Urinary Incontinence: Chuck the embarrassment, be treated

Did you wet your pants without realizing it? Were you ever embarrassed and stuck on the street while you suddenly wanted to pee? Do you find that urine leaks out before you are able to get to a bathroom? Do you find you have an urge to pee several times a day (more than 8)? If the answer is yes, then you have a condition called Urinary Incontinence (UI), and all you need is treatment and a few exercises.

According to reports, 200 million people worldwide are affected by urinary incontinence (UI). Urinary Incontinence basically means involuntary passage of urine and is twice as common in elderly women as men. Most of the women are uncomfortable sharing this problem even with their doctors due to embarrassment. Moreover it is a common belief that it is a part of ageing and they have to live with it.

“It is a myth that there is no cure to UI as around 80 per cent of UI can be cured completely,” points Dr Prakash Shetty, Urologist, Dr L H Hiranandani Hospital.

Urinary incontinence is when one can’t control the bladder and lose a few drops of urine involuntarily. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. This is not a disease but a side effect of multiple childbirths, traumatic delivery, neurological diseases or ageing.

The main causes are weak bladders, constipation, illness, medication, weakening of the muscles around the bladder, arthritis and a blocked urinary tract.

Diagonosis: See your doctor. He will give you a physical examination and carry out urine, blood and other tests that measure your endurance and capacity to hold your bladder. Your doctor may ask you to keep a diary so as to establish the type of incontinence you have via any discernable pattern.

Decoding UI: There are different types of UIs, “Stress urinary disorder - this is mostly related to women who have had children or are undergoing menopause, you leak a little when you do an activity like sneeze, laugh, or pick up a heavy object. Urge Urinary Incontinence - this is when you cannot hold the urge to urinate long enough to reach the bathroom, this too can be found in healthy people) and Overflow Incontinence- usually occurs when an always full bladder leaks small amounts”, informs Dr Prakash.

He adds "patients often think that because of age or medical history, incontinence is something they have to learn to live with, but in reality that couldn't be further from the truth." Health care professionals need to be aware of the role that physical therapists play in treating incontinence so that their patients know about alternatives to diapers, medication, or surgery. The initial patient evaluation requires determining the type of incontinence, the extent of incontinence, assessing the strength, motor control and endurance of pelvic floor muscles, and screening for any other musculoskeletal issues, then developing an individualized exercise treatment program, and making sure patients understand their role in the treatment program. Kegel exercises that involve contracting, holding, and releasing pelvic floor muscles, are the most effective weapon in the fight against stress incontinence.
 
Getting cured: Do not think that you will be limited to adult diapers or pads, there are many other options available

Habit training - This helps you form a habit of going to the bathroom at a set time periods to void a mishap usually once every two to four hours.  Scheduling bathroom trips with gradually longers periods will retrain your bladder to better hold urine. 

Bladder exercises - This will help strengthen the muscles around your bladder.

Medication - a healthcare professional should be consulted about the latest pharmacological alternatives that best suit you.

Surgery - Common surgical procedures include implanting a sacral nerve stimulator or an artificial urinary sphincter, periurethral bulking injections, sling procedures and bladder neck suspension.

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