Urinary Incontinence

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What is urinary incontinence?

Urinary incontinence is when you involuntarily lose urine (pee) from your bladder. It means losing control over urinating (peeing) and accidentally leaking urine. It affects the health of one in four Canadian women at some point in their lives. Urinary incontinence is nothing to be ashamed of and can be treated with various methods.

How does the bladder work?

It helps to think of the bladder as a small muscular balloon. It expands to hold urine and contracts when you pee. At the bottom of the bladder is a ring of muscle much like an elastic band on a balloon. This is called the sphincter muscle. A sphincter muscle tightens when the bladder begins to fill, stopping urine from leaking. When you pee, the sphincter relaxes and the bladder empties. The brain and spinal cord control this system. When the bladder is full, it sends a message to the brain that it needs to empty. The brain replies by either relaxing the sphincter or keeping it closed tight.

What causes urinary incontinence?

Leaking urine may result if the brain or bladder are slow to send the proper signals.

Another muscle group also helps you keep dry. These are the pelvic floor muscles. To keep dry, you can tighten these muscles on your own around the tube coming out of the bladder. These work much like clamping a garden hose shut. Any weakness or damage to these muscles can lead to leaking.

Other common causes of urinary incontinence may be urinary tract infections or certain diseases, such as diabetes. Many women may experience urinary incontinence during pregnancy, menopause, or as they age. It is important to see a qualified health care professional to help determine the cause and to plan treatments.

Will I lose control over urinating when I’m old?

Aging may lead to incontinence in a small percentage of women. However, there are treatments available, depending on the cause.

What are some signs that I may have a bladder problem?

    •    straining to start or finish peeing;
    •    needing to pee more than nine times a day or more than once a night;
    •    having to think about where and when you can pee before you go out; and
    •    knowing the location of every washroom around you or in your neighbourhood.

What are some signs and symptoms of urinary incontinence?

    •    sudden urges to urinate and being unable to reach the bathroom on time;
    •    wetting accidents from activities like laughing, exercise, or sex; and
    •    no control over urine “leaking out.”

There are three general types of urinary incontinence:

    •    Urge incontinence : sudden urges to urinate; a loss of control before reaching the bathroom.
    •    Stress incontinence : wetting due to pressure on the lower stomach muscles, like coughing, sneezing, or laughing.
    •    Overflow incontinence : when an overfull bladder constantly leaks.
Many women have a combination of stress and urge incontinence and this is called mixed incontinence.
In some cases, the bladder may never feel fully emptied; it might feel like you need to strain to start or finish urinating. Straining may be due to diseases such as diabetes, certain medicines, or a urinary tract infection (UTI).

What can I do for my incontinence?

    •    Adjust your food and liquid intake to avoid irritating your bladder. Drinking too little can lead to concentrated (strong) urine and bladder irritation. It can shrink the bladder so it takes less liquid to signal the urge to pee.
    •    Do Kegel exercises. Tightening and relaxing the pelvic floor muscles will strengthen the muscles and help develop control over the sphincter and retrain the bladder. When done properly, pelvic floor exercises can prevent urinary incontinence and help correct problems after they start.
    •    Schedule times during the day to go the bathroom so you pee before the bladder feels full. This can prevent accidents.

What are some treatments for urinary incontinence?

    •    Biofeedback . Special sensors painlessly attached to the body show signals from the pelvic area on a computer screen. This helps women locate and properly contract their pelvic floor muscles. Strengthening these muscles and being able to contract them helps to gain control over the urge to urinate.
    •    Muscle therapy . Special devices are used to help strengthen the pelvic floor muscles.
    •    Medication . Some drugs stop the bladder from contracting when it is not the right time. Other drugs relax the bladder muscle to help control its spasms. Talk with your doctor about the benefits and side effects of using any medicine for a long time.
    •    Surgery . Usually only advised if other methods fail. May require local anaesthetic and involve a one-day stay in hospital.

What might my health care professional need to know?

    •    your medical background;
    •    how urinary incontinence affects your life; and
    •    medications you may be taking.

Before you see your health care professional, keep a ‘bladder diary’ to track your bathroom trips and accidents as well as what you drink for three days. This helps your health care professional understand your experiences.