What Causes Urinary Incontinence

smiling female doctor

What is Urinary Incontinence?

Urinary incontinence is involuntary bladder leakage of any kind and an overall loss of bladder control, which can make everyday life uncomfortable. Urinary incontinence is not a disease or illness but rather an indicator of other underlying bodily and health problems that are occurring in the body. There can be many factors that need to be taken into account while treating this issue, and it is a condition that is more common that you may know.

What Causes it?

The causes of urinary incontinence can vary and depend on multiple aspects. Firstly, temporary incontinence can occur due to consumption of certain foods and drinks. Alcohol, caffeine (i.e. coffee or tea), high sugar content, smoking, and some medications such as muscle relaxers can all cause irritations in the bladder. Diabetes, stroke, Multiple Sclerosis, and Parkinson’s disease can also be major causes, as well as surgery, menopause, and obesity. Essentially, anything that is interfering with the urinary system working correctly can cause urine to leak and loss of bladder control.

Urinary incontinence is a problem that is more associated with women, but men can experience this issue as well. In women, stress incontinence is usually experienced the most. Stress incontinence is experienced when any movement such as sneezing, laughing, coughing, bending, lifting, or physical activity such as running puts pressure on the bladder and causes urine to leak. This type of urinary incontinence can happen to women who have been pregnant and gone through childbirth, cystocele and pelvic organ prolapse, and menopause. Urge incontinence, also called overactive bladder, is another type of urinary incontinence women can sometimes experience, where the overwhelming urge to urinate is felt very suddenly and cannot be ignored or stopped.

It is a reasonable question to ask why incontinence affects women more than men and why factors such as pregnancy or menopause play a part. After pregnancy and childbirth, either by vaginal or c-section delivery, the pelvic floor muscles that support the bladder, urethra, uterus (womb), and bowels may become weaker or damaged. When the muscles that support the urinary tract are weak, those muscles in the urinary tract must work harder to hold urine until you are ready to go to the bathroom. This extra stress or pressure on the bladder and urethra can cause urinary incontinence or leakage. As previously mentioned, women experiencing menopause are at risk of developing urinary incontinence as well. This may be due to the drop in the estrogen hormone.

In men, the most common type of incontinence men experience is overflow incontinence, which happens when the bladder is full. It is rare in women and more common in men who have problems with the prostate. Constant dribbling and feeling the need to go to the bathroom are often common symptoms. Men with prostate gland problems are at an increased risk of urge incontinence as well. The most common cause of incontinence in men is prostate surgery. Other medical conditions that men may have that cause urinary leaking are prostate cancer and enlargement of the prostate gland. For both women and men, injury to the nervous system, birth defects, and physiological problems associated with aging can cause incontinence. In some instances, some people both leak urine with activity (stress urinary incontinence) and also feel the urge to urinate often (overflow urinary incontinence), a condition known as mixed incontinence. Medical conditions that are easily treatable such as urinary tract infections and constipation can also trigger some kinds of incontinence.

How is Urinary Incontinence Diagnosed?

Diagnosis can include your doctor giving you a physical examination and inquiring about past medical history. If your doctor thinks you are experiencing stress incontinence, for example, you may be asked to cough with a full bladder to see if any urine leaks; this is simply known as a stress test. Some questions about past medical histories may include how often you empty your bladder, how much urine is leaked, and what kind of medications you take. Doctors may diagnose the type of urinary incontinence you are experiencing based on your medical history and the physical exam. They may also use this information to decide if more testing is needed for you. Other kinds of tests are urinalysis and urodynamic tests. Urinalysis is when your urine sample is sent by your doctor or nurse to the lab and tested to find the source of any infections or complications. Urodynamic tests include several painless tests that will assist your doctor in understanding how your urinary system is functioning, including a test that lets your doctor to measure the pressure in your bladder, in order to see what level of fluid your bladder can hold. An ultrasound may also be needed to take pictures of the kidneys, bladder, and urethra to see if there is anything causing complications.

In some cases, your doctor may find that what is causing the leakage can be corrected easily. Impacted stool, restricted mobility, and certain medications you may be taking are other causes that are simple to fix. Pads or diapers can prevent embarrassing leaks, but other treatment options may be a better fit for your condition and experience.

What Are Treatment Options?

Regardless of what kind of incontinence you have and its level of severity, you should talk to your doctor and work together to create a unique treatment plan that will be effective in treating you specifically. Starting out with treatment may be as easy as taking steps from home, such as losing weight or changing your diet. Watching what you drink in a day is also a key part of treatment. Drinking six to eight glasses of water per day may be recommended to you, which can help reduce bladder irritation. Staying away from and/ or limiting drinks such as fruit juices and coffee may be required. Some form of bladder training may prove to be effective as well; keeping track of how often you urinate and when you have leakage are the first steps. Getting a more regular routine down with less visits to the bathroom should gradually make leaking less of a problem. For men and women especially who have minor medical conditions or irritations, strengthening the pelvic floor muscles can be effective in treatment for some cases. Exercising the pelvic floor can be done by doing kegel exercises regularly; this exercise should be done about three times a day, and it can be beneficial for some.

Other treatments may be recommended if these steps do not improve your condition, depending on what your doctor thinks will be the best for your health. More intensive treatments include: medication, medical devices such as a urethral insert or a pessary, interventional therapies such as botox and nerve stimulators, or surgeries, which is not recommended for women who plan on becoming pregnant in the future. Other options such as absorbent pads are very effective when experiencing leaks and are often not bulky or uncomfortable.

If you are experiencing incontinence due to your bladder not emptying properly, you may need to learn to use a catheter. Catheters are soft tubes that are inserted into the urethra until it reaches the bladder and drains the urine. Catheters and other supplies can be bought at medical supply stores, and you will get a prescription for the right catheter for you. There are many different types and sizes. Some catheters are meant to be used only once, and others can be reused if cleaned appropriately. Most insurance companies will pay for you to use a sterile catheter for each use. If you are reusing your catheter, you must clean it every day. There are also catheters called “indwelling” catheters that can be kept in day and night if it is suitable for your conditions. Catheters as a method of treatment for incontinence can be used for any type of urinary incontinence, and it may be the best course of action for you if other treatments are not effective. Talking to your doctor about which specific catheters and available treatments for incontinence are right for you is highly recommended.