Incontinence: Everything You Need To Know

If you've been experiencing a leaky bladder and searched around for answers to your problem, you've probably heard the term 'incontinence' being thrown around quite a bit. But what exactly is urinary incontinence? And how does it affect you?

Urinary incontinence is a term to describe urine leaks. There are several different types of incontinence that may be contributing to these unexpected accidents. And, with so many variations, it can be tricky to fully understand why you're leaking or what to do about it.

Whilst we cannot replace a visit to your doctor (and you should see your doctor if you are experiencing bladder leaks for the first time)r, , we are here to help. That's why we've put everything you need to know about incontinence in one handy place. So, get ready to say goodbye to discomfort and embarrassment and hello to a new lease on life!

Understanding Incontinence

Have you ever found it really difficult to control when you pee? You're not alone.

Urinary incontinence (UI) refers to loss of bladder control, which can lead to accidental urine leaks. You may notice a small amount of pee escapes when you laugh or sneeze, for example, Alternatively, you may feel the sudden and super overwhelming urge to pee but struggle to reach the loo in time.

Although incontinence can feel embarrassing, it's important to remember that it's a common issue that plenty of women experience. And it becomes even more common after life events like pregnancy - or even as you age and go through menopause.

Risk Factors For Urinary Incontinence

Urinary incontinence can affect anyone. However, some people are more likely to experience UI due to several factors. These include:

• Women: Women are generally more prone to urinary incontinence than men. This is particularly true after pregnancy, childbirth, and menopause because of the hormonal changes we experience through these life stages.

• Age: As we get older, the muscles that support our bladder get weaker, which can make it harder to control the urge to pee.

• Pregnancy and childbirth: Carrying a baby and giving birth puts a massive strain on your bladder muscles. It may also damage the nerves around your pelvis, which can lead to incontinence.

• Medical conditions: Certain medical conditions like diabetes and multiple sclerosis can damage the nerves and muscles that are involved in your bladder control.

• Weight: Being overweight can put additional pressure on your bladder, which can cause leaks. This is particularly common during certain activities like coughing or lifting heavy objects.

• Smoking: If you're a smoker, it's important to know that you may be at a higher risk of developing incontinence. Smoke is a bladder irritant, which means you may feel the need to pee more frequently. Plus, if you've been smoking for long enough, the constant coughing can weaken your pelvic floor muscles and cause you to leak urine.

Types Of Urinary Incontinence

Urinary incontinence is actually an umbrella term since it can come in several different forms. Knowing which type you're dealing with can help you find relief from the symptoms you're experiencing.

Stress urinary incontinence

Stress incontinence is incredibly common for older women and those who have been pregnant and given birth since it's usually connected to weaker bladder muscles. This happens when there's pressure or strain on your pelvic floor caused by things like laughing, coughing, sneezing, or lifting. When you do any of these activities, your body naturally tenses up to prevent leaks but since you have a weaker pelvic floor, it is not able to do as good a job, which can lead to leaks.

Urge urinary incontinence

Urgency or urge incontinence typically involves a sudden and urgent need to pee. Although it doesn't always cause leaks, it's incredibly common - especially when you can't find a loo in time. It's also commonly associated with an overactive bladder (OAB) and other conditions that affect your bladder control.

This urgency can happen pretty frequently, too, and may even wake you up at night. In turn, urge incontinence can lead to a loss of sleep or anxiety around being away from a bathroom when you leave your home.

Overflow incontinence

Overflow incontinence can be a real inconvenience caused by an inability to empty your bladder completely. Since your bladder is never technically empty, overflow incontinence can lead to a constant dribble of urine or bigger leaks when your bladder is full.

Generally, overflow incontinence is caused by nerve damage, blockages, a weakened bladder muscle, or certain medical conditions like diabetes. While it's more common in men with enlarged prostates, it also affects a significant number of women.

Overactive bladder

Overactive bladder actually refers to a group of symptoms, which is why it may be associated with other forms of incontinence like urge incontinence. Like urge incontinence, it typically causes an incredibly strong urge to pee that comes without warning.

By the time you feel the urge to pee, it may be too late, and you may experience some leaks before you're able to get to a nearby toilet. Alternatively, you may feel the need to pee more at night or during the day.

Although the root cause of OAB isn't always clear, it may be linked to things like nerve damage or bladder irritation.

Mixed urinary incontinence

Mixed urinary incontinence is exactly what it sounds like: a combination of multiple types of urinary incontinence. So, if you find yourself experiencing symptoms of both stress and urgency incontinence, then it may be caused by mixed incontinence.

