Urinary incontinence
DEFINITION
Urinary incontinence is the unintentional passing of
urine.
urine.
DESCRIPTION
Urinary incontinence causes a person to pass urine
unintentionally. This can range from a small dribble now and then,
to large floods of urine. Urinary incontinence is common. It is
more common in women and older people. There are different causes,
most of which are treatable.
unintentionally. This can range from a small dribble now and then,
to large floods of urine. Urinary incontinence is common. It is
more common in women and older people. There are different causes,
most of which are treatable.
The bladder is a muscular bag that collects and stores urine
and is located in the pelvis. Filtered urine from the kidneys is
held in the bladder by the pelvic floor muscles, which keep the
urinary opening (urethra) closed. A signal is sent to the brain
that triggers the need to pass urine once the bladder is full. When
we are ready to pass urine, the brain tells the pelvic floor
muscles to relax and the bladder contracts to push the urine out.
However, this process can be interrupted in several different ways,
resulting in urinary incontinence.
and is located in the pelvis. Filtered urine from the kidneys is
held in the bladder by the pelvic floor muscles, which keep the
urinary opening (urethra) closed. A signal is sent to the brain
that triggers the need to pass urine once the bladder is full. When
we are ready to pass urine, the brain tells the pelvic floor
muscles to relax and the bladder contracts to push the urine out.
However, this process can be interrupted in several different ways,
resulting in urinary incontinence.
There are various types of Urinary incontinence. The two main
types are;
types are;
Stress incontinence which occurs when the pelvic floor muscles
are too weak to prevent urination. Stress incontinence is not
related to feelings of stress, but occurs when your bladder is put
under an extra amount of sudden pressure. This type of incontinence
is common in women who have given birth or been through the
menopause. Having had a hysterectomy or being obese are also risk
factors.
are too weak to prevent urination. Stress incontinence is not
related to feelings of stress, but occurs when your bladder is put
under an extra amount of sudden pressure. This type of incontinence
is common in women who have given birth or been through the
menopause. Having had a hysterectomy or being obese are also risk
factors.
Urge incontinence which is thought to occur as a result of
incorrect signals being sent between the brain and the bladder. It
can be described as an unstable, or overactive bladder. Conditions
that affect the nervous system are also risk factors for urge
incontinence. These include Parkinson’s disease, multiple sclerosis
and stroke.
incorrect signals being sent between the brain and the bladder. It
can be described as an unstable, or overactive bladder. Conditions
that affect the nervous system are also risk factors for urge
incontinence. These include Parkinson’s disease, multiple sclerosis
and stroke.
These two types of urinary incontinence are thought to be
responsible for up to 90 percent of all cases of the condition. It
is also possible to have a mixture of both stress and urge urinary
incontinence.
responsible for up to 90 percent of all cases of the condition. It
is also possible to have a mixture of both stress and urge urinary
incontinence.
SIGNS AND SYMPTOMS
Stress incontinence – can cause leaks of small amounts of
urine during physical activities such as: coughing, sneezing,
laughing, heavy lifting and exercise. If the bladder is very full,
stress incontinence can trigger a larger amount of urine
loss.
urine during physical activities such as: coughing, sneezing,
laughing, heavy lifting and exercise. If the bladder is very full,
stress incontinence can trigger a larger amount of urine
loss.
Urge incontinence – can cause a sudden and very intense need
to pass a large volume of urine. There is often only a few seconds
between the need to urinate and the release of urine. Triggers can
include a sudden change of position, the sound of running water
etc. Urine may be passed during sex. A person with Urge
incontinence may need to pass urine very frequently including
several times during the night.
to pass a large volume of urine. There is often only a few seconds
between the need to urinate and the release of urine. Triggers can
include a sudden change of position, the sound of running water
etc. Urine may be passed during sex. A person with Urge
incontinence may need to pass urine very frequently including
several times during the night.
Overflow incontinence – can occur when there is an obstruction
to the outflow of urine preventing the normal emptying of the
bladder. An enlarged prostate gland in men is the common cause of
this. Overflow incontinence can cause small trickles of urine to be
passed very often. It may also feel as though the bladder is never
fully empty. The normal bladder emptying mechanism becomes faulty
and urine may leak past the blockage from time to time.
to the outflow of urine preventing the normal emptying of the
bladder. An enlarged prostate gland in men is the common cause of
this. Overflow incontinence can cause small trickles of urine to be
passed very often. It may also feel as though the bladder is never
fully empty. The normal bladder emptying mechanism becomes faulty
and urine may leak past the blockage from time to time.
