Incontinence

Incontinence Incontinence

What is urinary incontinence?

The meaning of incontinence is having no or insufficient voluntary control over urination or defecation. Urinary incontinence is where you involuntarily pass urine, and it is thought to be a common problem that affects millions of people*. Although many people are too embarrassed to talk about it or get the help they need. This needn’t be the case as it is such a common issue that can be solved with lifestyle changes or medication, depending on the severity of your incontinence.

Are there different types of incontinence?

There are four types of incontinence which you can experience, it is also possible that you can have a mixture of stress and urge urinary incontinence.

The four types of incontinence are:

  • Stress incontinence – when your bladder is under pressure urine can leak out, for example, when you sneeze, cough or laugh.
  • Urge incontinence – when you feel a sudden or intense urge to pass urine and some urine leaks out.
  • Overflow incontinence – also known as chronic urinary retention. This is when you are unable to empty your bladder fully as so experience frequent leaking.
  • Total incontinence – when your bladder can’t store any urine, this causes you to pass urine constantly or frequently leak.

What is the cause of incontinence?

There are certain factors that can increase your chance of developing urinary incontinence, for example if members of your family experience incontinence then you are more likely to. Incontinence is also more common as you reach middle age and is particularly common if you are aged 80 or over.

Stress incontinence occurs when your urethra (the tube where the urine leaves the body) cannot stay closed, this is due to your pelvic floor muscles or urethral sphincter being weakened or damaged.

Stress and female incontinence can be caused by:

  • Childbirth
  • Increased pressure on the stomach
  • Surgery
  • Neurological conditions
  • Certain medications

Urge incontinence, the urgent and frequent need to urinate can be caused by issues with the muscles in the walls of your bladder (detrusor muscles). These muscles relax as the bladder fills with urine and then contract when you go to the toilet to allow the urine to leave your body. Sometimes the detrusor muscles can contract too often meaning that you feel the need to urinate frequently. These contractions can be caused by:

  • Consuming too much alcohol or caffeine
  • Not drinking enough water or staying hydrated
  • Constipation
  • Urinary tract infections (UTIs)
  • Neurological conditions
  • Certain medications

Although the exact cause is not always clear, making sure that you stay well hydrated can help to keep you bladder working as it should.


Overflow incontinence can be caused by:

  • A blockage or obstruction in the bladder which stops you from completely emptying your bladder. These blockages could be an enlarged prostate gland which affects men only, bladder stones or constipation.
  • The detrusor muscles in the wall of your bladder are not fully contracting which means when you go to the toilet your bladder doesn’t empty completely.

Total incontinence can be caused by:

  • A problem with your bladder that you have had since you were born
  • Injury to your spinal cords
  • A bladder fistula or a small hole that can occur between your bladder and a close part of the body.

What are the symptoms of urinary incontinence?

Most people who have incontinence have urge or stress incontinence. Stress incontinence is not caused by stress but rather when your bladder is put under pressure. For example, when you sneeze, laugh, cough, do exercise or heavy lifting.

Urge incontinence occurs when you feel the need to urgently urinate; usually there is only a few seconds between the feeling of needing to urinate and urinating. This can be triggered by a change of position or the sound of running water. Many people with this type of female incontinence also urinate during sex, especially when they orgasm.

Are there any treatments for incontinence?

The type of treatment that you’ll be offered by your GP will depend on the type of incontinence you have and how severe your symptoms are. If your incontinence is caused by an underlying condition you may be given treatment for this alongside incontinence treatment. There are a number of lifestyle changes that you can make to help alleviate your incontinence, for example stretching your pelvic floor muscles, bladder training or losing weight if you are overweight. Making sure that you are drinking enough fluids throughout the day as well as reducing your caffeine intake may also help to reduce the symptoms of your incontinence.

Even though incontinence products such as pants and pads are not a treatment for incontinence you might find them a helpful way to manage your condition.

How do you cure incontinence?

After trying a range of lifestyle and non-medicinal solutions you might be offered medication to help control your incontinence or surgery to cure your incontinence. However with any major surgery or procedure you should talk to your specialist about your options as well as the risks and benefits. If you are a woman who would like to have children in the future this might affect which options are suitable for you. Find out more about surgical treatments here.

The NHS also run continence services where you can receive advice and treatment without the need of a referral from your GP. Find more information and your local services here.

Sources

*www.nhs.uk/conditions/urinary-incontinence

www.nhs.uk/livewell/incontinence/pages/incontinence

www.nhs.uk/chq/Pages/can-i-get-incontinence-products-on-the-nhs

www.nhs.uk/chq/Pages/1063.aspx

There are some medications that can disrupt the way that you store and pass urine, as well as increasing the amount of urine that you produce. It’s advised that you speak to your doctor about alternatives before you stop taking these medications, or whether there are other ways that you can help your incontinence.

These medicines can include; angiotensin-converting enzyme inhibitors, diuretics, some anti-depressants, hormone replacement therapy and sedatives.

It is possible for you to receive incontinence products on the NHS, but only after a full assessment has taken place and you have met certain criteria.

Women who experience female incontinence can complete daily pelvic floor exercises to help strengthen their muscles and treat their incontinence. You can feel your pelvic floor muscles if you try and stop the flow of urine when you go to the toilet, however this is not recommended. Once you have located the muscles and know how to tighten them you can sit and comfortably squeeze the muscles for 10-15 times in a row. When you are squeezing the muscles make sure that you are not holding your breath or tightening your stomach at the same time. Try holding the squeeze for a few seconds at a time and make sure to rest between each set of squeezes.