Urinary incontinence in women: Causes, symptoms and treatment
The two most common types of urinary incontinence in women
Stress incontinence. This is the most common type of incontinence. More
common in younger women. Caused by stress or pressure on the bladder due
to weak pelvic floor muscles. Everyday actions that use the pelvic floor
muscles, such as coughing, sneezing, or laughing, can cause you to leak
Urge incontinence. With urge incontinence, urine leakage usually happens
after a strong and sudden urge to urinate and before you can get to a
bathroom. Urge incontinence is sometimes called “overactive bladder.” Urge
incontinence is more common in older women and can occur unexpectedly,
such as during sleep, after drinking water, or when you hear or touch
Many women with urinary incontinence have both stress and urge incontinence. This is called “mixed” incontinence. Certain health events unique to women, such as pregnancy, childbirth and menopause, can cause problems with these muscles and nerves.
Other causes of urinary incontinence include:
- Overweight. Being overweight puts pressure on the bladder, which can weaken the muscles over time.
- Constipation. Constipation, straining to have a bowel movement, stresses
- the bladder and weakens the pelvic floor muscles.
- Nerve damage. Damaged nerves send the wrong or no signals to the bladder. Childbirth, diabetes and multiple sclerosis can cause nerve damage in the bladder, urethra, or pelvic floor muscles.
- Surgery. Any surgery involving the reproductive organs, such as a hysterectomy, can damage the pelvic floor muscles
- Medication. Side effects of medicine such as diuretics (“water pills”)
- Caffeine. Drinks with caffeine can cause the bladder to fill quickly
- Infection. Bladder may cause incontinence for a short time.
Treatment of urinary incontinence
These steps can make urinary incontinence go away entirely, or help leak lessurine. These steps may include:
- Kegel exercises. If you have stress incontinence, Kegels are pelvic floor strengthening exercises.
- Training your bladder. You can help control overactive bladder or urge incontinence by using the bathroom at set times, using a bladder diary to track gradually increasing amount of time between visits
- Losing weight. Weight loss will reduce extra weight that puts pressure on the bladder and muscles, which will improve bladder control
- Change your eating habits. Minimize drinks with caffeine, carbonation (such as sodas), or alcohol that make bladder leakage or urinary incontinence worse.
- Quit smoking. Smoking can make many health problems, including urinary incontinence, worse.
- Treat constipation. Eat more fiber and increased hydration since constipation can make urinary incontinence worse.
Other conservative medical options:
Hormones. After menopause, applying vaginal creams, rings, orpatches with estrogen (called topical estrogen) can help strengthen the muscles and tissues in the urethra and vaginal areas. A stronger urethra will help with bladder control.
Vaginal pessary. A small plastic or silicone device (shaped like a ring or small donut) that you put into your vagina can be fitted. The pessary pushes up against the wall of the vagina and the urethra to support the pelvic floor muscles and help reduce stress incontinence.
Bulking agents. A bulking agent, such as collagen,injected into tissues around the bladder and urethra can cause them to thicken. This helps keep the bladder opening closed and reduces the amount of urine that can leak out.
Surgery. Surgery for urinary incontinence is not recommended if you plan to get pregnant in the future. Pregnancy and childbirth can cause leakage to happen again.
Common Types of surgery
The two most common types of surgery for urinary incontinence are:
- Sling procedures. The mid-urethral sling is the most common type of surgery to treat stress incontinence. The sling acts like a hammock to support the urethra and hold the bladder in place.
- Colposuspension. This surgery also helps hold the bladder in place with stitches on either side of the urethra. This is often referred to as a Burch procedure.