Urinary incontinence: what it is, symptoms and treatment

Urinary incontinence is the inability to control the bladder, i.e. you cannot always hold your urine. It can affect anyone, but usually occurs after the age of 50. Women experience it twice as often as men.

Urinary incontinence ranges from occasional urine leakage due to sneezing or coughing to having a sudden urge to urinate so strong that you can’t reach the toilet. There are several types of urinary incontinence:

Stress incontinence: urine leaks when there is pressure on the bladder, when laughing, coughing, sneezing, exercising or lifting heavy objects.
Urge incontinence: before urine leakage, you feel a sudden and very intense need to urinate.
Mixed urinary incontinence: associated with sneezing, physical exertion or coughing, but also with an urgent need to go to the toilet.
Overflow incontinence: frequent dribbling of urine occurs because the bladder does not empty completely.
Functional incontinence: occurs when you have a physical or mental disability, such as severe arthritis.
Continuous or total urinary incontinence: there is a constant loss of urine.

Prognosis of the disease

Urinary incontinence usually occurs as people age, but surgery, exercises or drugs allow them to continue their daily activities and improve their quality of life.

What are the symptoms?

Symptoms can range from mild urine leakage to heavy, uncontrollable urine leakage. There may also be a sudden urge to urinate urgently.

It usually occurs after the age of 50.

Medical tests for urinary incontinence

To diagnose urinary incontinence, a medical history and physical examination are performed. In addition, the patient must answer questionnaires for the doctor to assess the symptoms, as well as perform a urinalysis in order to rule out a urinary tract infection and a record or voiding diary to keep a record.

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In order to better understand the causes, a urodynamic study, residual urine measurement and pelvic floor ultrasound can be performed.

Causes of urinary incontinence or why it occurs

Most control problems occur because the muscles that maintain the bladder are too weak or too active. If they are weakened, small amounts of urine are lost when performing actions such as laughing or coughing, which is known as stress incontinence. Conversely, if they are too active, they may have an urgent need to go to the bathroom, even if they have little urine in their bladder (urge incontinence or overactive bladder). Other causes may be problems with the prostate, if it is enlarged, and neurological lesions.

On the other hand, incontinence can be caused by diseases such as arthritis or damage to the nerves that control the bladder due to multiple sclerosis or Parkinson’s disease.

Can it be prevented?

Urinary incontinence is a problem that can be prevented or, if not prevented, at least delayed. Practicing Kegel exercises to strengthen the pelvic muscles, avoiding obesity, reducing the intake of sugary drinks after mid-afternoon and not pushing when urinating are actions that can help prevent this pathology. In addition, it is advisable to reduce the consumption of substances that stimulate the bladder in excess, such as caffeine, alcohol and certain medications such as diuretics.

What is the treatment?

Treatment of urinary incontinence depends on the cause and type, but broadly speaking it usually includes simple exercises aimed at strengthening the pelvic floor muscles, medications and special devices such as a catheter. Surgery may also sometimes be helpful in order to keep the bladder in its usual position.

It is also important to make lifestyle changes such as drinking the recommended amount of fluids, exercising, maintaining a healthy weight, not smoking and avoiding constipation.

Which specialist treats it?

The specialist in charge of treating urinary incontinence is the urologist.

Index

What is urinary incontinence?