What causes urinary incontinence?
There are several reasons why urinary incontinence occurs, including:
- Weakened pelvic floor muscles: Pelvic floor muscles support the bladder and the urethra, and when they become weak it’s harder to effectively hold in urine. Women often experience a weakened pelvic floor due to pregnancy and childbirth. Hormonal changes during menopause can also cause the tissue in your pelvic floor to thin and weaken.
- Nerve damage: If the nerves that control your bladder become damaged, it can cause involuntary contractions and incontinence.
- Prostate problems in men: When the prostate gland enlarges, typically among older men, it can press against the urethra and disrupt the normal flow of urine.
- Certain medications: Medications like diuretics can increase your need to urinate. Conversely, some medications cause dry mouth and dehydration which leads to an increased risk of incontinence.
- Chronic constipation: If the rectum is full of stool, it can apply pressure to the bladder and lead to incontinence.
- Obesity: Being overweight or obese can put extra pressure on the pelvic floor muscles and increase the risk of incontinence.
What are the different types of urinary incontinence?
Though common, urinary incontinence shows up differently from person to person. There are four primary types of urinary incontinence:
- Stress urinary incontinence (SUI): This is when everyday physical activity or movement like laughing, coughing or sneezing puts pressure on the bladder, causing urine loss.
- Urge (or overactive) incontinence: This is defined as having a strong urge to urinate, along with an inability to hold it in. Sometimes called overactive bladder (OAB), this is when the bladder muscles involuntarily contract.
- Overflow incontinence: As the name implies, overflow incontinence is when the bladder is when the bladder is full and a person is unable to empty it. This causes urine to leak as a result. Typically overflow incontinence is caused by a nerve problem or an obstruction in the urinary tract.
- Functional incontinence: Functional incontinence is when a physical or cognitive impairment like Parkinson’s disease or dementia prevents someone from reaching the toilet in time.
How is urinary incontinence treated?
Treatment options for urinary incontinence are dependent on the type and severity of your condition. Options include behavioral therapy, drugs, neuromodulation and surgery. At Austin Urology Institute, we usually recommend a combination of therapies for your unique situation.
Behavior Therapy
- Timed voids: Timed voids train your bladder, helping control any urges. This involves voiding every 2-3 hours during the day, and avoiding any fluids two hours before going to sleep. It’s important to empty your bladder before bedtime.
- Kegels (pelvic muscle exercises): These are specific exercises that can be done in combination with antimuscarinic drugs, minimizing any unwanted urges.
- Diet: Certain foods, drinks or dietary habits can make incontinence worse. Try to minimize the amount of acidic foods, alcohol, caffeine, energy drinks and artificial sweeteners in your diet. Weight loss and smoking cessation can also alleviate symptoms.
Drugs
- Antimuscarinics: This is a family of medicines that help treat overactive bladder, using an agent that relaxes the detrustor to prevent a bladder contraction.
- Beta-3 Agonist: Commonly known on the market as Myrbetriq, this is a medication that signals to bladder receptors that the bladder should fill up properly before getting the urge to contract.
- Vaginal estrogen: Because estrogen keeps vaginal and urethral tissue strong and healthy, women going through menopause often experience atrophy due to hormonal changes. Vaginal estrogen comes in both tablets and creams, and restores weakened pelvic tissue.
- Axonics Bulkamid: Bulkamid consists of gel-based injections that “bulk up” the urethral opening, preventing bladder leaks. This is an increasingly popular treatment that offers relief to at least 92% of patients.
- Bladder Botox: Yep, Botox can also help an overactive bladder! It works by relaxing the bladder muscles, reducing frequency, urgency and leakage.
Neuromodulation
When drugs and behavioral therapies fall short, electrical stimulation of the nerves or pelvic region can help address an overactive bladder and incontinence. At Austin Urology Institute we use Axonics neuromodulation device, a two-stage sacral nerve stimulation technique.
Surgery
Surgery can be especially beneficial for women who experience vaginal prolapse in addition to incontinence.
What treatment is best for me?
If you’re someone who is suffering from urinary incontinence, rest assured that you’re not alone. Contact Austin Urology Institute to set up an appointment so we can further evaluate your symptoms and come up with a plan that works best for you: (512) 694-8888.