An Introduction To Urinary Incontinence

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Incontinence – what is it?

Incontinence can be defined as not being able to control when you need to visit the toilet, resulting in leakage of either urine, faeces or both.

From the very nature of the symptoms, it is obviously a very personal problem that many people understandably do not want to admit to, or perhaps even worse, seek help for. It is sad to think that so many suffer in silence, especially when in most cases, patients can be helped to manage and even cure the condition and return to a more normal lifestyle.

Starting with urinary incontinence, this can be divided into anything from three to six different categories depending on your information source, but the NHS in the UK divides Urinary Incontinence into four subgroups and a last type of Incontinence which is a mixture of two types. (Reference 1)

1. Stress incontinence – when urine unexpectedly leaks out, typically when you cough, laugh or sneeze.

Stress incontinence is thought to be the most common type of incontinence in women, this is different for men – for example, another survey from the US found that in men, urge incontinence was the most common with 41% reporting this type of problem compared to 29% of men reporting stress incontinence. (Reference 2)

This difference is likely due to the causes of the different types, as stress incontinence is often suffered by women following childbirth.

The cause of stress incontinence is often as a result of weak or damaged pelvic floor muscles. Increased pressure on your stomach, for example pregnancy or obesity, is another cause of Stress Incontinence.

2. Urge incontinence – urge incontinence occurs when you have a strong, sudden need to urinate that is difficult to delay. The bladder then squeezes, or spasms, and you lose urine.

This type of incontinence can be caused by a problem with the detrusor muscles in the walls of the bladder – these muscles relax to allow the bladder to fill with urine, then contract to let the urine out. In Urge Incontinence the detrusor muscles contract too often, creating an urgent need to go to the toilet.

The cause is often not clear but can include:

Drinking too much alcohol or caffeine – these can have the effect of irritating the bladder.

Not drinking enough fluids – this can cause strong, concentrated urine to collect in your bladder, which can also irritate the bladder and cause symptoms of overactivity.

Certain neurological conditions can also cause urge incontinence.

3. Overflow incontinence (or chronic urinary retention) – when the bladder cannot fully empty, resulting in frequent leaking.

This causes the bladder to swell above its usual size. This occurs when the bladder cannot hold as much urine as the body is producing, or the bladder cannot empty completely, causing urinary leakage.

This is more common in men with prostate gland problems as an enlarged prostate gland can obstruct the bladder but can also occur as a result of a damaged bladder, or a blocked urethra. Often, patients will need to urinate frequently, and they may experience “dribbling” or a constant dripping of urine from the urethra. (Reference 3)

4. Total incontinence – when the bladder cannot store any urine at all, which causes the constant passing of urine or frequent leaking.

This can be caused by several reasons including the patient being born with a congenital defect, an injury to the spinal cord or urinary system, or a hole between the bladder and the vagina or penis otherwise known as a fistula. (Reference 2)

5. Mixed incontinence – which is a mixture of both stress and urge incontinence.

How common is the problem of Urinary Incontinence and who does it effect?

This varies considerably between the sexes and with age. For example, a US sample of 21,590 men found that 9% of men reported a bladder control problem in the last 30 days. Compare this to a survey, again in the US, of 23.5 million women, 38% said they had suffered at least one episode of urinary incontinence. It is important to note that in a general population survey this percentages will rise as the age range of the participants rises.

What can be done about Incontinence?

As there are many different types of incontinence with many different causes, there are many different forms medical treatment available, therefore it is important to get a proper diagnosis by seeing your health professional.

One of the first steps is to strengthen the pelvic floor muscles, which for some people can be very hard to locate. Under the urinary incontinence section of their website the NHS describes how “Research has shown that pelvic floor muscle training can benefit everyone with urinary incontinence.”

In many people the pelvic floor muscles are so weak they can be hard to locate - the NHS further advise that “If you're unable to contract your pelvic floor muscles, using electrical stimulation may be recommended” – this where one of the ranges of electrical therapy devices provided by Tenscare can help.

Apart from being a safe option in the treatment of incontinence – all Tenscare Pelvic Floor stimulators meet the international safety standard EN60601-2-10, and have found to be effective in independent medical trials. For example, in a study of 180 patients comparing TensCare’s iTouch Sure device with a different type of electrical stimulator, the researchers concluded : “At week 12, significant improvements from baseline were seen in both groups for secondary endpoints including mean urine leakage”. (Reference 4)

A great advantage of the type of devices Tenscare supply is that they are designed to be used at home. Other options may include drug therapy and a range of devices from slings to clamps – some permanently implantable within the body.

Along with kegel exercises, lifestyle changes are also advised to help manage incontinence – weight loss is a major factor as is cutting back on drinks that are known to irritate the bladder such as those containing caffeine.

Lastly, it is important that this condition should no longer be seen as some sort of social taboo subject, so people are encouraged to discuss it and seek the various treatment and management options that can help.

References