What Is Female Incontinence
Female incontinence describes the inability to hold in urine until youre ready to use the toilet. Incontinence causes leaks and sometimes full loss of control over your bladder.
Although there are different types of female incontinence, including overactive bladder and mixed incontinence, many women struggle with one type: stress incontinence.
Causes Of Stress Incontinence
Weak Tissues Lead to Leaks
Weakness of the pelvic floor muscles and tissues that support the bladder and urethra causes stress incontinence. These muscles and tissues may be weakened by a variety of things. Some of the factors that contribute to the disorder are modifiable, and some are not. Knowledge is power. Knowing the modifiable factors is the first step toward managing the condition.
Causes of Pelvic Floor Muscle Weakness
Anything that damages, stretches, or weakens pelvic floor muscles may lead to stress incontinence. Some causes cannot be changed. Increasing age and female gender increase the risk. Pelvic floor surgery, injury to the nerves in the lower back, chronic coughing, smoking, obesity, and pregnancy and childbirth are also causes. Women who have multiple pregnancies are at an even greater risk, as are those who have undergone a C-section.
What Are The Treatment Options For Women With Stress Urinary Incontinence
Women have both non-surgical and surgical options to treat SUI.
Not every woman with SUI will need surgery. Some factors you should consider before deciding whether to undergo surgery include:
- the severity of your SUI symptoms and their effect on your daily activities;
- your desire for future pregnancy as vaginal delivery can cause recurrence of SUI symptoms, which could require future surgery
NONSURGICAL TREATMENT OPTIONS
Examples of nonsurgical treatment options for SUI include:
- Pelvic Floor Exercises: A type of exercise to strengthen the pelvic floor by contracting and relaxing the muscles that surround the opening of the urethra, vagina, and rectum. These exercises, commonly referred to as Kegel exercises, improve the muscles strength and function and may help to hold urine in the bladder longer.
- Pessary: A removable device that is inserted into the vagina against the vaginal wall and urethra to support the bladder neck. This helps reposition the urethra to reduce SUI.
- Transurethral Bulking Agents: Collagen injections around the urethra that make the space around the urethra thicker, thus helping to control urine leakage. The effects may not be permanent.
- Behavioral Modification: This includes avoiding activities that trigger episodes of leaking.
SURGICAL TREATMENT OPTIONS
Surgical mesh in the form of a “sling” is permanently implanted to support the urethra or bladder neck in order to correct SUI. This is commonly referred to as a “sling procedure.”
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What Should I Do After My Surgery To Treat Stress Urinary Incontinence
- Continue with annual check-ups and follow-up care, notifying your health care provider if complications develop, such as persistent vaginal bleeding or discharge, pelvic or groin pain, or pain during sexual intercourse. There is no need to take additional action if you are satisfied with your surgery and are not having complications or symptoms.
- If you have complications or other symptoms:
- Discuss complications and treatment options with your health care provider. Only your health care provider can give you personalized medical advice.
- Consider getting a second opinion from a surgeon who specializes in female pelvic reconstruction if you are not satisfied with your discussion with your health care provider.
Treatment Of Fecal Incontinence
The first step in treating your fecal incontinence is to see a doctor. Your doctor will talk to you about the causes of fecal incontinence and how they can be treated. Simple treatmentssuch as diet changes, medicines, bowel training, and exercises to strengthen your pelvic floor musclescan improve symptoms by about 60 percent.5 These treatments can stop fecal incontinence in 1 out of 5 people.5
Your doctor can recommend ways you can help manage and treat your fecal incontinence. Your doctor can also recommend ways to relieve anal discomfort and cope with your fecal incontinence.
You can play an active role in your treatment by talking openly and honestly with your doctor about your symptoms and how well your treatments are working.
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Can Incontinence Be Prevented
Different events throughout your life can lead to many of the things that cause incontinence. The muscles that support your pelvic organs can weaken over time. For women, these muscles can also be weakened by big life events like pregnancy and childbirth. However, in the same way you work out to build strength in your legs or arms, you can do exercises to strengthen your pelvic floor muscles. Doing exercises to strengthen your pelvic muscles may not prevent you from having any issues with incontinence, but it can help you regain control of your bladder. Maintaining a healthy body weight can also help with bladder control. Talk to your healthcare provider about the best ways to maintain strong pelvic floor muscles throughout your life.
Be Ready And Prepared
Despite your best efforts, accidents may still happen from time to time. There are many products that can help you feel confident being out and participating in the world. Adult diapers are one option to stay dry in the event of an accident if you tend to leak large amounts. Disposable pads worn in underwear may be enough protection if you are prone to smaller accidents. Waterproof underwear is another safeguard to help keep clothing from getting wet. If nighttime accidents are a concern, disposable pads can be placed on the bed to protect the mattress.
