By Lee Ann Boyd, Urology Nurse Practitioner
Have you ever avoided a social situation, exercise or even just everyday activities because of urinary incontinence? Urinary incontinence, or the involuntary loss of urine, can have an impact on a person’s overall well-being. If it keeps you from everyday life or a special occasion – no matter what age you are – there are different preventive treatment options, and you should seek medical advice.
Our urological health expert, Lee Ann Boyd, is breaking the stigma and giving us the whole picture on urinary incontinence and tips to improve your bladder control.
The facts about urinary incontinence
Urinary incontinence is defined as an involuntary loss of urine. For some, it may occur throughout the lifespan. Urinary incontinence is more prevalent in women compared to men. It is estimated that 13 million people suffer from urinary incontinence. That number is probably far greater, because many do not report the problem due to embarrassment or fear that urinary incontinence cannot be treated. People often wonder if urinary continence is a normal part of aging – the answer to that question is no.
What causes urinary incontinence?
There are many factors associated with urinary incontinence. Childbirth, pelvic prolapse and previous pelvic surgery or pelvic radiation are examples. Underlying medical conditions such as diabetes, multiple sclerosis, stroke or spinal cord injury can be causes as well. Incomplete bladder emptying can cause an overflow of urine. Functional urinary incontinence may occur in those with mobility issues. Attempting to identify the cause of urinary incontinence is helpful when deciding on treatment options.
How to help/improve bladder control
There are many self-help techniques that can be used to improve urinary incontinence, urgency and frequency as well.
Many incontinence sufferers tend to decrease their fluid intake in the hopes that the urinary symptoms will improve – that is a myth. If fluid consumption is lower than normal, it may concentrate the urine, which may actually increase urinary incontinence as the urine becomes more irritating to the bladder lining.
Avoidance of bladder irritants, such as caffeine, alcohol and spicy/acidic foods, may lessen voiding complaints.
Bladder-training techniques, timed voiding, pelvic floor exercises and physical therapy for the pelvic floor are also beneficial.
There are multiple oral medications available for controlling urge-related urinary leakage. Newer agents that are slow release over a 24-hour period have shown effectiveness, while decreasing incidence of adverse side effects.
Neuromodulation is another method to treat certain types of urinary incontinence. As the name implies, these are techniques that stimulate nerves to achieve a desired effect. Pretibial nerve stimulation (PTNS) can be done on a weekly basis for 12 weeks in an outpatient clinic. There is an implantable device called a sacral nerve implant that can act like a “pacemaker” for the bladder.
Urinary incontinence from stress
Stress urinary incontinence occurs with activities such as coughing, sneezing, laughing or exercise. Unfortunately, there are no FDA-approved medications at this time for stress urinary incontinence. In women, topical vaginal estrogen is helpful for stress urinary incontinence as the sphincter or urinary valve relies on estrogen to maintain its ability to close properly.
A simple procedure to inject bulking agents into the bladder neck by using a cystoscope may be used to treat stress urinary incontinence. Injections of Botox in the bladder can be very helpful for urinary urgency. These treatments may need to be repeated over time, but require very little if any down time following the procedure.
Removing the stigma and seeking care – the impact of urinary incontinence
Removing the stigma associated with urinary incontinence is the first step to ensure that men and women feel comfortable in seeking care. The social issues are very impactful, as people tend to avoid social situations, sexual activity and healthy physical activities for fear of incontinence. Urinary incontinence also remains the leading reason the elderly are placed in nursing homes. When urinary issues affect sleep, it not only affects a person’s general well-being, but can also be dangerous, leading to falls and hip fractures or other injuries.
The economic impacts can be felt throughout the country. It is estimated that persons with urinary incontinence may spend approximately $1,000 per year for pads and other items for urinary incontinence. In the U.S. almost $66 billion is spent to treat urinary incontinence each year. That figure is expected to increase to $82 billion by the year 2020.
Reach out to your healthcare provider if you are affected by urinary incontinence and see what we can do to help.
Lee Ann Boyd, MSN, ARNP, is a certified Urology Nurse Practitioner at Mission Urology.