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Urinary incontinence: Treatment, causes, types, and symptoms

08.03.19

Have you or anyone around you found that you accidentally leaked pee over yourself? It can commonly occur when you are scared or very drunk and is an embarrassing situation. Now imagine if you had to suffer from this all the time.

Not being able to control when you urine is a problem that one-quarter to one-third of women and men experience. This condition is known as urinary incontinence and can be socially and physically debilitating for many.

Let’s explore what the condition is in this article.

What is urinary incontinence?

The temporary or chronic loss of bladder control that leads to the leakage of urine is known as urinary incontinence. Its intensity varies from person to person.

Some people may pee a little when they laugh, cough or sneeze. Some others may experience an intense, unstoppable desire to pee, and they cannot reach a toilet in time.

We don’t know how many people truly suffer from it, as it is an embarrassing subject and people often refrain from reporting it.

Although it is a medical problem, its effects are wider. It can affect emotional, psychological and social activities and stop people from enjoying their lives.

It is, undeniably, a part of getting older. But it can still be avoided, managed better or treated.

Is urinary incontinence the same for everyone?

No, it isn’t. There are different types of urinary incontinence, and these are caused by different factors. Some people leak small amounts of urine and some leak large amounts more frequently.

Some types of urinary incontinence include:

1. Stress incontinence

  • Here, stress indicates physical stress, not mental
  • Urine leaks when there is pressure on the bladder
  • Can occur when the patient coughs, laughs, sneezes, exercises or lifts heavy objects

The factors that contribute to it include

  • Pregnancy and childbirth
  • Low estrogen levels due to menopause or hormonal disorders
  • Hysterectomy
  • Age
  • Obesity

2. Urge incontinence

  • There is a sudden urge to urinate, which is followed by leaking urines
  • Patients need to urinate frequently, and this can occur at night and hinder sleep
  • Can occur from a minor infection or severe underlying conditions like diabetes
  • Some patients who have inflamed bladders experience this condition
  • Some unexpected causes include a sudden change in position, orgasming during sex and the sound of running water

3. Overflow incontinence

  • There is a feeling that the bladder isn’t completely empty
  • Patients constantly experience urine dribbling out

This can occur if

  • The prostate is enlarged
  • A tumor presses against the bladder
  • There are urinary stones
  • Constipation occurs

4. Functional incontinence

  • Physical or mental impairments don’t allow the patient to get to the toilet in time
  • People with arthritis might not be able to unbutton pants fast enough
  • People with mental or physical disabilities might find it difficult to get to a toilet

5. Mixed incontinence

  • More than one of the above types manifest together

Do we know what raises the risk of incontinence?

Most of the causes of incontinence have been identified. But these causes are inextricably linked to some risk factors. Knowing these can help in keeping the condition at bay.

These risk factors include:

1. Obesity
The bladder experiences higher pressure when a person is obese, its muscles weaken and make leakage more likely.

2. Smoking
Although not directly linked, smoking can cause chronic cough, which can lead to stress incontinence.

3. Gender
Women, especially if they have recently had children or are menopausal, have a higher chance of experiencing stress incontinence.

4. Age
The older you get, the weaker your muscles become, making incontinence and loss of bladder control more likely.

Is urinary incontinence associated with other complications?

Other than the discomfort that urinary incontinence causes, it is a tricky condition because it also leads to some other complications. Firstly, it can lead to people excluding themselves from social situations due to the embarrassment. This can cause serious mental health issues including depression.

It can cause skin rashes and sores, which can be compounded by infections. Such a condition is a result of the dampness of the skin, slowing the process of healing and promoting fungal growth.

If a patient then begins using a urinary catheter, they expose themselves to the risks of contracting urinary tract infections. This is caused by the festering of bacteria near the urinary ducts.

Women can also experience prolapse, in which the vagina, bladder and urethra descend into the entrance of the vagina. It occurs if the pelvic floor muscles are weakened.

How is incontinence diagnosed?

Frequently urinating on yourself or not being able to reach a toilet in time indicates urinary incontinence. However, this is a symptom, and doctors must conduct tests to determine if this truly is the case.

Some ways to diagnose urinary incontinence include:

1. Maintaining a record of events related to urination: How much and how often you drink water and how much and how often you pee, and how often you pee on yourself. This helps a physician identify the type and cause of your problem.

2. Physical exams: Doctors sometimes examine the genitals of their patients to determine the strength of the pelvic muscles. Sometimes, the prostate gland is examined to see if it has swollen.

3. Urine tests: These show if there is any infection or abnormality.

4. Kidney functioning is tested through blood analysis.

5. Post-voidal residual measurements help assess how much urine is retained in the bladder after urination.

6. Pelvic ultrasounds: detect abnormalities through an imaging system.

7. Stress tests apply pressure on the patient’s body while the doctor checks for urine leakage.

8. Other tests include urodynamic testing, cystograms and cystoscopy.

What are the conventional treatments for urinary incontinence?

Generally, to manage urinary incontinence, people use devices and products that temporarily store urine. They can help people of all ages, regardless of their gender.

