What is Urinary Incontinence?

Incontinence is a urological medical condition that affects many throughout the world. It is the loss of voluntary control over urination for any number of reasons. This lack of bladder control can result in embarrassment and feelings of shame among those suffering from it, and severely affects the quality of their life. Urinary incontinence can occur at any age, in both men and women, and can be caused due to a number of factors.

Urinary Incontinence can be divided into two types which include:

Urge Incontinence – Loss of bladder control is preceded by an intense sudden urge to urinate.
Stress Urinary Incontinence (SUI) – This type of incontinence is due to physical stress putting pressure on the bladder, resulting in urine leakage.

Urge Incontinence

This type of incontinence is often associated with an overactive bladder. Each time that you felt a strong urge to go the bathroom, even when you feel like your bladder wasn’t full yet, were incidences of urge incontinence. This type of incontinence is common amongst both women and men. The symptoms include feeling an all-encompassing urgency to go to the bathroom immediately, and with unintended urination before you can reach the bathroom. While the loss of urine does not occur in more mild cases, the increased frequency of urination and the constant urgency association with this condition can still cause disruptions in both work and social lives because of having to keep returning to the bathroom.
woman having urge incontinence

Stress Urinary Incontinence

This type of incontinence is one of the most common variations of involuntary loss of bladder control. In Stress urinary incontinence (SUI), any type of physical activity or exertion can lead to urine leakage. This is due to the increased abdominal pressure that happens during such activities such as jumping, coughing or even laughing, which in turn exposes bladder to increased pressure as well. This ‘stress’ caused by these physical activities leads to urinary leakage. There is no warning before the leakage of urine happens.
Depending on the situation and individual, urine might leak out in small amounts or empty the bladder completely. In SUI, the leakage of urine happens without the contraction of bladder muscles and there is no discernible urge to urinate that the individual can anticipate.
SUI takes place when the urethral sphincter or pelvic floor muscles or both cannot reliably hold urine in the bladder. This might be due to structural damage or weakness leading to these issues. Women who deliver children vaginally (natural birth method) are more prone to develop SUI because giving birth can potentially damage nerves and pelvic floor muscles.
The risk of developing SUI is further dependent on the age of the mother, number of births, the length of labor and the size of the baby. SUI can be divided into two main variants.
1. Urethral Hypermobility – As abdominal pressure rises, bladder and urethra move downwards, increases chances of urine leakage due to lack of urethral support.
2. Intrinsic Sphincter Deficiency – Issues with the urinary sphincter itself leads to unwarranted urine leakage. This is seen in women who give birth to a large number of children vaginally or experience complicated long labors during child birth.
incontinence after pregnancy, woman playing with her kids

Statistics and Background Information About Stress Urinary Incontinence

Stress Urinary Incontinence is a very common condition among women, which is often under-reported due to the associated shame and sense of embarrassment. Nearly one out of every three women have stress incontinence, but less than half of them ever discuss their symptoms with their physician or seek help. They go through their lives struggling to deal with the significant negative impact that SUI has on the quality of their lives.
Women who play sports such as running, jumping and a lot of physical strain report some leakage of urine at least half the time when they are participating in these activities.
Stress incontinence can occur at any age, but increasing age is a significant factor in the development of SUI.
women jogging precaution against stress urinary incontinence
Certain other risk factors that increase the possibility of developing stress incontinence include:

• Age-related changes, which includes weakened ligaments and muscles. With weakened pelvic floor muscles, a lesser pressure is needed for the urethral sphincter to open, making it prone to leakage.

• A large number of vaginal deliveries, especially with long labors and the delivery of a large baby.

• Obesity causes additional abdominal pressure on organs, thus increasing the chances of developing SUI.

• Pelvic surgery done previously also makes it more likely for the woman to experience SUI.

• Chronic coughing, especially in conjunction with smoking.

• Injuries to nerves in the lower back.

Quality of Life and Dealing With Stress Urinary Incontinence

Stress urinary incontinence is a chronic medical condition that can severely affect the quality of life for women who have it. It has a direct negative impact on the lives of these women, as they have to deal with the inevitable leakage of urine every waking hour. Their lives become limited to deciding which activities they can do and to calculate how far the restrooms are from them at any given moment, whether at work, home, on a family day outing or simply running errands.
SUI makes women extremely conscious of their bodies. They learn the hard way to be extra mindful when they cough, sneeze, laugh, exercise, run or even bend over because they can’t be sure of what movement or action will result in unintended leakage of urine. This uncertainty of impending leakage of urine and the constant running to the bathroom throughout the day is not only a nuisance physically by causing exertion but also results in mental anguish and exhaustion.
woman with active lifestyle wearing dark color pants
Dealing with SUI means that women have to come up with various coping mechanisms to ensure that they are able to limit the influence of SUI on their daily lives and activities as much as possible. Women do this by having to wear darker color pants, so an accident if it happens, is less visible and reduces embarrassment.
They tend to give up activities they once enjoyed such as exercising, playing with kids, doing yoga, running, jumping and any other number of daily activities. Another way women counter the urgency to urinate and prevent accidental leakage is by making frequent timed visits to the restroom to empty the bladder, whether there was an urgency or not.
Dealing with SUI means that women have to come up with various coping mechanisms to ensure that they are able to limit the influence of SUI on their daily lives and activities as much as possible. Women do this by having to wear darker color pants, so an accident if it happens, is less visible and reduces embarrassment.
The issue with all of these attempts to reduce the impact of SUI is that they don’t actually solve the issue or reduce the occurrence of the related urinary accidents. These tips and tricks are simply an effort to limit SUI from disturbing their daily lives. Even if these tips help them retain a sense of normalcy, they are highly draining, both physically and mentally.
SUI is a medical condition that literally holds the sufferer hostage, as if they are chained to a restroom every day, only able to do a certain number of things on any given day. The problem is very embarrassing to women, resulting in feelings of self-shame, low self-esteem and depression, due to an issue they have no control over. They have to avoid doing what they enjoy and also abstain from exercising which can lead to other health problems.
treatment for women with urinary incontinence
In the beginning, women dealing with SUI will have to deal with wet pants, when they least expect it, as there is literally no warning before the involuntary leakage of urine happens.
SUI can affect the daily lifestyle of any woman, whether single or married, working or otherwise. It can lead to problems when dating, due to the heightened sense of self-scrutiny and shame, and the embarrassment associated with having to tell their partner about this intimate problem.
They feel they must be extra cautious during sex. This problem can even lead them to avoid intimacy completely in order to avoid any embarrassing accidents. As a woman with children, SUI can severely debilitate a mother’s active role as a parent. It becomes difficult to actively play with the children, especially outdoor activities, due to the constant fear of leakage, and having to locate the nearest restroom.
woman with urinary incontinence resuming to daily activities
All in all, SUI is a common medical condition among women, and its psychological and physical impact on their daily lives is severely arresting. Over the years they have been a number of treatment modules that have been designed to reduce or treat SUI, but not all of them result in similar results or often have negative ramifications.
Some of these common treatments are discussed followed by the more painless, longer lasting new treatments, to give your life back to you and reduce the impact of SUI on your daily activities significantly.

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The Menopause Association is polling women to better understand the extent to which this issue affects the population. Your participation is appreciated.


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