Urinary incontinence, uncontrolled urination: What's it, causes, symptoms, diagnostics, treatment, prevention

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Urinary incontinence, uncontrolled urination: What's it, causes, symptoms, diagnostics, treatment, prevention

Urinary incontinence; Loss of bladder control; Uncontrollable urination; Urination – uncontrollable; Incontinence – urinary; Overactive bladder

Urinary incontinence: symptoms, causes and treatments

Urinary incontinence (or bladder) there, when you are unable to prevent urine from leaking out of the urethra. The urethra is a tube, the way urine leaves your body from your bladder. You may occasionally urinate or be unable to hold urine.

Three main types of urinary incontinence:

Stress urinary incontinence occurs during such activities, How cough, sneezing, laughter or exercise.
Urgent urinary incontinence - occurs as a result of a strong, sudden need to urinate immediately. Then the bladder contracts, and you lose urine. You don't have enough time after, how you feel the need to urinate, to get to the bathroom, before you urinate.
Overflow incontinence - occurs, when the bladder does not empty and the volume of urine exceeds its capacity. This leads to leakage of urine.

Mixed incontinence occurs, when you have more than one type of urinary incontinence.

Bowel incontinence is when you cannot control the passage of stool. It is not covered in this article..

Causes of Urinary Incontinence

Causes of urinary incontinence include:

Blockage of the urinary system
Problems with the brain or nerves
Dementia or other mental health problems, which make it difficult to feel and respond to the urge to urinate.
Problems with the urinary system
Problems with nerves and muscles
Weakness of the pelvic or urethral muscles
Enlarged prostate
Diabetes
The use of some drugs

Urinary incontinence may be sudden and disappear after a short period of time. Or, it can last for a long time. Causes of sudden or temporary urinary incontinence include:

Bed rest - for example, when you recover from surgery
Some medications (such as diuretics, antidepressants, trankvilizatorы, some cough and cold remedies, as well as antihistamines)
Confusion
Pregnancy
Infection or inflammation of the prostate
stool Constipation due to severe constipation, which causes pressure on the bladder
Infection or inflammation of the urinary tract
Weight gain

Causes, which may be longer, include:

Alzheimer's Disease
Bladder Cancer
Bladder spasms
Large prostate in men
Nervous System Disorders, such as multiple sclerosis or stroke
Nerve or muscle damage after radiation therapy to the pelvis
Pelvic prolapse in women, in which the bladder, urethra or rectum protrudes or slides into the vagina. It can be caused by pregnancy and childbirth
Problems with the urinary tract
Spinal cord injury
sphincter weakness, round muscles, opening and closing the bladder. It can be caused by prostate surgery in men or vaginal surgery in women.

Symptoms of Urinary Incontinence

Urinary incontinence symptoms can vary, but some of the more common symptoms include:

The excretion of urine during such activities, How cough, sneezing or laughing
Sudden urge to urinate and inability to control it
Frequent urination
wake up at night, to urinate
Constant urination

If you are experiencing any of these symptoms, it is important to talk to your doctor, to determine the underlying cause and the best course of treatment.

When to contact a healthcare professional

If you are experiencing urinary incontinence, it is important to talk to your doctor. You should also seek medical attention, if you have any of the following symptoms:

Blood in the urine
Pain or burning during urination
Fever
Abdominal pain
Backache

If you are experiencing any of these symptoms, this may indicate a more serious condition, requiring emergency medical attention.

Questions, that your doctor may ask

When you visit your doctor for urinary incontinence, he may ask you a series of questions, to help determine the underlying cause of your symptoms. Some of the questions, which they can ask, include:

When did you first experience urinary incontinence??
How often do you leak urine?
What activities or situations cause you to leak urine?
Do you have any other symptoms, such as pain or burning during urination?
Are you taking any medication?
Do you have any comorbidities?
Have you recently had surgery or childbirth?
Do you smoke?
You use caffeine or alcohol?
Do you have a family history of urinary incontinence?

To determine the underlying cause and develop a treatment plan, you can effectively manage your symptoms and improve your quality of life. Lifestyle changes and home remedies can also help manage symptoms and reduce the risk of urinary incontinence.. Be sure to talk to your healthcare provider before starting any new treatment or exercise regimen.. Taking an active approach to bladder health, you can reduce your risk of urinary incontinence and lead a healthy and active lifestyle.

