Urinary incontinence is a common condition, which causes people to urinate without meaning to; it is thought to affect more than 3 million people and the UK and usually gets more common with age. Urinary incontinence affects women much more often than men; around 1 in 5 women over 40 are affected by urinary incontinence.
What causes incontinence?
Incontinence is caused by a disruption in the signals sent from the bladder to the brain when the bladder is full; usually, when the bladder is full, a signal is sent to the brain so that the person feels the need to urinate; the pelvic floor muscles then start to relax and the bladder contracts so that urine can be passed. There are two main types of urinary incontinence; these are stress incontinence and urge incontinence; these two types account for 90 percent of cases of incontinence.
- Stress incontinence: stress incontinence may be caused by several different factors which may cause an individual to have weakened pelvic floor muscles; as a result, the urethra cannot close completely and urine may seep out if the slightest bit of pressure is applied to the bladder. Common causes of stress incontinence include:
- Pregnancy
- Menopause
- Age (older people are more likely to suffer from incontinence)
- Obesity
- Hysterectomy
- Urge incontinence: urge incontinence occurs when the bladder contracts too early, which can cause people to urinate before they have made it to the toilet. The reason for this is not known but many experts think there may confusion between the signals sent to and from the brain. In many cases, no cause can be identified but some common causes may include:
- Urine infections, including cystitis
- Prostate problems in men
- Conditions that affect the nervous system, including Parkinson’s disease and strokes
Symptoms of incontinence
Incontinence causes a lack of control of the bladder, which results in urine being passed without the individual meaning to urinate. Stress incontinence is the most common form of incontinence, especially amongst women that are pregnant, going through the menopause or over the age of 50. Triggers for stress incontinence include sneezing, coughing, laughing and exercising. Symptoms of urge incontinence include:
- Sudden need to urinate
- Sudden urination
- Passing urine frequently
- Passing urine during sexual intercourse
- Disturbed sleep (due to going to the toilet often)
- Urge to pass urine generated by triggers such as running water or quickly changing position
Treatment for incontinence
If you have any of the symptoms listed above, you should see your doctor; you will probably be asked to do a urine sample and then the doctor will be able to identify the condition and suggest a suitable treatment. Many mild cases can be improved by making simple changes to your lifestyle; these include:
- Cutting down on caffeine
- Losing weight (if you’re overweight)
- Drinking less in the evenings (if you are having trouble sleeping because of the need to urinate frequently)
- Increasing or decreasing the amount you drink (depending on how much you currently drink- your doctor will advise you about how much you should be drinking)
Many women are also advised to practice exercises to strengthen their pelvic floor muscles, especially after they have had children. If these changes do not ease the condition, medication or surgery may be recommended; surgery can be used to enlarge the bladder slightly, insert an implant into the bladder to allow greater control (this is known as sacral nerve stimulation), support the urethra and control the flow of urination (by means of an artificial sphincter). Some patients may also be advised to undergo bladder training, which involves learning techniques to stop the need for frequent urination.