It is common for people to be resistant or afraid to talk about the health problems they have, especially when they are related to more delicate issues, such as incontinence. Urinary incontinence, for example, is a common disease that affects men and women of different ages, but it is often not discussed due to the shame of bringing it up.
However, it is important to talk about the topic, after all, several other people can benefit from knowing more about this issue. Therefore, we have prepared this text to let you know more about urinary incontinence and answer your questions. Follow!
What is urinary incontinence?
Urinary incontinence is the involuntary loss of urine through the urethra, that is, the person cannot control his pee. The problem is more common in older women, but as we have seen, it can also affect men and women at other ages. This is because the woman has some changes in the pelvic floor, that is, in the muscles that support the organs in the region, so that they can “lose strength” more easily.
In order to better understand how incontinence happens, let’s explain the urinary control system:
- the kidneys are the organs responsible for constantly producing urine, which is stored in the bladder;
- the “exit” of the bladder is surrounded by the urinary sphincter, which remains contracted to keep the bladder closed and prevent urine from going into the urethra;
- when the bladder fills, stimuli are sent to the brain, making the person feel like urinating;
- the person makes the voluntary decision to urinate, sending the message to the sphincter to relax;
- urine flows into the urethra and out of the body, while the bladder muscles contract.
Thus, the person with urinary incontinence has some abnormality in one of the stages of the process, compromising the ability to control urination (the act of expelling urine).
Types of incontinence
There are different types of urinary incontinence, such as:
- urge incontinence: urgent and sudden urge to urinate associated with the inability to hold urine until you reach the bathroom;
- stress incontinence: loss of urine in small jets that happens when there is an increase in abdominal pressure (when the person laughs, coughs, sneezes, exercises or lifts a heavy object);
- mixed incontinence: mixture of stress incontinence with urge incontinence;
- overflow incontinence: it happens when the person loses sensation in the bladder and does not feel when it is full, so that the bladder is so full that the urine overflows;
- total incontinence: continuous leakage of urine due to failure to close the urinary sphincter.
What are the causes and risk factors?
The control of urination is done by the autonomic nervous system, which is responsible for controlling the body’s functions, such as digestion, the cardiovascular system and breathing. Some normal or abnormal conditions can alter its functioning, leading to urinary incontinence. The main causes of the problem are:
- pelvic muscle weakness in elderly women, during pregnancy and after normal delivery;
- impairment of the pelvic floor or sphincter muscles caused by other reasons, such as obesity or surgeries in the region;
- diseases that compress the bladder;
- obstruction of the urinary tract;
- functional disorders such as stroke and dementia in the elderly , which compromise the nervous control of urination;
- overactive bladder, a syndrome that is characterized by involuntary contraction of the bladder muscle;
- medicines that cause weakness of the pelvic or sphincter muscles, hypoactivity of the bladder wall muscles, or blockage of urine output.
The risk factors for developing the problem are female gender, old age, obesity, diabetes and neurological diseases.
How is the diagnosis made?
The first step in the management of urinary incontinence is the recognition of the problem and the search for medical assistance. This means that anyone, after childhood, who experiences involuntary urine loss should see a urologist . He is the professional responsible for the diagnosis and treatment of urinary problems.
First, the doctor will make an assessment of the person’s medical history, to identify the symptoms and the type of incontinence. Then, a physical examination is performed and procedures can be requested to confirm the diagnosis and exclude other more serious problems, such as:
- urine analysis;
- bladder diary (the patient notes how many times he went to the bathroom in the day, what he ate and what he drank);
- residual post-voiding measurement (checking how much urine was produced and how much remained in the bladder after the patient urinated);
- pelvic ultrasound;
- cystoscopy (examination of the inside of the bladder).
How to treat urinary incontinence?
The treatment of urinary incontinence is done according to the type of incontinence, its severity and other individual factors that are evaluated by the doctor. The good news is that many people with the problem can make a big improvement or even heal with different treatments.
In cases of mild incontinence, the treatment modalities are simpler and less likely to have side effects. Some examples are:
- diet with fluid intake control;
- bladder training to increase the interval between visits to the bathroom;
- double urination technique to completely empty the bladder (urinate, wait a few minutes, and force yourself to urinate more);
- schedule of trips to the bathroom every 2 hours, instead of waiting for the urge to appear;
- exercises to strengthen the pelvic floor;
- physiotherapy for incontinence.
For cases of moderate or more severe incontinence, treatment with electrical stimuli in the pelvic floor region, the use of medications or even surgery may be necessary . Surgery is usually indicated in cases of stress incontinence and consists of placing a support to restore the ligaments that support the urethra.
Finally, if medical or surgical treatments do not completely correct the problem, there are some options for improving patient comfort. They are:
- use of urinary catheter to empty the bladder continuously or at intervals;
- wearing special underwear for incontinence;
- use of disposable pads and diapers.
Since there is no specific prevention for urinary incontinence, it is best to invest in the control of risk factors and be attentive to the first signs of the problem. Always remember that seeing a urologist is one of the most important points for controlling incontinence and managing effective treatment.