Loss of urine can be irritating to the skin. Keep skin clean and dry. Ask your doctor for recommendations about cleansers that are gentle enough to be non-irritating to the area around the urethra. Creams are also available to help block the urine from the skin. If strong urine smell is distressing, deodorizing tablets are available to help cut down on odor.
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Symptoms Of Stress Incontinence
Common in Women
Stress incontinence occurs when pelvic floor muscles weaken. The condition is the most common type of urinary incontinence in young women. Stress incontinence is the second most common type in older women. Activities like exercise, walking, stretching, bending, laughing, coughing, sneezing, or lifting place strain on weakened pelvic floor muscles, and that leads to leaks. Any activity that increases physical strain on pelvic floor muscles may lead to stress incontinence–even sex. The amount that leaks varies. It may be a few drops or up to a tablespoon or more, depending on severity.
Some studies suggest 24% to 45% of women over the age of 30 suffer from stress incontinence. If you suffer from urinary incontinence, you are definitely not alone. Weakness in not just the pelvic floor muscles, but also in the urethral sphincter often plays a role in this type of urinary incontinence.
Causes Of Urinary Incontinence
Stress incontinence is usually the result of the weakening of;or damage to the muscles used to prevent urination,;such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it;from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
Find out more about the;causes of urinary incontinence.
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How Do I Cope With My Fecal Incontinence
Doing the following can help you cope with your fecal incontinence:
- using the toilet before leaving home
- carrying a bag with cleanup supplies and a change of clothes when leaving the house
- finding public restrooms before one is needed
- wearing absorbent pads inside your underwear
- wearing disposable underwear
Causes Of Bowel Incontinence
The most common cause of bowel incontinence is damage to the muscles around the anus . Vaginal childbirth can damage the anal sphincters or their nerves. That’s why women are affected by accidental bowel leakage about twice as often as men.
Anal surgery can also damage the anal sphincters or nerves, leading to bowel incontinence.
Other potential causes of bowel incontinence include:
- Nerve damage
- Radiation damage to the rectum
- Cognitive impairment
- Rectal prolapse, where your rectum drops down into your anus
- Rectocele, a condition in women where your rectum pushes through your vagina
- Loss of stretch of the rectum, which can happen with scarring and stiffening after surgery, radiation treatment, or inflammatory bowel disease
Itâs common to have more than one cause of bowel incontinence. Doctors sometimes are unable to determine the cause.
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What Is Bowel Incontinence
Bowel incontinence is when youâre not able to control your bowel movements. It’s a common problem, especially among older adults, and ranges from irregular stool leaks while passing gas to a total loss of control of your bowels.
Accidental bowel leakage isnât usually a serious medical problem. But it can dramatically interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment.
Many effective treatments can help people with bowel incontinence. These include:
Talking to your doctor is the first step toward freedom from bowel incontinence.
Surgical Treatments For Ui
Surgery to treat stress incontinence is available and works by giving more support to the urethra. There are also procedures available to treat urge incontinence.
Our doctors will help to decide if a procedure or surgery is the best option for you and will walk you through how it works as well as answer any questions you may have.
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Treatments For Bowel Incontinence
Bowel incontinence is usually treatable. In many cases, it can be cured completely.
Recommended treatments vary according to the cause of bowel incontinence. Often, more than one treatment method may be required to control symptoms.
Non-surgical treatments are often recommended as initial treatment for bowel incontinence. These include:
These steps may be helpful:
- Eat 20 to 30 grams of fiber per day. This can make stool more bulky and easier to control.
- Avoid caffeine. This may help prevent diarrhea.
- Drink several glasses of water each day. This can prevent constipation.
Who Suffers From Stress Incontinence
According to the National Institute of Diabetes and Digestive and Kidney Diseases , women are twice as likely as men to suffer from involuntary leakage. The most common causes of stress incontinence among women are pregnancy and childbirth, especially having multiple vaginal deliveries. During pregnancy and childbirth, the sphincter and pelvic muscles stretch out and are weakened.
Older age and conditions that cause a chronic cough can also cause stress incontinence. This condition can also be a side effect of pelvic surgery.
Some women only suffer from stress incontinence during the week before they get their period. The NIDDK explains that estrogen drops during this phase of the menstrual cycle, which can weaken the urethra. This is not common though.
Among men, prostate surgery is a common cause of stress incontinence. The prostate gland surrounds the male urethra, and its removal can result in the loss of support of the urethra.
Other risk factors for stress incontinence include:
- smoking due to chronic cough
- any other condition associated with chronic cough
- excessive caffeine and alcohol use
Treatment for stress incontinence varies according to the underlying cause of your problem. Your doctor will help you come up with a treatment plan using a combination of medications and lifestyle adjustments.
