Urinary incontinence is defined as loss of bladder control. It can range from mild, where there is a minor leakage of urine when you cough or sneeze, to severe-urge incontinence, where you suddenly have a strong desire to urinate and do not make it to the toilet in time. Urinary incontinence is a very common condition that may be embarrassing for the person who is affected by it, preventing them from seeking medical help.
Typically, as we age, we lose strength in the bladder and urethra and thus a minor degree of urinary incontinence becomes very common, especially over the age of 60.
Urinary incontinence tends to be more common in women than men, as it’s made worse by pregnancy, childbirth, menopause and the female anatomy, as the urethra, which is the tube coming off the bladder, is much shorter than in the male. The more children a woman has had, the greater the risk for urinary incontinence.
In males, a degree of urinary incontinence is common over the age of 60, especially if there is any disease of the prostate, such as benign prostate swelling (known as benign prostatic hypertrophy) or the more serious prostate cancer.
The more weight you carry, the stronger the risk for this condition.
There are some genetic factors as well, so a family history is helpful.
It’s important to have an assessment for diabetes and also a variety of neurological conditions such as multiple sclerosis, Parkinson’s disease, prior stroke, varying forms of brain tumour and local spinal disease or injury. Many people experience problems with their lumbar spine as they age, and this can affect the local nerves that supply the bladder and bowel.
1) Cigarette smoking can make urinary incontinence worse.
2) A complicating urinary tract infection can make incontinence worse. At times it may be the first presentation of urinary incontinence.
3) Chronic constipation can exacerbate the condition because the bladder and bowel share the same nerve supply.
4) Incomplete emptying of the bowel can press on the bladder and lead to a degree of incontinence.
1) Stress: Coughing, sneezing, laughing and any form of exercising — in particular, heavy lifting — may lead to a degree of incontinence during the activity.
2) Urge: This is characterised by a very sudden and intense urge to urinate and is often accompanied by a degree of nocturia, which is getting up at night to pass urine.
3) Overflow: Frequent constant dribbling, due to the fact the bladder is not being emptied properly during urination.
4) Functional: Any physical or psychological impairment that prevents you from getting to the bathroom in time, such as a physical disability or mental health issues.
5) Mixed: This is due to anywhere from two to all of the above.
Encountering any of the above symptoms should prompt an appointment with your doctor. If your symptoms are restricting your daily activities or limiting your social interactions — and thus impacting on your quality of life — you need to discuss this with your general practitioner.
Lifestyle factors, such as maintaining a healthy weight and avoiding smoking, are important in helping to prevent this condition. It’s also recommended that you limit your consumption of alcohol, caffeinated beverages and spicy or acidic foods.
Have a full medication review with your general practitioner, as many cardiac drugs, blood pressure treatments, sedatives and muscle relaxants may exacerbate this condition. High-dose vitamin C supplements may also contribute.
In my opinion, all males and females over the age of 60 should be practising daily pelvic floor exercises. Your general practitioner or physiotherapist can teach you these very simple exercises, and there are a number of videos on YouTube that are also quite helpful.
The greatest piece of advice I can give here is that urinary incontinence is not only an embarrassing condition that may affect your quality of life, it may also indicate a more significant underlying disorder. So, please, don’t suffer in silence.
IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.