it can lead to stress incontinence. Hormonal changes in pregnancy can also increase the need to urinate. |
| Constipation | If you are constipated, you might find that you have to urinate more frequently. Since your rectum is located close to your bladder and utilises many of the same nerve endings, hard stool in this area can over-stimulate urine production. |
| Foods and drinks | Many foods and drinks can act as diuretics. That means that they simulate your bladder and cause a higher volume of urine to be produced. These foods can include: – Alcohol – Sparkling water – Chilli peppers and spicy foods – Caffeinated drinks – Chocolate – Acidic foods, including citrus – Extremely sugary foods – Artificial sweeteners |
Here are some of the most common causes of persistent urinary incontinence:
| Childbirth | Once a woman gives birth vaginally, this can weaken the muscles surrounding the bladder, leading to a dropped pelvic floor (often called a prolapse) In this case, the uterus, bladder, rectum, and/or small intestine can become pushed downwards, and then protrude into the vaginal canal, increasing incontinence. |
| Ageing | As we age, our bladder muscles can grow weaker, and this decreases the bladder’s ability to store large amounts of urine. |
| Menopause | When women go through the menopause, they produce lower amounts of oestrogen. This hormone helps to keep the bladder and urethra in good condition, and so its depletion can cause incontinence. |
| Enlarged prostate | When men get older, their prostate can become enlarged. This can then lead to an incontinence condition known as benign prostatic hyperplasia. |
| Obstruction | If you have a tumour or urinary stones in your urinary tract, they can block your urethra and cause overflow incontinence. |
| Neurological disorders | There are many neurological disorders that can interfere with the nerve signals that help to control the bladder, including a spinal injury, Multiple Sclerosis, Parkinson’s disease, a stroke, or a brain tumour. |
| Obesity | If you carry extra weight, it is placing pressure on your bladder muscles. This causes them to become weak, and you will leak urine when you cough, laugh or sneeze. |
| Smoking | Tobacco use can directly lead to incontinence, as it stimulates the bladder. |
How to Manage/Treat Urinary Incontinence?
Remember – the first thing you need to do in order to manage or treat urinary incontinence is to book an appointment with your GP. If you are suffering with urinary incontinence, it is always a good idea to have some incontinence products on hand.
The next step is to have a look at the list below to see if you can avoid the issue in the first place. This can include maintaining a healthy weight, quitting smoking, avoiding alcohol and caffeine, and staying well hydrated.
| Bladder Training | Another great strategy is to try bladder training. This involves taking scheduled bathroom breaks at specific times, starting with short intervals, no matter if you need to go to the toilet or not. The prompt of the toilet will likely stimulate your bladder, and you will urinate. Over time, you should start to prolong the time between the bathroom trips. Over time, you can increase the time between bathroom breaks to 3-4 hours, and overnight. |
| Pelvic Floor Exercises | Pelvic floor exercises, can help both men and women to strengthen their bladder muscles. Locate your bladder muscles (the ones you use to halt the flow of urine) and tense them for 3 seconds, followed by relaxing them for 3 seconds. Work your way up to doing 3 sets of 10 repetitions. The best part? You can do pelvic floor exercises at any time of day – at work, in bed, or while driving. You should see results within approximately six weeks. |
| Maintain a urination diary | Keep a diary of everything you eat and drink (including alcoholic units), as well as every time you urinate, for at least one week. This way you will have a record of any potential triggers or patterns, and you can share this data with your GP. |
How to Avoid Urinary Incontinence?
While you may not be able to fully prevent urinary incontinence, you can prevent many of the conditions that can lead to the problem.
Some of the most simple things you can do include:
- Maintain a healthy weight
- Engage in preventative pelvic floor exercises
- Limit your consumption of caffeine, alcohol and acidic foods (such as citrus)
- Increase the amount of fibre in your diet to prevent constipation
- Quit smoking, or don’t start in the first place
- Practice double voiding when you finish urinating, pause for a few minutes and then try again. This will reduce or prevent ‘dribbling’ between voiding.
- Stay well hydrated. Whilst this may seem counter-intuitive, staying hydrated ensures your urine doesn’t become too concentrated, which can irritate your bladder.
Summary
Urinary incontinence is a common problem that affects both men and women of all ages. If you are dealing with this issue, seek advice from your GP as soon as possible.
HARTMANN has worked with the Self Care Forum to produce a fact sheet on urinary incontinence which you can download from the fact sheets page.
