Incontinence

Incontinence is a common condition where someone hasn’t any control over their bladder. It can affect someone quite mildly, ie. They leak some urine if they cough or sneeze only or it can get to the other extreme where someone has a sudden urge to go to the toilet, but doesn’t make it in time. It is a very embarrassing problem and condition for some people. There are five types of incontinence: Stress Incontinence, Urge incontinence, Overflow incontinence, Functional incontinence and Mixed incontinence
Stress Incontinence happens when there is pressure on the bladder, such as, when you laugh or sneeze or lift something heavy. Urge incontinence is when you have the sudden urge to urinate but cannot get to the toilet in time or when someone is up frequently during the night to urinate. This can either be caused by an infection or more sever problems such as a neurological disorder or diabetes. Overflow incontinence is when someone experiences leaking frequently throughout the day as the bladder isn’t completely empty. Functional incontinence is when you are not able to make it to the toilet on time because of another medical problem, such as, arthritis and mixed incontinence is if you have these problems combined
There are lots of contributing factors to the cause, which include, water infections, age, certain food and drinks that stimulate the bladder and certain medications.

SYMPTOMS OF INCONTINENCE

Symptoms of incontinence are leaking urine frequently unexpectedly either small amounts or large amounts.

Treatments

Depending on the type of incontinence, the severity and underlying cause can mean different treatments. You could be prescribed a number of treatments to help.

Behavioral Techniques

Bladder Training — you will be told to try and hold off going to the bathroom by ten minutes every time you feel the urge to go and steady increase the time. The result should be to go to the bathroom only once every two and half to three and a half hours.
Double Voiding — this means urinating and then waiting for a couple of minutes to make sure all urine has been excreted. It makes sure you avoid overflow incontinence.
Scheduled Toilet Trips — urinate every two to four hours even if you don’t need to go.
Fluid and Dietary Management — Try to cut back on alcohol, caffeine and acidic foods. If you can lose weight, reduce liquid consumption, and increase exercise it can help to strengthen the muscles.

Pelvic Floor Muscle Exercise

You might be recommended to do exercises to build strength in the muscles and help to control urination. To do these exercises you need to imagine that you are trying to stop the urine flow:

Contract or tighten the muscles you use to stop urinated and hold it for five seconds and then repeat the process. If you can’t hold for five, you can hold for two seconds and relax for three.
Build up the strength by working up to holding for ten seconds and try to do ten repetitions every day.

You could also work with a physical therapist if you are having difficulty.

Medication

Anticholinergics —- this can calm the overactive bladder and can help with urge incontinence. You may be prescribed oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium (Sanctura).
Mirabegron (Myrbetriq) — can treat urge incontinence and relax bladder muscle. It can also increase the amount of urine held by the bladder as well as increasing the amount of urine you can excrete at one time.
Alpha Blockers — these relax the bladder neck muscles and muscle fibres to help with urge or overflow incontinence and make it easier to empty the bladder. These medications include tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), doxazosin (Cardura) and terazosin.
Topical Estrogen — topical estrogen can help women to tone and rejuvenate the tissues in the urethra and vaginal areas.

Surgery

If other treatments are not working then you might be recommended for surgery.

Sling procedures
Bladder neck suspension
Prolapse surgery
Artificial urinary sphincter

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