Diagnosis of urinary incontinence

Your health care provider may perform several tests to diagnose urinary incontinence., including:

Urinalysis for infection or other abnormalities.
Emptying diary to record the frequency of urination and the amount of urine produced.
Measurement of residual urine after urination, to determine, how much urine remains in the bladder after urination.
Urodynamic study, allowing to evaluate, how well the bladder and urethra function.
Imaging studies, such as ultrasound or MRI, to assess the structure of the urinary tract.

Based on the results of these tests, your healthcare provider can determine the underlying cause of your urinary incontinence and develop an effective treatment plan..

The treatment of urinary incontinence

Bladder training and pelvic floor exercises. Bladder retraining helps you better control it. Kegel exercises help strengthen your pelvic floor muscles. Your doctor can show you, how to do it. Many women don't do these exercises correctly., even if they think, what makes them right. Often people benefit from formal bladder strengthening and retraining from a pelvic floor specialist..

Medicines. Depending on the type of urinary incontinence, your healthcare provider may prescribe one or more medications for you.. These medicines help prevent bladder muscle spasms., relax the bladder and improve its function. A doctor can help you find out, how to take these medications and manage their side effects.

Operation. If other treatments don't work or you have severe urinary incontinence, the doctor may recommend surgery. The type of operation depends on:

type of incontinence you have (for example urges, stress or overflow of the bladder)
The severity of symptoms
Causes (eg, pelvic prolapse, prostate enlargement, uterine enlargement or other causes)

If you have a full bladder or cannot empty your bladder completely, you may need a catheter . You can use a catheter, that stays for a long time, or that, which you have been taught to put in and take out by yourself.

Bladder stimulation. Urge incontinence and frequent urination can sometimes be treated with electrical nerve stimulation. Pulses of electricity are used to reprogram bladder reflexes. In one method, a doctor injects a stimulant through the skin near a nerve in the leg.. This is done weekly in the doctor's office. Another method uses a battery-powered implanted device, similar to a pacemaker, which is placed under the skin in the lower back.

Injection of botox. Urge incontinence can sometimes be treated with an injection of onabotulinum toxin A (also known as botox). The injection relaxes the muscles of the bladder and increases the capacity of the bladder. The injection is given through a thin tube with a camera at the end. (cystoscope). In most cases, the procedure can be done in the doctor's office..

Treatment of urinary incontinence at home

There are also several lifestyle changes and home remedies., that can help manage urinary incontinence, including lifestyle changes. These changes may help improve urinary incontinence.. Maybe, you will have to make these changes along with other treatments.

Monitor stool regularity, to avoid constipation. Try increasing the amount of fiber in your diet.
Quit smoking, to relieve cough and bladder irritation. Smoking also increases the risk of bladder cancer.
Avoid alcohol and caffeinated drinks, like coffee, which can stimulate the bladder.
lose weight, if needed.
Avoid foods and drinks, which can irritate the bladder. These include spicy food, carbonated drinks, citrus fruits and juices.
If you have diabetes, keep your blood sugar under control.

If you leak urine, wear absorbent pads or underwear. There are many well thought out, that no one will notice.

Despite, that these home treatments can be helpful, it is important to talk to your doctor, before starting any new exercise or diet.

Prevention of urinary incontinence

Although urinary incontinence is not always preventable, there are several steps, you can take, to reduce the risk, including:

Maintaining a healthy weight
Smoking cessation
Regular pelvic floor exercises, especially after pregnancy and childbirth.
Drinking water and other liquids, to keep your bladder healthy.
To avoid constipation, stick to your diet, rich in fiber, and stay active.
Treating chronic cough or sneezing by treating underlying conditions, such as asthma or allergies.

Taking these steps, you can reduce your risk of urinary incontinence or manage your symptoms, if you already have this condition.

Used sources and literature

Heesakkers JPFA, Blok B. Electrical stimulation and neuromodulation in storage and emptying failure. In: Party AW, Dmochowski RR, Kavousi LR , Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 122.

Lentz GM, Miller JL. Lower urinary tract function and disorders: physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Gershenson DM, Lentz GM, Crazy FOUR, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 21.

Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Party AW, Dmochowski RR, Kavousi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.

Resnick NM. Incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 23.

Reynolds WS, Dmochowski R, Karram MM, Mahdy A. Surgical management of refractory overactive bladder and detrusor compliance abnormalities. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 90.

Vladimir Andreevich Didenko