Urinary Incontinence

Urinary incontinence is a condition that affects the lives of many people. According to the Urology Care Foundation, an individual with incontinence could struggle with bladder control and leak urine. This leaking frequently cannot be stopped and may have a significant impact on everyday life. Urinary incontinence is not just a medical problem, it also may impact social, psychological, and emotional health. 

When the urinary system is working smoothly, there is usually time to go to the bathroom before urinating and there is no urinary incontinence, but incontinence can occur when it is not working as it should. 

People of all ages can experience urinary incontinence, which can happen for a variety of reasons. However, this condition can be diagnosed, managed and treated. Men and women of all ages can benefit from many devices and products that collect and hold urine. They help in the treatment of incontinence and urine retention. (1)

Definition and Overview

The inability to prevent urine leakage is known as urinary incontinence. This means that a person urinates against their will. The ability to control the urinary sphincter is either lost or diminished. The issue of urinary incontinence is widespread and affects many people. It may occur before and after pregnancy, be brought on by stress-related actions like coughing, and is more frequent in circumstances like obesity. As people age, urine incontinence becomes more likely. (2)

There are several different types of urinary incontinence, such as

• stress incontinence

Urine leaks out when the bladder pressurizes, such as coughing or laughing.

• urge incontinence 

Urine leaks when a sudden, intense urge to urinate is felt or soon after.

• overflow incontinence (chronic urinary retention)

It often causes leakage when the bladder cannot be completely emptied.

• total incontinence 

When the bladder cannot store any urine, it causes constant urination or frequent incontinence. (3)

Incontinence of the urine is not a disease. Men and women may have distinct reasons for this condition. It is not hereditary, though, and this is not a typical aspect of aging. 

Procedures

The type of incontinence, the patient's age, general health, and mental state are some of the factors that might influence the treatment plan. Here are the incontinence procedures:

1. Bladder Training

Bladder training helps the patient gradually regain control over their bladder.

• Delaying the event: The goal is to control the impulse. The patient learns how to delay urination when there is an urge to urinate.
• Double peeing: This includes urinating, then waiting a few minutes, and then urinating again.
• Toilet timeline: The person plans a toilet at certain times during the day

   2. Medications

If medications are preferred, this is often done in conjunction with other techniques or exercises. Some medications are prescribed to treat urinary incontinence. 

• Anticholinergics can benefit people with incontinence by relaxing hyperactive bladders.
• Topical estrogen can improve tissue health and ease some symptoms in the urethra and vaginal regions.
• Tricyclic antidepressants include imipramine (Tofranil).

   3. Medical Devices

These medical devices are made specifically for female patients.

• Urethral inserts
• Pessary
• Radiofrequency therapy
• Botox (botulinum toxin type A)
• Bulking agents
• Sacral nerve stimulator

   4. Surgery

If other alternative treatments are unsuccessful, surgery can be an option. Before making a choice, pregnant women should discuss their surgical choices with a doctor.

• Sling procedures

Mesh is placed under the neck of the bladder to support the urethra and stop urine from leaking out.

• Colposuspension

This procedure lifts the bladder neck and helps relieve stress incontinence.

• Artificial sphincter

It is an insertion of an artificial sphincter or valve to control the flow of urine from the bladder to the urethra.

   5. Urinary Catheter

It is the name given to the tube that goes from the bladder through the urethra to a bag that collects urine from the body.

   6. Absorbent Pads

They are absorbent pads that can be purchased online as well as in pharmacies and supermarkets. (4)

Candidates

Those who experience the following symptoms should receive urinary incontinence treatments.

• Leakage of urine
• Frequency and urgency
• Stress incontinence
• Strong urge to urinate
• Overflow incontinence
• Functional incontinence (5)

Risks and Side Effects

Depending on the specific treatment approach employed, the risks and side effects of urinary incontinence treatments may change. The following are some potential risks and side effects related to common treatments for urine incontinence:

• Anesthetic risk
• Hemorrhage (Bleeding)
• Infection
• Deep Vein Thrombosis (DVT):
• Difficulty passing urine
• Dizziness
• Suture complications
• Vaginal irritation

It is crucial to keep in mind that the risks and side effects listed above are general warnings and could not apply to everyone. A healthcare provider can provide individualized information based on the patient's particular condition and treatment plan when discussing the specific risks and potential problems connected with incontinence treatments. (6)

Post-Procedure and Follow-up

Incontinence treatments play a major role in ensuring optimal results and minimizing potential complications. Specific aftercare instructions for each patient may vary depending on the type of treatment, medications, and procedures received. After each procedure, the doctor follows the patient closely, and based on the patient's feedback, the treatment is given.

Recovery

Recovery times will vary with different procedures. If surgery is performed, the doctor may recommend 2 to 6 weeks of recovery before returning to normal daily activities. Maintaining  

• a healthy weight, 
• avoiding or reducing alcohol consumption, 
• staying active, 
• and keeping your pelvic floor muscles strong 

are some steps that can help reduce the likelihood of urinary incontinence.

Results

In order for the urinary incontinence problem to disappear or not to recur, patients should follow the instructions given by the doctor. Thus, the treatments result in positive results and the person minimizes and even completely eliminates urinary problems.