“Urinary Incontinence or UI is a person’s inability to control urination.”
This disorder manifests in many forms:
- Stress Urinary Incontinence (SUI) is involuntary, resulting from activities which apply pressure on the bladder. This is the most prevalent type of UI in women with almost 80-86 per cent of women being affected, especially young and middle-aged women in the age group of 29-49 years. Even the simplest activities such as coughing, sneezing, laughing, running or lifting can be a predisposition to Stress Urinary Incontinence.
- Urge Incontinence results in involuntary leakage of urine from having a hyperactive or irritable bladder.
- Mixed Incontinence is a combination of stress and urge incontinence.
- Overflow incontinence is a condition where patients never feel the urge to urinate and the bladder never empties completely. Instead, small amounts of urine leak continuously. Overflow incontinence is prevalent in older men with an enlarged prostate gland. It is rare in women.
UI and Quality of life
Urinary Incontinence is a highly bothersome condition. It has a negative impact on the quality of life of patients as well as their families. Physical activities become restricted and the social and sexual activity of the patient is also impaired.
Diagnosis is based on symptom assessment chart, history, evaluation of patient, bladder diary, cough test, pad test and urodynamics.
Treatment of UI
- Non pharmacological
- Pelvic floor exercises involving muscle contraction and relaxation for 10 seconds each and repeated about 10-15 times. This exercise should be done twice or thrice every day for four to six months.
- Adequate fluid intake, approximately six to eight glasses per day, and a high fibre diet is helpful in controlling constipation which in turn helps in good urinary control management.
- Bladder voiding at regular intervals and double voiding is helpful is setting the biological clock and helps in bladder re-functioning.
- Urge inhibition, wherein the patient gains control over the body’s urge to empty the bladder, helps with the condition. Whenever the urge to use the restroom strikes, the patient stops whatever s/he is doing and does pelvic floor muscle exercises or other activities to distract the mind. Once the urge is overcome, s/he urinates calmly. With time the patient gets better control over the bladder.
- Anti-cholinergics like Oxybutynin, Tolterodine, Tropsium, Solifenacin and Derifenacin drugs are mainstay. These drugs are reasonably effective though tolerability consideration may be necessary for persistence.
- Side effects are influenced by dosage form and route of delivery.
- Surgical treatment may be necessary in some cases.
- Botox injection into the bladder is effective in cases that are unresponsive to conservative treatment.
The best solution to combat UI is to be aware, and to go for proper checkup and treatment at the earliest signs of any symptoms.