Can’t Seem To Control Your Bladder? You’re not alone!
Urinary Incontinence is more common than you may think
What is Urinary Incontinence?
The International Continence Society has defined incontinence as the involuntary leakage of urine and/or feces. Urinary incontinence (UI) is the more common type. It is important to note that incontinence is a symptom of underlying conditions, and should be discussed with a knowledgeable healthcare professional. [1] The Canadian Bladder survey in 2003 found that people of different ages are affected. The following shows age-stratified data (% of men and women with any degree of incontinence): [2]
18 - 40 years: | 41 - 64 years: | 64+ years: |
|---|---|---|
10% of men | 16% of men | 30% of men |
16% of women | 33% of women | 55% of women |
It is estimated that 10% of the total population is affected, which means that approximately 3.5 million Canadians experience some degree of incontinence [3]- a number which is set to increase with the aging baby boomer generation.
Different Types
Stress Incontinence – Occurs when doing activities that increase abdominal pressure which in turn increase the bladder pressure to a point that is stronger than the bladder’s closure mechanism (urethral sphincter). For example: coughing, sneezing, laughing, lifting, jogging.
Urgency Incontinence – Caused by a sudden involuntary contraction of the bladder and is associated with a sudden strong feeling of urgency with the inability to hold it long enough to get to a toilet. This type usually results in small amounts of leakage at a time.
Overflow Incontinence – This type is characterized by frequent leakages that happen without feeling the need to urinate or urinating normal volumes. The bladder remains full while the volume that exceeds capacity leaks out.
Total Incontinence – The total absence of control, either periodically or continuous emptying of the bladder.
Overactive Bladder (OAB) – Is the medical term for a group of symptoms that result from bladder spasms including frequent urination especially at night and feelings of urgency with or without leakage
Mixed – Is a combination of the symptoms of stress and urgency incontinence
Functional – Refers to those who are not originally incontinent but have an inability to make it to the toilet due to mental or physical limitations
Enuresis – The loss of bladder control at night in adults and children who are old enough to be “potty trained” [1]
Impacts on Quality of Life
People who experience UI report impacts on their overall feeling of well-being and feelings of embarrassment and frustration.[4] It causes stress, depression, impedes on interpersonal relationships, decreases sexual function, and increases the risk of debilitating falls, institutionalization and mortality in older adults [5] ; in addition to significant changes in lifestyle and overwhelming anxiety. Many find it is a relief to learn that others have the same problem. [6] Urinary incontinence along with Alzheimer’s disease and stroke have been found to be the top 3 chronic health conditions that most adversely affect ones health-related quality of life. [7] The Canadian Continence Foundation in 2014 estimated that the total direct and indirect costs associated with UI was a total of $5.31 billion, or $6,263 per individual per year. [3]
Common Misconceptions
About half the people who experience incontinence do not consult with healthcare professionals. [8] This is partly due to the fact that some people feel too embarrassed to talk about it, which is why there are many myths surrounding the topic.
“Only old ladies have it” This is false! As mentioned above, there are many women under the age of 65 who are affected, and men experience it too. Although the prevalence does increase with age, many young women start to experience UI after having a baby, yet it can still happen even if you’ve never had children.
“It will get better by itself” The contrary! Over time, incontinent women generally report a worsening of symptoms.
“There’s nothing that can be done about it” Not true! There is a wide variety of treatment options out there that can eliminate the problem. [9]
Treatment Options
Although the Canadian Continence Foundation recommends conservative treatments (non-drug, non-surgical) as the first response to UI, behaviour modification is often overlooked as the first treatment option.
Lifestyle Changes; Healthy Bladder Behaviours
- Limiting or avoiding caffeine/alcohol
- Drinking six to eight cups (1.5-2.0 L) of water or non-caffeinated drinks a day
- Maintaining a healthy weight
- Not smoking
- Not “pushing” when urinating
- Eating more fibre to avoid constipation, therefore limiting strains
Pelvic Floor Retraining
- The use of Kegel exercises to strengthen the pelvic floor muscles and prevent leakages
- The proper use of Kegel exercises requires education and proper training on the techniques provided by a physiotherapist
- Physiotherapy has been shown to be 80% effective in treating stress urinary continence. Meaning that 8 of every 10 surgical treatments for stress incontinence can be prevented using pelvic floor exercises
- It has also been found to be effective in treating postnatal stress incontinence
Bladder Retraining
- Bladder Retraining: Increasing bladder capacity and awareness by encouraging the patient to ignore the first urge and void on their second urge
- Timed Voiding: Voiding on a schedule based on time between incontinent episodes
Intermittent Self-Catheterization
- Some people struggle with the inability to empty their bladders completely. In severe cases the result is overflow incontinence
- This process involves passing a small disposable catheter through the urethra and into the bladder to empty it
- This can be done multiple times per day to keep the bladder from getting too full. Just make sure to do it in a clean environment to avoid infection [3]
Other medical, mechanical and surgical treatments are available but should be discussed with healthcare professionals first.
Author: Katrina Kanbergs, BSc. Kin Candidate
DISCLAIMER
This article is not intended as a substitute for the medical advice of doctors and/or other healthcare professionals. The reader should consult their physician and/or healthcare providers in matters relating to their health.
References
- https://www.canadiancontinence.ca/EN/what-is-urinary-incontinence.php The Canadian Continence Foundation
- Herschorn S, Corcos J, Gajewski J, Schulz J, Ciu E (2003) Canadian Urinary Bladder Survey: Population-Based Study of Symptoms and Incontinence Neurology and Urodynamics 22(5)
- Incontinence: The Canadian Perspective (December 2014), The Canadian Continence Foundation: 3, 11; Miller, D (2007) Office management of stress incontinence: current and future role Clin Obstet Gynecol 50(2):376-82.
- Experience, perceptions and needs among a large-scale Canadian population experiencing incontinence in the community. Unpublished draft prepared by Malvina Klag for The Canadian Continence Foundation, 1998.
- Farage MA, Miller KW, Berardesca E, Maibach HI (2008) Psychosocial and societal burden of incontinence in the aged population: a review Arch Gynecol Obstet 277(4):285-90.
- Older individuals’ perspective on incontinence: Phase I and II qualitative research reports. Prepared by Cherrie Holdings for The Canadian Continence Foundation, 1997, 1998
- Schultz SE, Kopec JA (2003) Impact of chronic conditions Health Rep 14:41–53.
- Angus Reid Group, Urinary incontinence in the Canadian adult population, 1997.
- https://pelvichealthsolutions.ca/for-the-patient/uriniary-incontinence/myths-about-incontinence-for-women/ Pelvic Health Solutions
