Incontinent or incontinence refer to lack of self-control which results in natural discharges of urine or feces. Incontinent condition is far more prevalent in women than men with a significant progress in incidence with the increase of age.
Incontinent Definition – Let Us Define Incontinence More Formally
Incontinence is a medical condition due to which a person is unable to control the bladder or bowels and tends to urinate or defecate involuntarily.
Fecal incontinence is the involuntary or accidental bowel excretion of gas, liquid stool elements or solid feces. Urinary incontinence is the involuntary leakage of urine and stool. Urinary incontinent strike woman twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference.
- You need not be embarrassed by incontinent.
- Urinary Incontinent is an extremely common complaint in every part of the world.
- All types of incontinence are treatable.
- Incontinent is treatable at all ages.
Urinary Incontinent Symptoms
Symptoms that people with urinary incontinent experience include :
- Leaking urine when they cough, sneeze, exercise, rise from sitting or lift
- A strong urge to urinate whether or not the bladder is full, often with pelvic pressure
- Excretion before reaching the toilet
- More frequently going to the toilet during the day and night
- Dribbling urine after leaving the toilet
- Bladder spasms
- Loss of bladder control
- Feeling that the bladder has not completely emptied
- Pain when passing urine
- A burning sensation when passing urine.
- Bed-wetting or leaking while sleeping
Types Of Incontinence
The various types of Urinary Incontinence are as follows :-
Leakage of large amounts of urine at unexpected times, including during sleep.
Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).
Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
Overactive Bladder incontinent
Urinary frequency and urgency, with or without urge incontinence.
Unexpected leakage of small amounts of urine because of a full bladder.
Usually the occurrence of stress and urge incontinence together.
Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing) .
Causes Of Urinary Incontinence
Incontinence occurs because of problems with muscles and nerves that help to hold or release urine.
The body stores urine (water and wastes removed by the kidneys) in the bladder, a balloon like organ. The bladder connects to the urethra, the tube through which urine leaves the body. During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body.
Incontinent will occur if the bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. Urine may escape with less pressure than usual if the muscles are damaged, causing a change in the position of the bladder. Obesity, which is associated with increased abdominal pressure, can worsen incontinent. Fortunately, weight loss can reduce its severity.
Urinary incontinent can be due to multiple causes :-
Urinary Tract Infection
Loss of bladder control may be caused by an infection of the urinary tract. Infections of the bladder (cystitis) are common in women. These infections are treated with antibiotics.
Loss of bladder control may be a side effect of medications, such as diuretics
Polyps, bladder stones, or less commonly, bladder cancer, can cause urinary incontinence. Abnormal growths often cause urge incontinence and may be associated with blood in the urine. If you see blood in your urine, or if you are unsure about the source of any bleeding, it is important to alert your health care provider right away.
Pelvic Support Problems
The pelvic organs are held in place by supportive tissues and muscles. These supporting tissues may become torn or stretched, or they may weaken because of aging. If the tissues that support the urethra, bladder, uterus , or rectum become weak, these organs may drop down, causing urine leakage or making it hard to pass urine.
Urinary Tract Abnormalities
A fistula is an abnormal opening from the urinary tract into another part of the body, such as the vagina. It can allow urine to leak out through the vagina.
These disorders can interfere with the transmission of signals from the brain and spinal cord
to the bladder and urethra.
How Is Incontinent Diagnosed ?
You may be asked to keep a voiding diary for a few days in which you record the time and amount of urine leakage. You also should note how much liquid you drank and what you were doing when a leak occurred. A pelvic exam will be done to detect physical conditions that might be linked to the problem.
Your doctor may also recommend other tests:
Bladder stress test
You cough vigorously as the doctor watches for loss of urine from the urinary opening.
Urinalysis and urine culture
Laboratory technicians test your urine for evidence of infection, urinary stones, or other contributing causes.
This test uses sound waves to create an image of the kidneys, ureters, bladder, and urethra.
The doctor inserts a thin tube with a tiny camera in the urethra to see inside the urethra and bladder.
Various techniques measure pressure in the bladder and the flow of urine
Urinary Incontinence Treatment
There are many options for treatment. Often treatments are more effective when used in combination. Treatment options include lifestyle changes, bladder training, physical therapy, devices, medications, bulking agents, and surgery.
Lifestyle Changes for Urinary Incontinent
Making few lifestyle changes may help you a lot :-
- Lose weight. In overweight women, losing weight has been shown to decrease the frequency of urine leakage.
- Stop smoking
- Drink less (but sufficient) fluids and limit intake of caffeine, which is a diuretic.
- Avoid constipation. Repeated straining may damage the pelvic floor.
- Seek treatment for chronic coughing.
Bladder Training For Urinary Incontinent
The goal of bladder training is to learn how to control the urge to empty the bladder and increase the times between urinating to normal intervals (every 3–4 hours during the day and every 4–8 hours at night). After a few weeks of this training, leakage may occur less often.
There are many different forms of physiotherapy available to help with bladder problems and incontinent. These include pelvic-floor muscle exercises, biofeedback, electrical stimulation and using vaginal cones.
Pelvic-Floor Muscle Exercises can help strengthen the muscles in the pelvic floor, giving more control over
your bladder. They are very helpful for stress incontinence problems. Your continence adviser or specialist continence physiotherapist (or both) can let you know how to do these properly.
Biofeedback uses simple devices and techniques during pelvic-floor muscle exercises to help the patient to improve their pelvic muscle function through increasing muscle awareness.
Electrical Stimulation Therapy usually involves using a vaginal or rectal probe to help strengthen your pelvic floor muscles.
Electrical Vaginal Cones are small cone-like devices that are inserted into the vagina to help strengthen the pelvic floor. Patients have their own individual set (usually two to three with different weights).
Kegel Exercises For Treating Incontinent
Kegel exercises, along with bladder training are often very successful in treating stress incontinence and urge incontinence.
Kegel exercises, can help strengthen the pelvic muscles. This is how they are done :-
- Squeeze the muscles that you use to stop the flow of urine (but do not do these exercises while you are urinating).
- Hold for up to 10 seconds, then release.
- Do this 10–20 times in a row at least 3 times a day.
Be careful not to squeeze the muscles of the leg, buttock, or abdomen. Do these exercises on a regular basis. It may take
4–6 weeks to notice an improvement in urinary incontinent symptoms.
What Medications Are Used For Treatment Of Incontinent ?
If you have an overactive bladder, your doctor may prescribe a medicine to block the nerve signals that cause frequent urination and urgency.
Drugs that help control muscle spasms or unwanted bladder contractions can help prevent leaks associated with urge incontinence. These medications also can help reduce the frequency of urination. Your health care provider will help you decide which drug is most likely to work best for you. Their most common side effect is dry mouth, although larger doses may cause blurred vision, constipation, a faster heartbeat, and flushing.
In some women, the bladder can move out of its normal position, especially following child birth. Surgeons have developed different techniques for supporting the bladder back to its normal position. Surgeries such as Retropubic suspension and sling procedures are sometimes used for treating incontinent .