Female Incontinence
Urinary incontinence (IU) is an inability to hold your urine until you go to the toilet.
Being in control of your bladder means that you are able to postpone the need to go to the toilet until it is convenient.
If you answer “yes” to any of the following questions then you may be suffering from a bladder control problem:
- Do you experience urine leakage during physical activity suchas lifting a heavy object during exercise or changing position?
- Do you experience urine leakage while coughing, sneezing or laughing?
- Has your sleep regularly been interrupted 2 to 3 times a night by trips to the toilet?
- Do you frequently experience strong or sudden urges to go to the toilet and not make it to the toilet on time?
- Do you wear protective underwear to protect yourself from urine leakage?
- Do you normally need to urinate 8 or more times a day?
Female incontinence is a common problem and a major source of aggravation for many women as they go through life.
The condition presents itself more frequently in older female patients however incontinence is not just an elderly problem nor is it an inevitable part of aging. Women experience IU twice as often as men in their lives. Pregnancy, childbirth, menopause and the structure of the female urinary system account for this difference.
What does the bladder system look like?
The bladder stays relaxed when full of urine. When you want to go to the toilet the bladder muscle tightens. This squeezes the urine from the Bladder. The urethra is surrounded by the sphincter muscle. The sphincter muscle keeps the bladder closed by squeezing it tightly. The pelvic floor muscles also keep the urethra closed. Therefore urine stays in the body when the pelvic floor and sphincter muscles are tight and the bladder is relaxed. Most bladder control problems happen when the muscles are weak or overactive, however problems can also occur when the nerve signals to the brain are not working properly.
What causes bladder control problems?
If the muscles that keep the bladder closed are weak then you may have accidents when sneezing, laughing or lifting a heavy object. This is called STRESS INCONTINENCE. This is the most common form of incontinence and can also occur after pregnancy, childbirth and during menopause. Lower oestrogen levels the week before your period can also cause a worsening of stress incontinence. Worsening can also be seen with obesity.
Sometimes the bladder muscles are too active which results in a sudden urge to go to the toilet even if your bladder only contains a little urine. This
is called URGE INCONTINENCE or overactive bladder. Causes include bladder infection, nerve damage, drinking alcohol and some medical conditions.Many women can experience what is known as Mixed
Incontinence, where stress and urge incontinence occur together.
Other types of incontinence include OVERFLOW INCONTINENCE where the bladder muscles are weak. It causes you to feel that you have never completely emptied your bladder. Patients can experience urine
leakage day and night.
FUNCTIONAL INCONTINENCE is where you have normal bladder control but have trouble getting to the toilet on time. Causes of this include age (lack of mobility),
arthritis, broken leg and some medical conditions.
Can it be treated?
UI is an embarrassing condition but it is important to remember that loss of bladder control can be treated. Research shows that up to 80% of women never discuss this problem with their GP. If you hide your condition you run the risk of getting sores, rashes, skin and urinary tract infections as well as personal hygiene problems. So your first step is to talk to your doctor.
DO IT YOURSELF routines will help with the symptoms. Pelvic Floor Exercises which strengthen the muscles around the urethra.
Bladder Training
This aims to help you increase the length of time between going to the toilet.
Stop Test. When passing urine, try to stop or slow mid stream. This should not be done more than once a week as it is a test not an exercise routine
Self Test. When in the bath insert 1 or 2 fingers into the vagina and see ifyou can feel the squeeze.
Many women consider the use of protection pads however it is important to say that these will deal with the symptoms but not the underlying problem. Medication may have to be considered in certain situations. Medications will not necessarily stop leakage in all patients but will lessen the problem and reduce the need to use pads.
Points to remember:
- Many women suffer from bladder control problems.
- Bladder control problems affect many women.
- Bladder control problems affect women of all ages.
- Try not to get embarrassed and the first thing to do is to consult your doctor. Bring a bladder control diary with you.
- Most cases of poor bladder control can be improved quickly.
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