Reflex incontinence

In some cases, your bladder may empty itself spontaneously without feeling as though you need to pee. This is known as reflex incontinence and is more common in people who have multiple sclerosis, those with nerve damage around their pelvis, or other neurological conditions. Another common cause for this is spinal cord injury.

Temporary incontinence

Some types of urinary incontinence are short-term and linked to temporary issues. For example, you may experience urinary incontinence if you have a urinary tract infection (UTI) or when you're taking specific medications or if you have been coughing a lot recently.

This type of incontinence usually clears up on its own. But it’s always best practice to discuss symptoms like these with your GP or a urologist.

Nocturnal enuresis

Also known as bedwetting, nocturnal enuresis isn't just a condition that affects children.

Sometimes, you may find yourself losing control of your bladder during sleep. Of course, this can be uncomfortable and embarrassing (especially if you share your bed with someone else). However, this is more common than you may think and should be addressed if it's an ongoing issue.

When this happens in adulthood, it's typically linked to things such as OAB or sleep disorders. It may also manifest as getting up multiple times at night to pee (nocturia).

Functional incontinence

A less common type of incontinence is functional incontinence. This is when a person with limited mobility or certain conditions isn't able to reach the loo in time, despite having normal bladder function.

While it's less common, it's important to note that it can occur in patients with dementia, arthritis, Parkinson's, or other physical or cognitive challenges.

How Is Urinary Incontinence Diagnosed?

When you're experiencing symptoms of urinary incontinence, it can be hard to open up about it. After all, it can feel embarrassing and even isolating. It may also be causing a lot of anxiety. The constant worry that you may leak urine or that you may not find a bathroom in time can leave you feeling hopeless.

The most important thing to remember is that this is more common than you may think, so the best approach is to schedule an appointment with your GP as soon as possible. Doing this also means you can work together with your GP to find a solution and get one step closer to relief from the discomfort that urinary incontinence causes.

Speaking to your GP

During your appointment with your GP, they will typically start by asking about your symptoms and how incontinence affects your daily life. This can give them a good idea of the severity of your condition, and rule out any other reasons for your leaks.

They may ask questions about:

• When you experience leaks

• How often you leak urine

• What activities or situations cause your symptoms

• Whether you experience any pain or discomfort when you empty your bladder

If you don't know the answers to these questions, don't worry. Your GP may ask you to keep a bladder diary for the next few days to track your bathroom habits.

Tip: It may be a good idea to go into your initial appointment with a completed bladder diary. This means your GP can more easily pinpoint what type of incontinence you're dealing with.

Physical exam

Depending on your symptoms, a GP or women's health specialist may perform a physical exam to test the strength of your pelvic floor muscles/ check for pelvic organ prolapse. It also helps them to rule out any obvious physical issues that may be causing your incontinence.

Tests

If your medical team needs more information than a physical exam can provide, your GP may suggest some simple tests to single out the cause of your incontinence. These may include:

• Urinalysis: For this test, you'll need to provide a urine sample, which is tested for signs of infection or blood. It also looks for any other abnormalities that may be causing your symptoms.

• Post-void residual test: Although it sounds complicated, this is a simple test that checks whether your bladder is fully emptied after you pee.

• Bladder scan: A bladder scan or ultrasound can help to pick up issues like bladder stones that could be causing blockages and leading to urinary incontinence.

Often most people gain a diagnosis after this stage but in some cases, your GP may also refer you to a women's health specialist or urologist for more advanced tests like:

• Urodynamic testing: This is a more advanced version of the post-void residual test. Typically, it assesses how well your bladder and urethra store and release urine. It does this by measuring the flow, pressure, and muscle activity when you pee.

• Cystoscopy: If your symptoms are more severe, your urologist may need to insert a small, thin tube with a camera into your bladder. They do this to check for any abnormalities that may not be picked up with a bladder scan.

The next steps

After tests have been done, your medical team should be able to diagnose the cause of your urinary incontinence. In turn, this will determine what treatment options will work best for your specific case.

Together, you and your team can come up with a treatment or management regime to restore your bladder control or ease your symptoms and make them more manageable on a day-to-day basis.

Urinary Incontinence Treatments

The good news is that urinary incontinence is often treatable, with tons of different options available to help you manage your symptoms.

Of course, your treatment regime will depend on the type of incontinence you're experiencing and how severe your symptoms are. The most common treatments typically include:

Medications

If your incontinence ranges from mild to severe, your GP may prescribe different medications to ease your symptoms and reduce any discomfort you have.

Usually, these medications work by relaxing your urethral sphincter muscle (which controls the flow of your urine).

