Urinary incontinence is the unconscious and involuntary discharge of urine. It simply means that an individual urinates when they do not intend to.

While you may see this problem as a rare condition, it is widespread, even in the United States. According to the American Urological Association research, about 25% to 33% of men and women in the United States experience urinary incontinence at least once in their lifetime. Going further into this research, the AUA observed that this condition is more common in women than men.

In today’s society, even toddlers are now ashamed when they pee in places where they aren’t supposed to. So when this happens to mature men and women, there is a problem.

Generally, the human bladder is responsible for holding urine, which is done by contracting the urethral sphincter. The urethra sphincter keeps the urethra closed, preventing urine from escaping the bladder. Contracting the sphincter muscles is how we hold pee.

When we feel like peeing but aren’t in the right place to do it, all we have to do is tighten the urethral sphincter. This method is how humans hold pee even when they have to. The importance of this essential but straightforward mechanism has helped so many people worldwide from unexpected urination.

The loss of bladder control is often embarrassing, and while this condition could be caused by various factors, old age and infection remain their leading causes. Even with aging being a significant cause of urinary infection, it is essential to know that only a few experience it as they age.

Types of Urinary Incontinence

Different types of urinary incontinence are listed below:

Urge Incontinence

Urge incontinence happens only when you urge to pee or just after peeing. When you have the sudden urge to urinate, the bladder can contract when it shouldn’t, and this could lead to the leakage of urine through the muscle keeping the bladder closed.

Urge incontinence is prevalent and can affect anyone. Unlike what the general scope of urinary incontinence entails, urge incontinence is not a disease. Instead, it is more a medical issue or a lifestyle option symptom.

Causes of Urge Incontinence

• Neurological conditions like Parkinson’s disease, stroke, and multiple sclerosis
• Cystitis
• Enlarged prostate

Stress Incontinence

Stress incontinence refers to the inability of an individual to control their urge to urinate under certain circumstances. In this condition, a tiny amount of pressure placed on the bladder could lead to the involuntary discharge of urine.

The name “stress” is often mistaken for emotional stress exerted on an individual. However, this is not the case. Stress implies the physical pressure exerted on the bladder, either internally or externally. For instance, the involuntary release of urine while jumping or coughing. When the sphincter muscles become weak, they can still hold pee, but when slight pressure is applied, they expand quickly and, in turn, lead to the discharge of pee.

Stress incontinence happens especially during physical activities like exercising, including jumping and heavy lifting. Any exercise that applies pressure to the pelvic muscles also applies pressure to the sphincter muscles. For an individual with stress incontinence, the sphincter muscles won’t be able to maintain their contracted state, which allows for the passage of urine.

Causes of Stress Incontinence

• Menopause; declining estrogen levels could make pelvic and sphincter muscles weaker
• Pregnancy and childbirth
• Hysterectomy
• Age
• obesity

Overflow Incontinence

Also known as chronic urinary retention, this condition happens when you cannot empty your bladder, and this causes frequent leaking. What makes overflow incontinence different is that it is more common in men than in women.

As a result of your bladder not emptying, small amounts of urine left begin to leak because now, the bladder quickly becomes full. People with overflow incontinence tend to urinate more often than usual. Benign prostate hyperplasia is the reason overflow incontinence is more common in men. In this case, the prostate is enlarged, and much pressure is exerted on the urethra. With this, it becomes difficult to urinate.

Generally, overflow incontinence is one of the leading causes of urinary tract infections. When urine in the bladder cannot empty, it stays there for an extended period and can turn into a breeding haven for many bacteria.

Besides being a condition of its own, overflow incontinence can be a symptom of diseases like bladder stones and tumors, diabetes, multiple sclerosis, brain injury, and severe prolapse. It could also be caused by previous pelvic surgery and certain medications.

Causes of Overflow Incontinence

• A tumor exerting pressure on the bladder
• Urinary stones
• Constipation
• Urinary stones
• Enlarged prostate gland

Total Incontinence

In this case, the bladder doesn’t store any urine at all. It makes you pass urine constantly or visit the bathroom frequently. During total incontinence, you are bound to experience leaking.

Total incontinence is usually caused by a problem with your bladder from birth. Other causes include spinal injury capable of disrupting the nerve signals between the brain and the bladder, and a bladder fistula, which is an opening between the vagina and the urinary bladder.