For some people, they are an inevitable way of living their lives. They can give people more physical and social freedom, and are particularly useful to older and disabled people.

A. Less intensive treatments include:

Behavioral training :This includes bladder training, double voiding and regulating toilet trips. This helps you regain muscle strength and control and may help in managing incontinence.

Pelvic floor exercises: Kegel exercises are not only for sexual function, but they also help strengthen the pelvic muscles. They are done by contracting and relaxing the pelvic muscles alternately. The intervals between the contractions are gradually increased.

Electrical stimulation: In this treatment, electrodes are inserted in the rectum and the pelvic muscles are stimulated. This can help but there are several treatments needed.

B. Some devices are:

Indwelling catheters:

Catheters are flexible tubes that are placed in the bladder and stay in day and night. Indwelling catheters remain in all the time and help collect urine in a collecting bag.

There are two basic types; the Foley catheters are placed in the urethra, while the suprapubic catheters are inserted through a small cut in the belly. Once inserted by a health professional, they are held in place by a balloon.

They then drain the urine into a bag outside the body. Foley catheters can be used only for 2 years at the most, and run the risk of contracting urinary infections.

Suprapubic catheters can be used longer, and since they are not open to the outside, they don’t lead to infections as frequently.

However, in both cases, the catheters must be replaced every month.

1. External collecting systems

Some of these are available for men and look like condoms. These can be rolled over the penis and then kept in place with adhesives or straps. The condoms have holes that drain the urine from the urethra to a drainage bag.

The benefits are that they are available in many sizes, and are made of silicone, which can reduce allergies. However, the problem is that it requires some amount of hand and finger control, which can make self-application difficult.

For women, there are collection devices that funnel the urine to a collecting device. They are applied to the labia, and for this reason, are not popular. The labia don’t form a good waterproof seal and the urine leaks out.

2. Urine drainage bags

These are more of an accessory that is used along with catheters and collecting systems. They come in various sizes and can be used for differing durations. The larger bags hold more urine, can be used overnight, but cannot be hidden. Smaller bags allow more freedom of movement and are inconspicuous and are easily concealed.

The bags can be cleaned and deodorized simply, by soaking them in cleaning solutions or a mixture of vinegar and water (2:3).

3. Catheters

Intermittent catheters can be used by men and women who have considerable control over their motor organs. This requires the insertion of catheters in the bladder a set number of times each day regularly to drain urine. After use, the catheters can be thrown away and don’t need to be worn. This reduces the chance of infection.

Catheters can be also subsidized through Medicaid-like programs and insurance companies. The length and design of the catheters differ, making them convenient and easy to use.

4. Absorbent products

Adult diapers and pads are very convenient products if you are suffering from incontinence. Some have adhesives that can attach to underwear while others are designed to be used similarly to underwear.

They are designed to absorb and hold urine, and in this, they differ from menstrual pads. Their surface is closest to the urethra, making absorption efficient. This reduces the chances of rashes and infection but depends on the materials.
5. Toilet substitutes

Say you didn’t want to have to rely on any of the other treatments, there is still an option for you. If you can still tell when you need to pee, you can opt for portable toilets. These can include commode seats and bedside commodes. These can be conveniently placed near you and used during the night.

It is important to consider the make and material of these commodes. Their height and weight can affect their accessibility in terms of physical ability as well as cost. Their comfort levels also change with the model.

Are there no other alternatives available?

If you don’t want to opt for any of the above treatments, fortunately for you, there is a great treatment. At The Derm Lab, we offer one of the latest treatments for urinary incontinence.

This is EMSELLA treatment, an FDA and TGA cleared treatment that has been determined to be safe and effective by several government bodies.

The principle of the functioning of the EMSELLA chair is based on magnetism.

The EMSELLA Chair is an FDA and TGA cleared medical device which works on the principle of using electromagnetic waves for the treatment of urinary incontinence. These electromagnetic waves are targeted at the pelvis to rectify the root cause of the urinary incontinence.

The average rate of contractions is 11,000 in 28 minutes. These are extremely mild and pose no inconvenience or discomfort whatsoever. The constant exposure to these electromagnetic waves effectively strengthens your pelvic floor muscles which restore its lost control.

In due course of time, you can hold and release your urine like before and take control. This, in turn, sets your issue of urinary incontinence right. There won’t be any more urgency of urinating or dribbling urine down your pants since you failed to keep it in.

This treatment using electromagnetic waves is more effective than any other medications, superficial treatments, or invasive surgeries. In fact, using the EMSELLA Chair has absolutely no side effects and can be used by anyone regardless of their age, sex, health conditions, and any physical disorders. *subject to consultation*

There are many reasons for getting the treatment, which include:

  • It is medically approved.
  • It is safe and effective.
  • It is painless and non-invasive.
  • It treats the entire pelvic floor.
  • There is no recovery period.
  • It is comfortable and convenient.
  • You can remain fully clothed during the treatment.
  • There are no side-effects.
  • The treatments last only 28 minutes.

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