Peeing your pants is traumatic enough when you are a toddler. The humiliation of an elementary schooler who wets the bed at a sleepover or who was too shy to ask for a bathroom pass is even more painful. But to be an adult and suddenly find yourself dealing with incontinence and planning your life around restroom locations is a headache many of us are not prepared for. Yet, the number of incontinence products on drugstore shelves and the volume of commercials aimed at treating incontinence makes it obvious this is a very real issue many women face.
12. Symptoms of Incontinence
The Mayo Clinic lists several types of urinary incontinence. Stress incontinence refers to urine leaking from the bladder when an individual coughs, sneezes, or lifts a heavy object. Urge incontinence occurs when a person experiences an intense, overwhelming need to pee. When this occurs, the bladder may involuntarily release urine. Overflow incontinence happens when the bladder never fully empties and instead releases steady leaks of small amounts of urine. Functional incontinence occurs when another medical issue prevents a person from making it to the bathroom on time. Finally, mixed incontinence can include more than one type of incontinence issue.
11. Causes of Persistent Urinary Incontinence
Temporary conditions such as urinary tract infections, diuretic medications, or constipation can cause short-term episodes of urinary incontinence. Urinary incontinence that persists and affects daily life may be triggered by other causes. Many women experience incontinence during pregnancy as the weight of the fetus presses on the bladder. With age, weakened pelvic muscles, involuntary contractions of the bladder, and changes in hormones can lead to incontinence. Physical blockages from tumors or calcified crystals in the bladder can also lead to leakage. Finally, disorders such as multiple sclerosis, Parkinson’s, or diabetes that affect nerves can cause incontinence.
According to the Cleveland Clinic, urinary incontinence plagues 10% of American women under the age of 65 and 35% of American women over 65. The percentage of women facing incontinence in nursing homes and skilled care facilities is as great as 30 to 50% of those residents. Meanwhile, the rate of incontinence for men is 1.5% for those under 65 and around 22% of those over 65. For young or active women, living a life restricted by urinary incontinence can be a challenge. Making sure to always be in close proximity to a restroom can prevent engaging in many of the normal activities of an active daily life.
9. Anatomy of the Pelvic Floor
The pelvic floor is made up of a group of muscles and tissues that form a hammock to support the bladder, uterus, and colon. Furthermore, the urethra, the vagina, and the rectum all have passageways through the muscles of the pelvic floor. Therefore, any damage to or weakening of the pelvic muscles can cause issues with urination, bowel movements, and sexual functioning.
8. Stigma Attached to Incontinence
While more than 10% of the female population suffers from some variety of urinary incontinence, this issue is not widely talked about. The fear of accidents and embarrassment keeps many women from sharing their struggles. In fact, a 2004 study in the Journal of Women’s Health found that less than half of the women suffering from urinary incontinence were able to comfortably broach the subject with their physicians. As new treatments and better products become available, it is critical for women to feel comfortable enough to seek the help they need to deal with this health issue.
7. Pads and Absorbent Underwear
A trip down the aisles at the local drugstore will showcase an array of products designed to absorb and camouflage leaks associated with urinary incontinence. From pretty, feminine-looking disposable underwear to pads and liners, there is a multitude of products to choose from. These items are handy for capturing occasional leaks, yet do not address the underlying issues causing the symptoms of leaking urine.
6. Oral Medications
Anticholinergic drugs are one class of medications that can treat urinary incontinence or the symptoms of an overactive bladder. These medications work by preventing contractions of the smooth muscles of the bladder. Meanwhile, the second class of medications beneficial for this condition is alpha blockers, which can help relax the bladder muscles in women, decreasing urine leakage. Additionally, the medication Myrbetriq (mirabegron) is a medication designed to increase the bladder capacity by relaxing bladder muscles and helping it to fill more completely. Some women may also achieve relief by using topical estrogen to restore urethra and vaginal tissues affected by hormone loss.
5. Behavioral Changes
The Office on Women’s Health offers several suggestions for behavioral changes that may improve bladder control. The first involves Kegel exercises to strengthen the pelvic floor. The second behavioral technique requires training your bladder by going to the restroom at set times each day. Losing excess weight, quitting smoking, and treating constipation issues can also help to decrease the frequency and urgency of urination. Lastly, avoiding beverages that contain alcohol, caffeine, or carbonation can help to decrease bladder control issues. Limiting fluid intake at crucial times of the day can help to avoid distressing leaks.
4. Surgical Intervention
The American College of Obstetricians and Gynecologists lists three types of surgery for urinary incontinence. Your physician may suggest surgically implanting a sling to lend support to the urethra and prevent urine leakage. A colposuspension is a surgical procedure in which a surgeon attaches the neck of the bladder to nearby structures in order to raise and support the urethra. If neither of these procedures is appropriate for you, your doctor may recommend urethral bulking. This strategy involves injecting a bulking agent into the tissues around the urethra to narrow the opening and prevent leakage.
3. Medical Devices
The use of medical devices may help to prevent urinary leakage. A urethral insert is a plug that you can insert into the urethra to prevent the flow of urine during times of heavy activity. This device can be messy to use and you must remove it after a few hours of use. Meanwhile, a pessary is a device that can be inserted into the vagina to support the pelvic area. The use of a pessary requires a visit to your physician for a fitting. Some women find this device to be uncomfortable or irritating.
2. Nerve Stimulation
Percutaneous Tibial Nerve Stimulation is a treatment for urinary incontinence in which electrodes are placed on the tibial nerve, near the ankle. According to the Simon Foundation for Continence, a device then sends electrical impulses through the nerve to the sacral nerve plexus at the base of the spine. As the device stimulates the sacral nerve plexus, it decreases the symptoms associated with an overactive bladder and urinary incontinence. Patients undergo 30-minute treatments once a week for 12 weeks.
1. Botox Treatments
If an overactive bladder is the cause of urinary incontinence, Botox treatments may provide relief. To treat this condition, a physician injects Botox into the bladder muscle. Botox then prevents the muscle from contracting and causing leaking, feelings of an intense need to urinate, and urinary frequency. Patients may notice results within two weeks of their first Botox injection. This result typically lasts six months until the next treatment. Side effects may include urinary tract infections, pain while urinating, and difficulty fully emptying the bladder.