Affinity Health, a leading provider of high-quality health coverage, explores the causes of adult urinary incontinence. Urinary incontinence(UI) is a condition that affects millions worldwide but is often stigmatised and misunderstood.
While it’s commonly associated with children or the elderly, many healthy, active adults experience this issue. Despite its common occurrence, UI is not an inevitable part of ageing.
“According to the National Institutes of Health, one in three women in South Africa suffer from urinary incontinence,” says Murray Hewlett, CEO of Affinity Health. “The prevalence of UI in men is around half that than in women.”
What is Urinary Incontinence?
UI refers to the involuntary loss of urine. It can occur during the day or night, ranging from occasional dribbling to full bladder emptying. UI affects both genders and can occur at any age. It is more common in women due to factors like weakening of the pelvic floor muscles due to obesity, childbirth, chronic coughing, constipation, or following a hysterectomy.
Menopause, urinary tract infections, and cancer treatments can also contribute. In men, UI is often related to prostate issues. Neurological injuries, such as spinal cord trauma, brain injuries, and post-surgical complications, can also lead to UI. Other causes of UI include an overactive bladder (OAB), certain medications, like diuretics, conditions like diabetes, multiple sclerosis, Parkinson’s disease and lifestyle factors, including obesity.
Types of Urinary Incontinence
Urinary incontinence appears in several forms, each with unique causes and symptoms.
Here’s a closer look at the various types:
- Stress Incontinence: When urine leaks during activities that put pressure on your abdomen, such as coughing, sneezing, laughing, or exercising.
- Urge Incontinence: When you suddenly feel a strong urge to urinate and can’t control the leakage.
- Overflow Incontinence: The bladder can’t empty fully, resulting in constant urine dribbling.
- Functional Incontinence: When physical or mental impairments prevent you from reaching the bathroom in time.
- Mixed Incontinence: This involves both stress and urge incontinence, so you experience symptoms of both conditions.
Solutions and Management
While UI can be challenging, there are ways to manage and reduce its occurrence. A few standard methods include:
Pelvic Floor Exercises: Exercises like Kegels can help strengthen pelvic floor muscles and improve bladder control.
Bladder Training: Bladder training involves scheduling bathroom visits and gradually increasing the time between trips. This helps train the bladder to hold urine for more extended periods.
Lifestyle Changes: Reducing the intake of caffeine, alcohol, and spicy foods can help minimise bladder irritation. Managing weight can also help, as obesity puts extra pressure on the bladder.
Medications: Various medications can help manage incontinence. Anticholinergics can reduce bladder spasms, while beta-3 agonists can relax the bladder muscles.
Medical Devices: Devices like urethral inserts or pessaries can support the bladder and urethra, helping to reduce incontinence.
Behavioural Therapy: Working with a therapist to manage stress and anxiety can be beneficial, as these emotions can exacerbate incontinence.
Surgical Options: This can range from minimally invasive injections to support the urethra to more extensive procedures like bladder augmentation.
Absorbent Products: While not a treatment, using absorbent pads or underwear can provide comfort and confidence by discreetly managing leaks.
Acupuncture: Acupuncture may help reduce symptoms of overactive bladder and incontinence by balancing the body’s energy flow.
Botox Injections: Botox injections into the bladder muscle can help relax it, reducing episodes of incontinence for those with an overactive bladder.
Seeking Help
If you’re suffering from UI, reach out to a healthcare professional. They’ll start with a medical history and physical exam and may run tests like urinalysis, bladder scans, or urodynamic studies to determine the underlying cause and treatment options. Joining a support group can also be helpful, offering emotional support and practical tips from others who understand what you’re going through.
Conclusion
UI is a common but often overlooked condition that can significantly impact an individual’s life. Understanding the causes and effects of urinary incontinence is crucial in managing it effectively. Many people can reduce or even eliminate their symptoms with the right combination of lifestyle changes, exercises, medications, and support.