HealthyCanada.com

Urinary incontinence - not being able to hold your urine -- is a complex condition that affects 1.5 million Canadians of all ages. It is significantly more common in women than men.

Not being able to hold your urine until you get to a toilet is discomforting but there's no need to feel ashamed or suffer in silence. An over active bladder is usually a symptom of an underlying medical condition and talking to your doctor about it is the best way to gain control of your bladder and avoid embarrassing accidents.

Urinary incontinence is categorized by symptoms. These symptoms can range from leakage or "dribbling" of urine to complete loss of bladder control.

Urge incontinence is the sudden uncontrollable need to urinate. A person cannot hold the urine in until he or she can reach the bathroom.

Overflow incontinence occurs when urine builds up in the bladder because of some obstruction or dysfunction of the bladder. Urine leaks without warning because the bladder never empties completely.

Stress incontinence occurs when any type of pressure on the abdomen such as laughing sneezing coughing etc. causes urine to leak.

Reflex incontinence is the sudden loss of bladder control because of some type of neurological disorder. Functional incontinence occurs when some type of physical disability such as multiple sclerosis or arthritis makes it difficult to get to the bathroom quickly. There is no problem with the urinary system.

If you're a woman you're more likely to experience an over active bladder compared to a man because of childbirth menopause and the structure of your urinary tract. Other causes of over active bladder in both sexes may include birth defects strokes and Multiple Sclerosis or physical problems associated with aging.

Aging doesn't cause loss of bladder control but normal changes in your urinary and genital systems such as sagging muscles that support the bladder make this condition more common as people grow older. In addition medications for a variety of illnesses such as arthritis and stroke can increase the chance of bladder control problems.

Bladder infection is a common cause of urinary incontinence. Other causes include:

• weakened pelvic muscles as a result of childbirth
• abnormal function of the bladder and/or urinary sphincter muscle
• gynecological surgery such as hysterectomy
• obesity
• excessive consumption of alcohol or caffeinated beverages
• enlarged prostate or prostate surgery
• damage to the nervous system from disease injury or a brain tumor
• prolapsed (dropped) bladder which can occur after menopause

Urinary incontinence can also be the side effect of certain drugs the result of disease or injury that either impairs the individual's ability to recognize that he or she must urinate or makes it difficult to get to the bathroom in time constipation an unusually small bladder or an obstruction in the urinary system. Urinary incontinence can be acute which means it occurs suddenly. In this case the cause and condition are usually temporary. Chronic urinary incontinence develops over time and the cause is not reversible.

If you're experiencing any of the symptoms mentioned above don't be embarrassed·talk to your doctor. A thorough physical exam and laboratory tests by your health care provider will lead to a sound diagnosis. Questions you'll need to answer will include what time of day you experience over active bladder most often how much urine you typically lose and what factors trigger the leakage. You also may be asked to keep a record of the medications you take and how much fluid you drink compared to how much you let out.

If you've been diagnosed with over active bladder there's a good chance you can be successfully treated. Your over active bladder could be a side effect of a drug you are taking. If so your doctor might be able to suggest an alternative. If the problem is a symptom of a disease it should clear up once your illness is treated. There are certain conditions however such as Alzheimer's disease and dementia that make treating over active bladder more difficult. In such cases you may have to wear undergarments use bedpans or in serious cases urinary catheters to help control urinary leakage.

Some other forms of treatment may include:

Kegel exercises: Kegel exercises are helpful if you suffer with stress or urge incontinence. As many as 75% of women with incontinence especially stress incontinence can improve their urine control with kegel exercises. These exercises specifically target your pelvic floor muscles that hold up your uterus and bladder. Although not a delicate description many women describe Kegel exercises as "pretending you are holding in some flatulence". When you contract these muscles the bladder outlet is strengthened and tightened. Try constricting your muscles for 5-10 seconds at a time. Kegel exercises need to be practiced consistently to be effective. Women need to be patient as it can take up to 6 weeks before Kegel exercises become very effective.

Behaviour training: This treatment option helps you learn to control your urine output and toilet habits over several weeks or months. You learn how to wait for longer periods of time before urinating as well as training yourself to go only go to the bathroom at specific time periods and resisting the ·urge to go' all the time. For example if you are incontinent after 3 hours of holding in your urine try and hold your urine for 2 hours at least but make sure you urinate by 3 hours.

Medication: If exercises or behaviour training don't work then your doctor may prescribe medication. Some drugs are designed to help prevent bladder contractions and others help you increase your bladder capacity. Some types of medications include muscle relaxants; antispasmodics which help increase the bladder's storage threshold and decrease bladder spasms; and calcium channel blockers which are normally used for people with heart conditions but can also aid an over active bladder. Don't medicate yourself with over the counter drugs. If you are experiencing over active bladder symptoms go see your doctor.

Surgery: If you're a woman experiencing severe stress incontinence your doctor may recommend surgery. The "vaginal sling" is a common procedure that provides support for the bladder by forming a "hammock" of sorts under the urethra.

Managing Over Active Bladder

Remember over active bladder can usually be cured or treated successfully. But if you find yourself experiencing symptoms and haven't been treated by a doctor here are some tips on how you can help manage your bladder:

• Try to stay away from foods and beverages such as parsley coffee tea and alcohol that can increase your urine output or irritate your bladder.
• Try to drink the majority of your liquids during the day and make sure to cut down your beverage intake 2 to 3 hours before going to sleep.
• If you're overweight try to lose weight. Weight reduction may help ease pressure on your abdomen.
• When you do urinate make sure you void completely.
• Adult undergarments should only be used as a last resort. Many people become dependent on absorbent pads and don't get the proper treatment they need. Before investing in these types of products talk to your doctor first.

Additional Resources:

Canadian Continence Foundation