Urinary incontinence refers to the inability to control bladder movements. While it does not affect the person’s health, it can be an embarrassing condition. The severity of this condition can range from passing small amounts of urine every time you sneeze or cough, to getting a sudden strong urge to urinate without the time to get to a toilet. Urinary incontinence is not a disease by itself but rather is a sign of another underlying condition. It may be caused as a result of childbirth, age, menopause, prostate, or a neurological disorder.
Treatment for this condition can take many forms:
- Medication: Urinary incontinence may be treated by many different types of medications depending on the underlying cause. Anticholinergics may be prescribed to calm the bladder muscles and reduce the urge to urinate frequently. Alpha blockers are typically prescribed to men to help them relax the prostate and bladder neck muscles so as to be able to pass urine freely. For women suffering from incontinence due to hormone fluctuations, topical estrogen may be helpful.
- Behavioural techniques: The patient will also be taught techniques to help control the bladder. This includes scheduling toilet visits every few hours rather than waiting for the urge to urinate. To avoid overflow incontinence, the patient may be advised to follow a double voiding process. This involves urinating, waiting for a few minutes and urinating again. Cutting back on diuretics such as alcohol, caffeine, etc can also help. In addition, regular exercise and physical activity can help ease the issue.
- Pelvic Floor Exercises: Pelvic floor exercises or Kegel exercises can help strengthen the pelvic muscles and prevent leakage. This involves contracting the pelvic muscles, holding them for a few seconds and then releasing them. Ideally, the patient should be able to hold the contraction for 10 seconds. This exercise should be performed in three sets of 10 repetitions each. It is very effective in treating stress and urge incontinence.
- Medical devices: Women suffering from severe urinary incontinence can consider the implantation of medical devices to help control the bladder. This includes a urethral insert to prevent leakage and a pessary or stiff ring to hold up the bladder muscles.
- Surgery: Surgery is usually considered only as a last resort. This could be in the form of a sling procedure, bladder neck suspension, prolapse surgery or inserting an artificial urinary sphincter. These procedures may be used to treat many different types of incontinence.
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