Twice as many women than men suffer from bladder leakage, otherwise known as urinary incontinence. Whether they lose a small amount whenever they laugh, cough or sneeze, or the urge strikes so quickly that their bladder empties completely with a few seconds’ notice, it can become embarrassing. Many women with UI avoid social situations out of fear they will not be able to get to a restroom soon enough. Understanding the causes and treatment of urinary incontinence can give you control of your daily activities again.
Common causes of bladder leakage for women include childbirth, menopause and structural defects of the urinary tract. Less common causes include physical disorders such as multiple sclerosis. Brain injuries and other neurological issues are also contributing factors to the development of urinary incontinence.
Urinary incontinence takes three basic forms. Stress leakage occurs during laughing, coughing or sneezing. Involving a small amount of urine, it can also be caused by any movement that pressures the bladder, such as running or intercourse. Pregnancy and childbirth are typical precursors to this type of urinary incontinence, which occurs when the pelvic muscles are weakened and the urethra does not close completely. The reduced estrogen levels in the week before your period can exacerbate the problem. The incidence of UI increases after menopause for the same reason.
Functional incontinence is caused by medical issues that prevent accessibility to the restroom. The issues can be those that affect the mind, such as Alzheimer’s disease or brain injury. Functional incontinence is also caused by a physical disability such as arthritis or by a physical obstruction, such as wheelchair confinement, that can make it difficult to get to the restroom in time.
Urge incontinence is caused by bladder spasms. When the spasms occur, the entire bladder may empty with just a few seconds’ warning. You will feel an extreme urge to go, and your bladder then releases the urine. It can happen while you are sleeping, when you hear water running or when you touch water for any reason. Stress and anxiety will exacerbate the condition, as will some medical conditions such as diabetes or hyperthyroidism.
Diagnosing incontinence involves taking a full medical history, discussing symptoms and situations when the leakage occurs and determining how much urine is released. The physician will also order blood work and a urine test to determine whether you have a bladder infection. An infection can cause bladder leakage. Bladder measurements may be taken, as well as an examination to measure how much urine is left in the bladder after urinating. A bladder stress test will be ordered if stress incontinence is suspected. During this test you will be asked to cough while the doctor watches the urinary opening for leakage. Ultrasounds and cystoscopy (a tiny tube inserted into the bladder) testing is performed when structural issues or blockages are suspected.
Treatment depends on the type and severity of the incontinence. In some cases, simple exercises designed to strengthen the bladder take care of it. Your doctor will tell you to practice tightening your bladder muscles several times a day and holding it as if you are holding back urine. For urge incontinence, spasm medications are available by prescription.
In persistent UI causes, surgery is an option. If the UI is caused by weakened bladder, vaginal or uterine walls, surgically tacking the walls back into place can take care of the leakage.