Urine leakage is a symptom that patients cannot control their bladder, causing them to urinate involuntarily. Patients may feel pain when urinating so much that they cannot hold it in, or it may occur while coughing or sneezing. This symptom occurs more often in women than in men. Some patients may have only temporary symptoms, while some may have long-term effects. The symptoms will depend on the disease or health problem that is the cause. The doctor will provide treatment according to that cause.
Urinary incontinence
Symptoms of urinary incontinence are divided into several types as follows:
Urine leakage due to pressure . Pressure in the bladder causes urine to leak. This can be caused by coughing, sneezing, laughing, exercising, lifting heavy objects, other body movements , or conditions that cause physical changes such as pregnancy, childbirth, and menopause. Patients usually only have a small amount of urine leakage. However, if the bladder is full at that time, a large amount of urine can leak out.
Urine leakage due to overflow or chronic urinary incontinence occurs when a patient is unable to completely empty the bladder due to weak bladder muscles or a possible blockage of the urethra , which may be caused by an enlarged prostate, bladder stones, or constipation, causing more urine than normal to remain. The patient may only be able to urinate in small drops and feel that they are unable to completely empty the bladder.
Incontinence is the sudden and unbearable urge to urinate. Some people may urinate frequently, even at night. Certain factors can trigger the urge to urinate, such as hearing the sound of running water or suddenly changing positions. Incontinence can also occur during sex or when reaching orgasm. The most common cause is overactive bladder, or infection, neurological disorders, and diabetes .
Urinary incontinence is caused by mental or physical disorders that cause the patient to be unable to reach the bathroom in time, such as patients with severe arthritis who may leak urine because of illness, making it difficult to remove their pants.
Urine leakage from multiple causes. Patients may experience more than one of the above types of urine leakage at the same time, such as urine leakage when coughing or sneezing along with chronic inability to urinate, or a sudden urge to urinate and being unable to hold it in.
Causes of Urinary Incontinence
Urinary incontinence can be caused by lifestyle, illness, or certain changes in the body, such as:
Diet and medication
- Eating certain foods or beverages, such as alcohol, soft drinks, artificial sweeteners, chocolate, pepper, citrus fruits, foods with high levels of spices, sugar, or acid, etc.
- Use of certain medications, such as antidepressants, antihypertensive drugs, muscle relaxants, diuretics,hormone replacement therapy, etc.
Body changes
- Pregnancy: Due to changes in the mother’s hormones and the increasing weight of the fetus, urine leakage may occur during this time.
- Giving birth because the muscles that control the bladder may become weak, causing the pelvic floor muscles to sag. This also causes the bladder, uterus, colon, and small intestine to move and protrude into the vagina, which may cause the patient to have urinary incontinence.
- After a hysterectomy, the pelvic floor muscles can be damaged, which can affect the bladder.
- Being elderly or in Increasing age can cause the bladder muscles to change and hold less urine. In women who are in menopause, the body produces less estrogen, which helps strengthen the lining of the bladder and urethra. Therefore, when there is less production of this hormone, the tissue deteriorates and results in urine leakage.
Various illnesses
- Urinary tract infection, which can cause irritation of the bladder and cause painful urination or
- Have bladder problems such as chronic urinary incontinence due to tumors, perforated bladder, bladder stones, etc.
- Constipation: Because the rectum is close to the bladder and shares many nerves, when feces accumulate, it can stimulate the nerves in that area, which can also affect the bladder.
- There are problems with the prostate gland, such as enlarged prostate, prostate cancer, etc., or it may be a side effect of prostate cancer treatment.
- Neurological diseases such as multiple sclerosis,Parkinson’s disease, stroke, brain tumors, or spinal cord injuries, etc., as these diseases can affect nerve signaling related to bladder control.
Diagnosis of urinary incontinence
The doctor will ask about the patient’s symptoms, take a medical history, and perform a physical examination to initially assess the type of urinary incontinence. Further diagnoses may be made as follows:
Keep a urine record . Have the patient record continuously for several days to track the amount of water they drink each day and the amount of urine they excrete, as well as to see if they experience any unusual urges to urinate or if they have urinary incontinence.
