Plug the leak of incontinence

Urinary incontinence could affect our day-to-day life as it not only has medical consequences but emotional and psychological ones too, writes Dr Thejaswini

Urinary incontinence i.e., leakage of urine that you cannot control, is a problem faced by many. It can happen at any moment. It is easy to ignore and brush aside as an embarrassing incident that you would rather not talk about. Many feel that they would be ashamed of it or there is nothing that can be done, so they just tolerate it and suffer in silence. But ignoring it is not the answer. It may seem like a small issue, but urinary incontinence could affect your day-to-day life. It not only has medical consequences but emotional and psychological ones as well.

People dealing with incontinence are often anxious and want access to a restroom wherever they go. The fear of accidental leakage stops them from having a normal life which they can enjoy.

Types of urinary incontinence

Stress incontinence: Leakage happens when you put pressure on your bladder and sometimes simple actions like laughing, sneezing, coughing may cause it.

Urge incontinence: Characterised by an intense need to urinate which is followed by involuntary urine loss, urge incontinence will make you urinate often, sometimes throughout the night.

Overflow incontinence: When there is persistent dribbling of urine caused by a bladder that does not empty totally.

Functional incontinence: When you cannot make it to the restroom in time due to a physical or mental impairment. For example, people with arthritis may not be able to unbutton their trousers quickly to urinate.

Mixed incontinence: When you experience a combination of any of the above, it is known as mixed incontinence.

Causes of urinary incontinence

Incontinence can be temporary as well as persistent. Temporary incontinence can be caused due to consumption of certain foods and beverages that stimulate your bladder and increase the quantity of urine like caffeine, alcohol, spicy food, sugary items. Medications for heart conditions and sedatives may also cause an increase in urine levels. Your incontinence may also be due to certain medical problems like UTI (Urinary Tract Infection) and constipation. However, the good news is these are easily treatable. If the loss of bladder control is persistent, there may be underlying health conditions or bodily changes that are causing it. Going through major life events like pregnancy, childbirth, menopause will result in hormonal changes plus the weakening of muscles that are responsible for bladder control.

Age is also a factor as involuntary contractions of the bladder increase with age. There could be underlying health issues that are causing constant leakage like a tumour along the urinary tract. No matter how uncomfortable discussing urine leakage may seem, it is important to consult a doctor. Apart from the psychological distress, incontinence may also be an indicator of an underlying health issue like infections, which should not be brushed aside. It is important to consult your doctor if you start noticing a frequent loss of urine while performing day-to-day activities.

Treatment: After performing appropriate tests to determine the type of incontinence (stress, urge, mixed etc.,) that is affecting you, the doctor may recommend the following treatments:

Behavioural techniques: These are ways to train your bladder to control the urge to urinate. You could start with double voiding (emptying the bladder once and after a few minutes trying again). Bladder training could also involve delaying the urge to urinate, starting with 10 mins at a time. Gradually try to lengthen the time between trips to the toilet. Scheduling toilet trips every few hours rather than going only when needed also helps.

Exercises: There are certain pelvic floor muscle exercises that strengthen the muscles that will control urination. These are known as Kegel exercises and are especially useful for stress and urge incontinence.

Medications: The doctor could recommend certain medications that will help in relaxing bladder muscles and calming it when it is overactive. If none of the treatments work and the condition is getting worse, your doctor may also recommend surgery. Urinary incontinence is a very common problem for women, yet it is rarely spoken about. It is a medical condition, just like any other and one should not feel embarrassed to get a consultation. Getting the necessary help will give women the much-needed support to cope with the issue and live a better life that isn’t plagued by embarrassing situations.

(The author is a consultant obstetrician & gynaecologist.)