Urinary incontinence: how to combat it?

Posted by Dr Anil Agarwal on February 16th, 2021

According to the definition of the International Continence Society (ICS), Urinary Incontinence (UI) is determined when there is “a complaint or discomfort derived from any involuntary loss of urine”. Incontinence may or may not be accompanied by an urgent sensation to urinate and entails the inability to retain urine permanently or temporarily. In addition, there is a significant decrease in quality of life that does not always correlate with the amount of urine lost.

It is a very common problem, but many patients hide it out of shame, so there are no exact figures. It is estimated that 50% of people with urinary incontinence do not consult their urologist in Delhi. It is estimated that 24% of women suffer from urinary incontinence, increasing to 30-40% in middle-aged women and up to 50% in elderly women. In the case of men, 7% suffer from it, reaching 14-29% in those over 65 years of age. It is not a situation of age, although aging favors it.

TYPES OF URINARY INCONTINENCE

There are four most common types of urinary incontinence:

• Stress urinary incontinence: involuntary loss of urine associated with physical exertion that causes increased abdominal pressure, such as coughing, sneezing, laughing, or during physical activity. It affects more middle-aged women. It is the “incontinence of the pregnant woman”, explains the urologist in Pitampura.

• Urge urinary incontinence: involuntary loss of urine associated with a sudden and urgent need to urinate, which occurs as a result of an involuntary contraction of the muscle that causes the expulsion of urine. It affects both sexes equally, especially in advanced age, says the urologist in Pitampura.

• Mixed urinary incontinence: combination of the two above.

• Overflow Urinary Incontinence: They call this “unconscious urinary incontinence.” Small losses occur during the day and the bladder, due to muscle weakness or obstruction, does not empty completely. This causes the bladder to fill to the maximum and with an increase in pressure in the abdomen, small amounts of urine escape.

Urinary incontinence affects the quality of life of those who suffer from it, since it prevents a good rest, or hinders leisure and work activities. It not only has physical effects (skin lesions and hygiene problems), but also psychological, says the best urologist in Delhi.

CAUSES

The causes are varied. There are the congenital ones caused by some disease and the acquired ones such as:

• Bladder disorders: muscle instability, increased abdominal pressure, obstruction of evacuation and atonic bladder.

• Endocrine disorders: diabetes or estrogen deficiency in menopause that influence the functioning of the bladder.

• Neurological problems that affect the ability to control the bladder.

There are some factors that contribute to the appearance of urinary incontinence such as pregnancies, traumatic deliveries, gynecological interventions, medications (consumption of diuretics, hypnotics or antidepressants), and certain psychological situations such as depression.

HOW IS URINARY INCONTINENCE TREATED?

1. Modify habits: Control the liquids (water, alcohol, infusions, etc.) that are drunk to avoid excessive formation of urine and train the bladder so that the patient can progressively delay emptying from the moment they feel the desire to urinate until they You can do it in a suitable place (get to the bathroom).
2. Re-educate the pelvic floor muscles (Kegel exercises):
   1. Try to stop the flow of urine while you are urinating.
   2. Make two or three short stops each time you urinate.
   3. Contract your bladder muscles and hold for three seconds (the idea is to reach 10 seconds) three times a day.
3. Medications: The most widely used are those which decrease the contractile capacity of the detrusor muscle, increase tolerance of bladder filling and continence.
4. Intermittent self-catheterization: A catheter is inserted into the bladder through the urethra to empty it. It is used mainly in incontinence caused by neuronal damage.
5. Use absorbents for urinary incontinence: on the market there are absorbent pads or pads specially designed for urine leakage.

PREVENTION

There are some steps that can help prevent UI:

• Reduce diuretic foods: Some foods stimulate kidney function by producing more urine. For example, melon, watermelon, asparagus, endives, grapes, onions, among others.
• Also reduce the consumption of diuretic drugs (whenever possible).
• Reduce the consumption of drinks that contain alcohol or caffeine.
• Follow a balanced diet.
• Reduce overweight and obesity.
• Avoid spicy foods.
• Increase your fiber intake to avoid constipation.
• Avoid drinking liquids between two and four hours before going to sleep.
• Get regular exercise.

If you suffer from urinary incontinence, you should consult with your urologist in Delhi and not resign yourself to living with the problem. The solution can be very simple, and it can improve your quality of life.