While urinary incontinence isn’t life-threatening, it can be a huge interference in normal, everyday life. It also induces stress, anxiety and frustration.
For some women, the condition may result in their having to wear sanitary napkins all day, every day, which may have a direct impact on many aspects of their lives and activities, such as exercising or socializing.
Urinary incontinence is a problem that generally affects women more than men. This is due to the anatomy and physiology of a woman’s urinary system, as well as the differences in reproductive hormones. Understanding the causes, treatment and management practices of the condition can help women—especially elderly women—to have a better quality of life.
Urinary incontinence occurs because the connective tissues and pelvic muscles supporting the urethra and bladder are weakened or become flaccid. Alternately, the condition may also come about due to deterioration of the urethral sphincter. These issues may be the result of a variety of factors including childbirth, obesity, abdominal tumors and chronic coughing. Certain foods and beverages can also irritate the bladder, such as certain citrus fruits, carbonated drinks or caffeinated drinks like tea and coffee, as they stimulate the bladder and opening of the urethra, allowing urine to leak out.
Additionally, as you get older, women produce less estrogen, resulting in deterioration and dryness of the vaginal lining, which can be a risk factor, and can aggravate incontinence as well.
In men, urinary incontinence may stem from enlargement of the prostate gland, an overactive bladder (OAB) or urinary tract problems. It may also be a side effect from surgery or radiation, which can cause weakening in the muscles of the sphincter.
If the symptoms of urinary incontinence increase, you should consult a doctor as soon as possible. Your doctor will start with a thorough history and health examination. An internal examination or other more specialized types of testing may also be carried out, depending on your symptoms. From there, your doctor will recommend your treatment.
Introduction to Behavioral Techniques and Self-Management
Pelvic Floor Muscle Exercises (Kegel Exercises): These are exercises that can be used to help strengthen the muscles that help control urination—the pelvic floor muscles. Between 60-80% of patients who practice these exercises properly for a reasonable length of time—usually after about 3 months—see improvement in their condition and symptoms.
There are a number of ways these may be carried out. For example, contract the muscles you would use to stop yourself from urinating, and hold this contraction for 6-8 seconds. Do this 20 times in a row for a total of 3 sets per day. Another method is to do quick muscle pulses, whereby you contract your pelvic muscle quickly and hard. Do this about 10-20 times per set. Frequent contraction of the pelvic muscles will help to strengthen and improve control of bladder movements.
Kegel exercises can be done on your own at almost any time. They are known to be both simple and effective. If they are stopped, however, there is a high chance of recurrence, so be sure to continue with them once you start.
Behavioral Changes: These include weight loss, treatment of chronic coughing and sneezing, and constipation treatment.
Avoid Caffeinated Beverages: Try not to drink tea, coffee, cocoa or carbonated drinks as caffeine is a known diuretic. You should also avoid drinking too much water or liquids. Drink about 1-1.5 liters of water per day, and space this out so that you drink it gradually throughout the day rather than in bulk amounts at different times.
Of course, no matter what, weight control, proper family and childbirth planning, and being consistent with your pelvic floor muscle exercises after giving birth are some of the most effective steps you can take to prevent urinary incontinence, especially when you cough or sneeze. Not only that, these preventative measures also provide great long term benefits for all women.
The Second Class Honors, M.D.,Faculty of Medicine, Chulalongkorn Unersity, 2003.