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What Questions Should I Ask My Surgeon If I Am Considering Surgery To Treat Stress Urinary Incontinence
Ask your surgeon about all SUI treatment options, including non-surgical options and surgical options that do and do not use mesh slings. It is important for you to understand why your surgeon may be recommending a particular treatment option to treat your SUI.
Any surgery for SUI may put you at risk for complications, including additional surgery. One complication that may occur when mesh slings are used is vaginal mesh erosion, which could require additional surgery to resolve.
If mesh erosion occurs through the vaginal tissue, it is possible that men may experience penile irritation and/or pain during sexual intercourse.
Ask your surgeon the following questions before you decide to have SUI surgery:
Incontinence And Mental Health
So, back to the chicken and egg question. Both anxiety and depression have been found in many patients with incontinence. But was the incontinence caused by the mental health problems or did the mental health problems cause the incontinence?
It turns out its a two way street when it comes to anxiety and urinary incontinence. Anxiety and incontinence interact and exacerbate each other. And, anxiety is a risk factor for developing incontinence.
The same appears to be true with other mental health issues, like depression, which is also a risk factor for developing incontinence. Several studies have linked depression to urinary incontinence in women especially. And, people with pelvic floor disorders are three times more likely to experience depression than the general population.
Anxiety even rears its head when you start talking about overactive bladder. ;According to one study, 48% of patients with overactive bladder exhibit anxiety symptoms. Plus, according to the same study, about 24% of OAB patients have moderate to severe anxiety.
While anxiety and incontinence dont have to go together, its easy to see how incontinence can cause anxiety — maybe even more anxiety than you started with.
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Important Points In Treatment
If you have stress incontinence, your physician will carefully evaluate you to be sure that you have no infection of the urinary tract. You should have with you a list of all the medications you are currently taking. Include your over-the-counter drugs as well as your prescription drugs. Drugs do not cause stress incontinence, but some cause the condition to get worse.
Exercises are often helpful, particularly Kegel’s exercises. The goal of these exercises is to make you aware of and be in control of the muscles that are involved in urination. The best way to become aware of these muscles is to stop your urinary stream and then restart it voluntarily. Become familiar with the process of tightening, stopping urination, relaxing, and then starting urination with these muscles. Once you are familiar with these muscles, try tightening and relaxing them at other times . Do these exercises three times daily, starting with five sets of tightening and then relaxing the muscles at each session, for a total of 15 sets per day. Pro gress slowly up to 25 sets at each session, for a total of 75 sets per day.
Overweight patients will notice a decrease in the frequency of involuntary urination when they lose weight.
MAT H. HO, NARENDER N. BHATIA, in, 2007
What You Can Do
Its easy for someone on the outside to say just dont worry, right? However, this is definitely one of those things thats easier said than done. If you have significant anxiety or depression, please give your doctor a call. For the more common daily stressors in all of our lives, there are things you can do to help you worry less and hopefully decrease leaks too.
One option is to use absorbent products, so that the only person that knows you leaked is you. NAFC recently conducted a study that found that those who felt positively about wearing absorbent products said it was because it made them feel more protected and in control. And who doesnt want to feel more in control? Plus, Lily Bird can help take the stress out of going to the store by delivering pads and disposable underwear straight to your door.
Dont forget about trying pilates to doing Kegels or making dietary changes to see if that helps with incontinence or stress, too. Whether your stress is a symptom or a cause, getting it under control can help no matter what situation youre in.
~Written by Lily Bird, a proud Trusted Partner of NAFC
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Causes Of Urinary Incontinence In Dogs
There are many causes of incontinence in dogs, including:;
- Urinary tract infection
- Inherited medical condition that occurs at or before birth
- Hormonal imbalance
- Prostate disorders
- Diseases that cause excessive drinking of water, for example, diabetes, kidney disease, and Cushings disease
- Some medications, like corticosteroids
- Urinary stones
How Is It Treated
Treatments are different for each person. They depend on the type of incontinence you have and how much it affects your life. After your doctor knows what has caused the incontinence, your treatment may include medicines, simple exercises, or both. A few men need surgery, but most do not.
There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.
- Cut back on caffeine drinks, such as coffee and tea. Also cut back on fizzy drinks like soda pop. And don’t drink more than one alcoholic drink a day.
- Eat foods high in fibre to help avoid constipation.
- Don’t smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Stay at a healthy weight.
- Try simple pelvic-floor exercises like Kegels.
- Go to the bathroom at several set times each day, and wear clothes that you can remove easily. Make your path to the bathroom as clear and quick as you can.
- When you urinate, practice double voiding. This means going as much as you can, relaxing for a moment, and then going again.
- Keep track of your symptoms and any leaking of urine with a bladder diary. This can help you and your doctor find the best treatment for you.
If you have symptoms of urinary incontinence, don’t be embarrassed to tell your doctor. Most people with incontinence can be helped or cured.
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