Causes of Total Incontinence

• Urinary tract infections
• Alcohol and drunkenness
• Medicines like antihypertensive drugs, sedatives, sleeping pills, muscle relaxants, and diuretics.
• Presence of a fistula
• Anatomical defect from birth
• Spinal injury impairing the nerve signals between the brain and the bladder

Functional Incontinence

Unlike other types of urinary incontinence, functional incontinence is not a problem related to the bladder or the urinary tract. Instead, it is a problem associated with a different disability.

Also known as disability-associated urinary incontinence, functional incontinence happens when a person cannot access the toilet, recognize the need to visit the bathroom, locate the toilet, or manage their personal needs, like removing clothing before peeing.

Functional incontinence is caused by an intellectual, physical, or environmental issue that makes it difficult for an individual to use the toilet. More specifically, a person with arthritis or cerebral palsy who finds walking difficult can pass out urine because they can’t get to the toilet. Also, an individual with dementia or intellectual disability who has problems with memory or learning can pass our urine because they don’t know what is happening.

Causes of Functional Incontinence

As stated earlier, functional incontinence is caused by intellectual, physical, and environmental issues.

Effects of Aging on Urinary Incontinence

As you age, your muscles become weak and gradually wear out. The sphincter muscles aren’t exempted from this process, leading to its ineffectiveness and increasing your incontinence risk.

As a remedy, it is advised that people in the late stages of their lives embrace the concept of exercise and physical activities. Exercising helps you maintain strong bones, muscles, and a healthy bladder. Even with old age being a significant risk factor for urinary incontinence, it is essential to know that only many aged people experience this condition.

Effects of Obesity on Urinary Incontinence

Studies have shown that obesity has a link to urinary incontinence. Firstly, obesity is associated with several health conditions like hypertension, heart disease, liver disease, depression, diabetes, arthritis, gallbladder disease, and cancer.

In the United States, obesity is a direct cause of more than 300,000 deaths per annum, and up to $100 billion is spent yearly on health expenditures caused by obesity.

Earlier, we discussed how obesity could trigger stress incontinence. Excess abdominal fat is one of the primary factors associated with obesity and is an essential factor influencing urinary incontinence. The abdominal fat puts pressure on the bladder, damaging the pelvic floor and other urethral structures. All of these make leakage more likely.

According to research, it is estimated that between 40% and 60% of obese women in the United States experience urinary incontinence at least once in their lifetime.

Effects of Diabetes on Urinary Incontinence

Can diabetes cause incontinence? Yes. Diabetes causes more frequent and urgent urination. Diabetes can directly cause urinary incontinence because increased blood sugar levels lead to frequent urination caused by increased thirst. The increase in appetite is caused by an increase in glucose levels which can cause the pulling of fluid from the tissues, leading to increased hunger and the need to drink.

Diabetes is also capable of causing urinary tract infections, a leading cause of incontinence. The link diabetes has with urinary incontinence spans a wide area. Diabetes can cause damage to the nervous system, which may affect the nerves controlling the bladder and the pelvic floor.

Diabetic drugs also cause fluid retention and cough, a known factor that triggers stress urinary incontinence.

Menopause and Urinary Incontinence

Estrogen, the hormone responsible for regulating monthly periods and developing other secondary sexual characteristics, goes through a decline when a woman gets to menopause. The repercussion of this decline is the occurrence of several symptoms jointly regarded as menopausal symptoms.

These hormone level fluctuations result in pressure and stress on the muscles that help you hold pee. The changes in hormones also weaken your muscle strength in the pelvic region, so urinary incontinence is more common in pregnant women and women already in menopause.

Diagnosis of Urinary Incontinence

Before going for any treatment, you must know the incontinence you’re dealing with. Your symptoms will often determine it, guiding you through your treatment options.

A urologist is a doctor who specializes in diseases of the urinary system. A typical diagnostic test involves your urologist running a thorough history and physical exam. You might be asked to do a simple demonstration to check for stress incontinence. From coughing to jumping to laughing, these demonstrations will help the urologist understand your situation better and recommend the best treatment option. After this, some other tests might be carried out.

Treatment of Urinary Incontinence

Incontinence is an embarrassing problem and needs urgent treatment, as issues concerning the bladder shouldn’t be taken lightly. The treatment option chosen depends solely on the type of incontinence, its cause, and its severity.