When this muscle is relaxed, your bladder won't send any unnecessary alerts to your brain to signal that it's time to empty your bladder. That means your bladder is less likely to spasm or start contracting, and you'll regain control over when and how often you pee. Plus, it reduces the likelihood that you'll have unexpected leaks.

For menopausal women, a topical oestrogen cream may also help to restore the muscle tone in your pelvic area.

Medical devices

If you're experiencing stress incontinence, a medical device may be the best course of action to eliminate unwanted leaks. For example, urethral inserts may be placed inside your urethra to prevent leaks during physical activity or exercise. Pessaries can be inserted directly into the vagina to support your bladder and the surrounding muscles.

Nerve stimulation therapy

For women with overactive bladder or urge incontinence, nerve stimulation therapy has proven to have extraordinary results. This includes two types of stimulation therapy:

Percutaneous tibial nerve stimulation (PTNS): This is when a small electrode is inserted near your ankle to stimulate the nerves that control your bladder. It's typically done during a series of treatments, which means it's an ongoing way to ease your symptoms.

Sacral nerve stimulation (SNS): For this type of therapy, a device is implanted near the sacral nerve in your lower back. Similar to PTNS, it allows for electrical stimulation that is connected to your bladder and helps to regulate your bladder function.

Surgical treatment

If your urinary incontinence affects your life in more significant ways or is more severe, there may be a need for surgical treatment. However, it's important to remember that this is typically used as a last resort, and isn't the most common route to take to treat this condition.

The type of surgery will also be determined by the type of incontinence you're experiencing. For example, bladder slings are used for stress incontinence, while bladder reconstruction may be necessary if the bladder needs to be enlarged.

Botox

For an overactive bladder or urge incontinence, another treatment option is Botox. This is injected directly into the bladder muscle to help it relax and potentially increase your bladder capacity.

Botox may be a more effective treatment if you haven't responded to other non-surgical treatments.

How To Manage Incontinence In Everyday Life

Medical or surgical treatments aren't always necessary. In fact, if you only have mild to moderate symptoms, there are some easy management techniques to bring you relief. Depending on the type of incontinence you are experiencing you may be able to combine these techniques with medical treatments to regain control of your bladder and ease your anxiety around potential leaks.

Bladder re-training

This technique is helpful for those experiencing overactive bladder or urge incontinence. Bladder re-training involves gradually increasing the time between your trips to the loo. This can help to strengthen your bladder muscles and make it easier for you to hold your pee when you get the urge to use the bathroom.

When you're practising this technique, just remember to listen to your body. Don't try to hold your pee for longer than you realistically can. It is best to complete bladder re-training under the supervision of a healthcare professional as they can offer additional support and monitoring.

Pelvic floor exercises (Kegel exercises)

If you are experiencing stress incontinence then a great way to support your bladder and regain control is to practice pelvic floor exercises. Exercises like Kegels strengthen your pelvic floor muscles, which directly impact your bladder control.

This may also be worthwhile for other types of incontinence when paired with the right medications and treatment.

If you're unsure of where to start or the proper techniques to use, then a pelvic floor specialist can help guide you through the safest and most effective way to exercise these muscles.

Incontinence products

Are you anxious over potential leaks when you're out and about?

We know the worry of leaking while you're at work or running errands. Fortunately, incontinence products like incontinence pads or leak-proof pants are the ideal solution for keeping you dry and fresh all day long. Plus, with discreet and comfortable products from Hey Jude, you can step out in complete confidence.

FAQs

Are there any natural remedies for incontinence?

While there are plenty of non-invasive treatments and management techniques for urinary incontinence, medical intervention is sometimes unavoidable. However, there are some natural supplements on the market that may help some people.

For example, Jude's bladder care supplements have been tested in clinical trials and shown positive results. Supplements tend to have fewer side effects which means you can enjoy results with reduced risk. However, it is important to check with your GP before starting a new supplement to ensure it is right for you in the context of your medical history.

How do I talk to a doctor about incontinence?

The best way to approach the subject with your GP is to be completely transparent. Urinary incontinence is incredibly common and is easily treatable when you seek out the right treatment with a medical professional. It may help you plan what you want to say and speak to others in similar situations. The Jude Community on Facebook is full of women going through similar experiences.

Final Thoughts

Now that you have a better idea of what may be causing your bladder leaks, it's time to get off your porcelain throne and find the relief you need. With the right treatment and management regime, you can rediscover the freedom of a stronger and healthier bladder in no time.

Just remember: There's no shame in your condition. So, be sure to speak up and seek medical advice without shame when you notice the symptoms of urinary incontinence.