Urine test: The doctor will collect a sample of the patient’s urine and culture it to check for bacterial infection, urinary tract stones, or other abnormalities. A urine test strip may also be used to check for blood and protein levels in the urine.
Check the amount of urine remaining in the bladder. If it is suspected that a patient is unable to hold urine due to overflow, the doctor may check the amount of urine remaining in the bladder after urination. This may be done by using an ultrasound to create an image of the bladder or by inserting a catheter into the urethra to measure urine volume.
Urinary tract examination involves inserting a catheter into the urethra to measure pressure in the bladder or abdomen. The doctor then has the patient urinate into a device that measures urine volume and flow.
Induction testing , the doctor will have the patient cough forcefully while the doctor examines the urethra and the amount of urine that flows out.
A urinary tract examination involves inserting a small tube with a camera into the urethra, which allows the doctor to view the bladder and urethra to identify any abnormalities in the patient.
Treatment of urinary incontinence
The doctor will consider treatment based on the symptoms, severity of the illness, and the underlying disease. Treatment may require a combination of methods. The methods that the doctor may use are as follows:
Advising patients to change their behavior
- Exercises to train the pelvic floor muscles can be performed. Patients may consult a physical therapist about an exercise plan or may practice contracting the muscles for 5 seconds and then relaxing for 5 seconds. Do this continuously for 10 repetitions, which is counted as one set. It is recommended to do 3 sets per day. Regular exercise in this way will strengthen the muscles and help control urination.
- Eat healthy foods and avoid caffeinated beverages. Also, the amount of beverages the patient drinks each day should be adjusted according to the doctor’s advice. Drinking too much or too little can make the symptoms worse.
- Practice urination, such as practicing slow urination by holding urine for about 10 minutes and then urinating when you feel the urge. Try to urinate again to help empty the bladder and reduce the occurrence of overflow, or hurry to the bathroom before the urge to urinate becomes too much to hold, etc.
- Take care of your health by always keeping your weight within the appropriate range.
Drug use
Doctors may recommend that patients take certain medications to help relax the muscles in the bladder, contract less, making it easier to urinate, or to help them hold their urine for longer, such as:
- Anticholinergic drugs
- Yamirabegron
- Alpha blockers
- Duloxetine
- Antimuscarinic drugs
- Desmopressin
- Hormone replacement therapy
Surgery
- Sling is inserted under the urethra to help keep the urethra closed to prevent urine leakage when the patient coughs or sneezes.
- Surgery to treat pelvic floor prolapse is often used in women who have urinary incontinence and pelvic floor prolapse. Doctors may also use this method in conjunction with surgery to place a sling under the urethra.
- Sphincter implantation is a surgical procedure for male patients in which the surgeon places a fluid loop around the neck of the bladder to keep the urethral sphincter closed at all times. When the patient needs to urinate, he or she presses a button under the skin to flatten the loop so that urine can flow out.
- A catheter is inserted through the abdomen through a surgical incision in the abdomen to drain urine.
Alternative treatment
- Electrical stimulation: A doctor inserts electrical electrodes into the vagina or colon to stimulate the pelvic floor muscles and strengthen them.
- Use of medical devices such as Urethral Insert, which is similar to a tampon and is inserted into the urethra to prevent urine from flowing. The patient must always remove the device before urinating.
- Botoxis injected into the bladder muscle to help reduce overactive bladder. This method is used in patients who have not received any treatment results from other methods.
Complications of urinary incontinence
Complications can occur in people with chronic urinary incontinence or incontinence. They may develop urinary tract infections or skin problems such as rashes, skin infections, and wounds from moisture in the intimate area. In addition, it may affect daily life, causing the patient to feel embarrassed when they leak urine, and it may affect work, relationships with others, and social life.
Preventing urinary incontinence
Although it is not possible to completely prevent urinary incontinence, you may be able to reduce your risk by:
- Exercise and strengthen your pelvic floor muscles, especially for those who are pregnant or have recently given birth.
- Weight control: Since obese or overweight patients are at risk of urinary incontinence, they should exercise and eat a healthy diet to keep their weight within a suitable range.
- Avoid alcoholic beverages and caffeinated beverages such as tea, coffee or soft drinks, and stop smoking, as these factors can cause the kidneys to produce more urine and may irritate the bladder.
