What is urinary incontinence?
Urinary incontinence is the inability to control the flow of urine from the bladder. Urine is produced continuously by the kidneys. From each kidney the urine passes down a tube called a 'ureter' into the bladder, which is a muscular 'sack' in which urine is stored until it is expelled from the body. There is a muscular ring, the 'sphincter', at the neck (outflow) of the bladder that prevents urine flowing out. When your bladder is full, you have the sensation of needing to pass urine. This sensation occurs through the nerves in the bladder wall. When you pass urine, your sphincter muscle relaxes while your bladder wall muscles contract and the urine passes out through a tube called the 'urethra'. You can increase the pressure on the bladder by contracting the muscles of your abdomen and pelvis to help expel the urine.
What are the causes, who is at risk and what are the symptoms of urinary incontinence?
This is because the muscles of the pelvic floor are weakened during childbirth and, after the menopause, a lack of the hormone oestrogen causes a weakened urethra. Childbirth may also cause damage to the sphincter, urethra and nerves of the bladder. Pelvic surgery may also be a cause of similar damage to these structures. All these problems cause reduced resistance to the flow of urine. Therefore, urinary incontinence in women tends to increase with age and is more common after childbirth and pelvic surgery.
Stress incontinence
Stress incontinence involves the leakage of small amounts of urine when coughing, straining, laughing or sneezing. It is the most common type of incontinence in women. It occurs when there is a reduced resistance to the flow of urine so that any activity that increases the pressure within the abdomen, and so on the bladder, causes a leakage of urine.
Urge incontinence
Urge incontinence involves the sensation of having a full bladder when the bladder is not full and having to rush to the toilet to pass urine. If you do not make it to the toilet in time, urinary incontinence occurs. Urge incontinence can be caused by a urinary tract infection and, more rarely, by problems with the spinal cord that result in overactivity of the bladder wall muscles, or by problems that affect the brain such as dementia or stroke.
What is the treatment for urinary incontinence?
It is very common and many experts are able to help you.
Self-care action plan
You can do many things yourself to control urinary incontinence. These include: empty the bladder at regular intervals, so it never becomes too full,
avoid drinks that contain caffeine, such as coffee, which can make you pass more urine,
Wear special pads to protect your skin from any leaking urine.
If you are pregnant, there are pelvic floor muscle exercises that you can do to help prevent urinary incontinence. One simple exercise is to tighten the muscles in your pelvis as if you were stopping the flow of urine.
Physiotherapy
Exercises to strengthen the muscles of the pelvic floor are often very useful. If you have stress incontinence, you can be taught to contract certain muscles when straining, so that you do not leak urine.
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