If an underlying condition causes your urinary incontinence, your doctor will first have to treat that condition before attempting to treat the incontinence.

Natural Remedies for Treating Urinary Incontinence

Before taking any herbal supplements, ensure you check with your doctor first. Taking herbal supplements with medications can mess up your system and cause unintended side effects.

Some of these herbs include:

Ganoderma lucidum (GL)

This traditional Asian medicine is one of the most well-known herbs used today for curing ailments like hypertension, cancer, and hepatitis. This mushroom growth is limited to Europe and several parts of China. Although inedible, Ganoderma lucidum can be made into a tea with a bitter taste.

For men with lower urinary tract symptoms, taking 6 milligrams of GL extract is recommended.

Gosha-jinki-gan

Since time immemorial, traditional Chinese medicines have proven to treat several illnesses existing today effectively. Another example of a Chinese herb is the Gosha-jinki-gan (GJG). This herb is a mixture of 10 traditional herbs blended to give optimal results regarding the inhibition of the bladder and the improvement of daytime frequency.

According to research, people who took up to 7.5 milligrams of GLG daily reported improved urinary incontinence results.

Hachimi-jo-gan

It is made up of up to eight natural herbs. Some of the herbs in this herbal blend are also in GLG. Research has shown that HE has a positive effect on bladder muscle contraction.

Capsaicin

Capsaicin is found naturally in all chili peppers. If your diet includes hot pepper or any form of hot sauce, it contains capsaicin. Capsaicin has a wide array of uses, from increasing metabolism to increasing the rate of energy usage and fat burn. Capsaicin is also used to lower appetite. You can eat and drink less, especially during frequent urination.

Studies have shown that the bladder’s maximum capacity increases by up to 200 milliliters when capsaicin is taken.

It is essential to know that capsaicin is not found on the seeds of chili peppers; it is only on the flesh.

Corn Silk (Zea mays)

Ever seen that yellowish thread-like strands gotten from the corn? That’s corn silk. Besides being an excellent herb for alleviating kidney diseases, stroke, and heart failure, it also treats urinary tract infections.

Corn silk is a traditional treatment option for bladder irritation and bedwetting ailments. It is also believed to help strengthen the mucous membrane of the urinary tract. This treatment, in turn, helps prevent incontinence. All of these have been proven by the International Continence Society.

Medications for Urinary Incontinence

Medications used for the treatment of urinary incontinence include:

Hormone Replacement Therapy

Abbreviated as HRT, this treatment option is used to treat problems caused by fluctuations in hormonal levels. Earlier in this article, we briefed how fluctuating hormone levels directly cause symptoms experienced during menopause and pregnancy. What hormone replacement therapy does is that it helps the body balance hormones that have become deficient in creating a hormonal balance.

For pregnant and menopausal women, fluctuations in hormone levels could cause the pelvic and urethra muscles to weaken, which can lead to incontinence. With HRT, changes in hormones like estrogen and progestin are alleviated, and a balanced system of hormones is formed.

Mirabegron

Mirabegron is a medication sold under the brand name Myrbetriq and used to treat overactive bladder that often causes overflow incontinence and urge incontinence. Mirabegron works by relaxing the bladder and urethra muscle and, at the same time, increasing the maximum amount of urine the bladder can hold.

Topical Estrogen

Topical estrogen is a gel used to treat several diseases, including strengthening the pelvic and urethra muscles. Topical estrogen is applied to the vaginal and will help you tone and restore tissues in the vaginal and urethra areas.

Anticholinergics

Anticholinergics are medications capable of calming an overactive bladder. These medications may also be helpful in the treatment of urge incontinence. Some examples include trospium chloride, solifenacin (Vesicare), oxybutynin (Ditropan XL), darifenacin (Enablex), tolterodine (Toviaz), and fesoterodine (Toviaz).

Alpha-Blockers

Men with overflow incontinence or urge incontinence use alpha-blockers to help relax their bladder muscles and muscle fibers in the prostate region. Alpha-blockers make it easier to empty the bladder. Some common examples of alpha-blockers include silodosin (Rapaflo), tamsulosin (Flomax), doxazosin (Cardura), and alfuzosin (Uroxatral).

Exercises for Urinary Incontinence

Before opting for medications, it is usually advised to try out exercises and physical activities to help alleviate incontinence. The type of exercise used for urinary incontinence is known as Kegel exercises.