TREATMENT OPTIONS
As with all medical conditions it is advisable to consult your
Doctor for a correct diagnosis and treatment. The type of treatment
you receive will depend on the type of incontinence you have and
the severity of the symptoms. If an underlying medical problem is
causing your incontinence e.g an enlarged prostate gland, you will
receive treatment for this first.
Doctor for a correct diagnosis and treatment. The type of treatment
you receive will depend on the type of incontinence you have and
the severity of the symptoms. If an underlying medical problem is
causing your incontinence e.g an enlarged prostate gland, you will
receive treatment for this first.
Stress incontinence is initially treated with simple lifestyle
changes, such as reducing your caffeine intake, insuring you are
drinking the correct amount of fluids and losing weight if you are
overweight or obese. Doing Pelvic floor exercises may also be
recommended. If lifestyle changes and pelvic floor exercises prove
to be unsuccessful in treating your stress incontinence, surgery
may be recommended. Your Doctor can discuss the benefits and risks
of this surgery.
changes, such as reducing your caffeine intake, insuring you are
drinking the correct amount of fluids and losing weight if you are
overweight or obese. Doing Pelvic floor exercises may also be
recommended. If lifestyle changes and pelvic floor exercises prove
to be unsuccessful in treating your stress incontinence, surgery
may be recommended. Your Doctor can discuss the benefits and risks
of this surgery.
Urge incontinence is also treated initially with the lifestyle
changes described above. Your GP may refer you to a specialist for
‘bladder training’. This involves learning techniques that will
help you to increase the length of time between feeling the need to
urinate and actually passing urine. The course should usually last
for a minimum of six weeks. If bladder training is not effective
your Doctor may prescribe medication to help you pass urine less
frequently. Your Doctor can discuss the risks and benefits with
you.
changes described above. Your GP may refer you to a specialist for
‘bladder training’. This involves learning techniques that will
help you to increase the length of time between feeling the need to
urinate and actually passing urine. The course should usually last
for a minimum of six weeks. If bladder training is not effective
your Doctor may prescribe medication to help you pass urine less
frequently. Your Doctor can discuss the risks and benefits with
you.
In some situations mild symptoms may resolve without
treatment. If your incontinence persists and is not helped by
treatment, your local continence advisor can give practical advice
on how to manage. Incontinence pants, pads, etc are available and
there are a range of aids and appliances that can greatly help when
living with Incontinence.
treatment. If your incontinence persists and is not helped by
treatment, your local continence advisor can give practical advice
on how to manage. Incontinence pants, pads, etc are available and
there are a range of aids and appliances that can greatly help when
living with Incontinence.
DIET HINTS
- Foods high in magnesium may help Incontinence. These include
almonds, cashews, green vegetables, figs, whole grains and
fish. - Foods high in silica are thought to support the bladder.
Sources include almonds, peanuts, sunflower seeds, linseeds, lean
red meat, strawberries and alfalfa. - Herbal teas such as horsetail, valerian, lemon balm and uva
ursi may be of assistance. Drink a cup morning and afternoon. - Try to reduce caffeine beverages such as coffee, tea and
cola. - Try to include foods high in B Group vitamins to help the
nervous system. These include brewers’ yeast, nuts, seeds and fresh
vegetables. - Increase fibre intake to avoid constipation. Psyllium, guar
gum, apple pectin, fresh fruit and vegetables and slippery elm are
good sources.
VITAMINS/MINERALS/HERBS
Vitamins may only be of assistance if dietary intake is
inadequate.
inadequate.
- Silica is a mineral which is believed to strengthen and
maintain elasticity of tissues. - Horsetail herb is very high in silica and may help strengthen
connective tissues and reduce urinary tract irritation. - Calcium Fluoride is thought to increase integrity and strength
of tissues. It is also thought to help prolapsed tissue. - Magnesium and calcium may support weak muscles and nerves.
ORGANISATIONS & SUPPORT GROUPS
See the Continence Foundation of Australia topic on the
Healthpoint.
Healthpoint.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the correct Pelvic Floor Muscle Exercises listed on the
Healthpoint. - Your Pharmacist stocks a range of Incontinence pads. These have
to be fitted correctly.
