Urinary Incontinence

Urinary incontinence is the unintentional loss of urine. It can be Stress incontinence when the bladder can’t handle the increased compression during exercise, coughing. It can also be Urge incontinence if caused by a sudden, involuntary bladder contraction. Overflow incontinence in which the bladder becomes too full because it can’t be fully emptied, is a rarer type of the disorder.

What are causes of UI?

Women are most likely to develop incontinence either during pregnancy and childbirth, or after the hormonal changes of menopause, because of weakened pelvic muscles. Pelvic trauma, spinal cord damage, caffeine, or medications, including cold preparations and diet drugs that are available over-the-counter, can also cause episodes of UI. Diseases which affect the nerves that control the bladder, such as multiple sclerosis, can be associated with UI.

Other factors that contribute to bladder incontinence include decreased mobility or impaired thinking (such as forgetfulness, confusion, or senility), particularly in combination with drugs such as sedatives, sleeping pills, and alcohol.

What treatments are recommended for UI?

Treatment for UI depends on the type of incontinence, its causes, and the capabilities of the patient. Here are commonly recommended treatments:

  • Pelvic muscle rehabilitation – to improve pelvic muscle tone and prevent leakage by :
    • Regular pelvic Kegel exercises.
    • Biofeedback in conjugation with Kegel exercises help people in awareness and control of their pelvic muscles.
  • Pelvic floor electrical stimulation. Mild electrical pulses stimulate muscle contractions. Should be done in conjunction with Kegel exercises.
  • Behavioral therapies – to help people regain control of their bladder.
    • Bladder training teaches people to resist the urge to void
    • Toileting assistance uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.
  • Pharmacologic therapies – to improve incontinence medically.
  • Surgical therapies – to treat specific anatomical problems.
    • Sling procedures, bulking injections (such as collagen) and other surgical procedures support or move the bladder to improve continence.