Kegel exercises are used to toughen and strengthen the pelvic floor muscles. Remember that the pelvic floor muscles support the bladder, uterus, small intestine, and rectum. Also known as pelvic floor muscle training, Kegel exercises can rejuvenate the pelvic floor muscles and prevent incontinence.

Besides helping prevent incontinence, Kegel exercises are also used to help prevent the accidental passing of gas and poop. It can also help you improve your orgasm. Now, doesn’t that sound right?

How to Find the Pelvic Floor Muscles

The pelvic floor muscles run from your pubic bone in front of you to the end of the spine at your back.

To find these muscles, you can start by stopping the urine flow while urinating (this should only be done while sitting on the toilet). Be careful so it doesn’t lead to other health problems.

As an alternative, you can insert a finger into your vagina while attempting to squeeze the muscles around it. While doing this, you should feel pressure around your finger. The muscles you feel inside the vagina are the same as the pelvic floor muscles.

How to Do Kegel Exercises

Kegel exercises are practiced by toughening and relaxing the pelvic floor muscles. Below is a typical Kegel exercise technique.

1. Before engaging in your Kegels, ensure that your bladder is empty. After this, sit or lie down.
2. Tighten your pelvic floor muscles, then hold tight for 3 to 5 seconds.
3. Relax your pelvic floor muscles for 3 to 5 seconds.
4. Do this procedure repeatedly ten times. Do this three times a day, i.e., morning, afternoon, and night.

This technique is the most accessible Kegel exercise, known as the squeeze and release.

While doing these exercises, ensure you breathe deeply and place your body in a very comfortable position. As you go further, the stomach, thigh, buttock, and chest muscles aren’t tightened.

Do this procedure for 4 to 6 weeks, and feel better. We mean experiencing fewer symptoms than you were before beginning your Kegel exercises by feeling better.

For Kegel exercises, you mustn’t increase their frequency per day or week. Overworking the pelvic floor muscles can stress the muscles, increasing the likelihood of incontinence.

Examples of Kegel Exercises

Examples of kegel exercises are listed below.

Squats

Although not originally a Kegel exercise, squats also help to strengthen the pelvic floor muscles. To perform a squat, follow the following instructions:

• Stand on both feet, having them wide apart and keeping them flat.
• Bend until your buttocks almost touch the floor. Keep on going low until you feel you can’t go any further.
• While doing this, keep your back straight simultaneously, tilting it slightly forward. At this point, the knees should be relatively straightforward to the toes.
• While doing this, try focusing on tightening the pelvic floor as you return to a standing position.
• Do this ten consecutive times, then take a quick rest before performing any other sets.

Bridge

This exercise strengthens the buttocks but can also help toughen the pelvic floor. To perform the bridge, follow the following instructions:

• On the floor, rest on your back and bend your knees. In this position, your feet should be flat on the floor. Ensure your arms are placed at the sides with your palms facing downwards.
• While in this position, contract your buttocks and pelvic floor muscles. As you tighten, lift the buttocks several inches from the ground.
• Remain in this position for at least 3 seconds and, at most, 8 seconds.
• After this, relax the buttocks and muscles of the pelvic floor as you lower your buttocks back to the ground.
• Repeat this process up to 10 times
• Take a quick rest and perform more sets, preferably two.

Weight Lifting

By weight lifting, we mean lifting weights with the legs. To do this exercise, ensure you use only lightweights. Follow the instructions to engage in this exercise

• Sit on a chair with your buttocks at the edge of the chair.
• Place light weights on your feet.
• Gently lift your legs with the weight still on your feet
• While doing this, contract your pelvic floor muscles
• Repeat this process ten times.

Gentle Jumps

This exercise is similar to squatting, and what makes it different is that instead of squatting on the spot, you take gentle jumps before going back down.

The steps are listed below:

• Stand on both feet, having them wide apart and keeping them flat.
• Bend until your buttocks almost touch the floor. Keep on going low until you feel you can’t go any further.
• While doing this, keep your back straight simultaneously, tilting it slightly forward. At this point, the knees should be relatively straightforward to the toes.
• As you go back up, jump gently and come back down.
• Repeat this process five times

Troubleshooting

Some people find it quite difficult to isolate their pelvic floor muscles to do the Kegel exercise. There are specialized physical therapists for you to remedy this problem; these therapists work using different feedback devices.

One standard device used by these therapists is the biofeedback device. To use this device, the physical therapist places the electrodes (which are sticky) on specific regions of your body. While doing this, the person is routinely asked to attempt contracting their pelvic floor muscles. As the patient attempts this, the electrodes send signals to a computer. The therapist reads the instructions on the computer’s screen, telling when the person contracts or relaxes the right muscles.

In other situations, a person might be unable to contract the pelvic floor muscles due to a nerve cell condition. In the case of nerve damage, a specialized physical therapist can offer to perform pelvic stimulation therapy. In pelvic stimulation therapy, one can assist another person in contracting the right muscles.

Exercises to Avoid

Some exercises may be too tough to practice for persons with a fragile pelvic floor. When this person performs this exercise, there is a high tendency to weaken the muscles, which may worsen the incontinence.

• Until the pelvic floor of that person has become tough enough from engaging in exercises like the ones listed above, such person is advised to avoid these exercises:
• Lifting heavy weight with the legs
• Double leg lifts
• Sustaining the legs straight while engaging in situps
• Avoid high-impact activities like running and jumping.

Essential Tips to Remember while Practicing Kegel Exercises

Do not do these exercises while in the course of urinating. If you stop urinating midstream to test for the contracting power of your pelvic floor muscle, it could cause incomplete emptying of the bladder. This situation can make you more susceptible to urinary tract infections and other disorders related to the urinary tract.

Effects of Incontinence on Mental Health and Lifestyle

We can’t talk of embarrassing conditions without mentioning urinary incontinence. Data indicates that people with urinary incontinence experience high depression and low self-esteem compared to those without the disease.

In the United States, more people, up to 45% of men and women, are being diagnosed with incontinence, causing lifestyle changes for these people.

People with incontinence looking for ways to improve it have to try out lifestyle changes and behavior therapies like:

Focus on Fluids and Food

The amount of fluid you drink directly influences the frequency of your urination. Take in smaller amounts of liquid. You can reduce fluid intake from 16 ounces daily to 8 ounces and only between meals. Drink more of your fluids during the day and less at night. It will prevent you from bedwetting. It is also essential that you stop using alcohol and caffeinated beverages. These foods are capable of increasing urine production.

Bladder Training

Due to the frequent urge to urinate, you must make lifestyle changes to how you pee. Your bladder can send signals to your brain during incontinence even when it isn’t complete.

You can engage in bladder training, like visiting the toilet on a set schedule, even when the urge to urinate isn’t coming. As you do this, try increasing the time frame between each urination. This way, you train your bladder to frill more fully before sending any signal to your brain.

Maintain a Healthy Weight

Obese people are more prone to urinary incontinence; if an obese person already has continence, losing weight is an excellent idea. Eat your vegetables and do subtle physical exercises.

FAQs on Urinary Incontinence

Is urinary incontinence normal?

No, urinary incontinence is not normal. If you find it difficult to pee or hold, you should see a doctor immediately.

Is bedwetting a form of urinary incontinence?

Yes, bedwetting is a form of urinary incontinence. However, kids still wet on the bed might need more time to develop their sphincter muscles and train their mindset. For adults, it could be caused by an underlying problem and, as such, should see the doctor.

Is incontinence a sign of old age?

It depends on the person. Not all older adults experience urinary incontinence; at the same time, old age can cause it. According to research carried out in the United States, it is reported that up to 60% of older adults experience incontinence.

When to Speak to a Doctor

Most times, urinary incontinence arises from an underlying illness. The underlying illness simply means that you should see a doctor immediately if you start getting problems with urinating.

Conclusion

Urinary incontinence is a significant issue affecting so many people worldwide. In today’s society, little or no sensitization is given to incontinence, so many people today are unaware that a problem like this exists. We ought to be more aware of issues that affect our bodies to know how to prevent them, how to live with them, and what to do when they come.

In this article, we spoke about how women are the most affected by urinary incontinence. While it is primarily caused by menopause, it is essential to know that menopause comes with more symptoms than just incontinence. Managing these symptoms is crucial to continue living life just like we’ve always been. With the innovations available in the health sector, getting inquiries about your health has never been easier.

In the words of Mahatma Gandhi, “it is health that is true wealth and not fancy pieces of gold and silver.”