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Urinary Incontinence: Are you peeing your pants?

What is urinary incontinence?

Urinary incontinence refers to the accidental leaking of urine. While it is not a disease by itself, it is a symptom which suggests that something may be wrong with your urinary tract.

urinary problems in men, urinary problems

Urinary incontinence causes

What causes incontinence in men?

The urinary system is a combination of nerves and muscles that must work in tandem for it to function properly. A mismatch in either of them can lead to incontinence. Following are the some of the causes of incontinence:

  • Nerve damage in men due to prolonged and unmanaged or mismanaged diabetes impacts the bladder control.
  • Nervous system diseases such as stroke, Parkinson’s diseases, or multiple sclerosis can also cause bladder issues.
  • Spinal cord injury can interrupt the nerve signals that control the bladder muscles and thus cause incontinence.
  • Prostrate conditions such as surgery, removal or radiation treatment due to cancer, or enlarged prostate (benign prostatic hyperplasia) can also lead to bladder incontinence.
  • Bladder contractions due to urinary tract infections, prostatitis, kidney or bladder stones, can cause urge incontinence.
  • Urethral stricture causing narrowing of the urethra can also lead to overflow continence.
  • Some medications such as diuretics, decongestants, antihistamines are also known to cause urinary incontinence.
  • Substance abuse such as caffeine, alcohol consumption, carbonated drinks, artificial sweeteners, spicy foods, etc. can stimulate the bladder and increase the urine volume.

urinary problems

 

Urinary incontinence types

There are different types of  incontinence:

  • Stress incontinence – Is the involuntary loss of urine during coughing, laughing, sneezing, lifting, etc., activities which exert abdominal pressure.
  • Urge incontinence – happens when you have an overwhelming urge to urinate and you are unable to control it.
  • Overflow incontinence – Is the constant dribbling of the urine due to frequent and incomplete urination.
  • Total incontinence – Can happen when your sphincter muscle is no longer functional. You tend to leak urine all the time.
  • Functional incontinence – This occurs when you are unable to reach the bathroom in time due to hurdles or if you were physically unable to get yourself there in time.

The urinary incontinence occurrence differs in men and women based on the age factors. For instance, in childhood, the girls tend to get better bladder control earlier than boys, whereas adult women tend to have this condition more than men due to anatomical pelvic region differences and pregnancy and childbirth. Age does play a role in the prevalence of this symptom, is not an inevitable cause of incontinence.

Urinary incontinence diagnosis

Diagnostic methods

If you suspect that you have been leaking urine, while sneezing, coughing, exerting pressure, sleeping, or unable to control urine, you must visit your physician immediately. Your doctor may use the following methods to determine the cause of your symptoms and provide treatment options:

  • Medical history – Your doctor will seek your medical history, regarding major illnesses or surgeries that you may have, your lifestyle habits, your medications prescribed and non-prescribed.
  • Physical examination – Digital examination to check for prostate enlargement or any nerve damages.
  • EEG and EMG – Your doctor may ask you to get electroencephalogram and electromyogram to determine the cause of loss of bladder control.
  • Ultrasound – Abdominal and transrectal ultrasound may be done to look for images of the prostate or any mass.
  • Urodynamic testing – This testing checks the bladder’s ability to store urine and empty it steadily and completely and tests the sphincter control mechanism. It can help in identifying limited bladder capacity, overactive or underactive bladder, or any form of urinary obstructions.

Urinary incontinence treatment

Treatment options for incontinence

Treatment of urinary incontinence varies from person to person and case to case. Depending on the cause and the severity of the conditions, your doctor may recommend a combination of treatment options. Many times, a simple adjustment in the lifestyle can treat the problem. Behavioural changes such as avoiding fluids at the certain time of the day can also help control the incontinence. Your doctor can also teach you kegel exercises to strengthen your pelvic muscles which help hold the urine in the bladder. A urinary continence device like an artificial sphincter or catheter may also be recommended. If none of the above treatments works, you may choose to try medicines or a continence device—either an artificial sphincter or a catheter. Sometimes, surgery to may be required. For some men, surgery is the best option. 

Incontinence, though socially may be an awkward situation, however, it is like any other condition such as arthritis or diabetes. With proper diagnosis and treatment, this condition can be solved. It is important that you neither ignore or hide it and visit your physician promptly.

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References

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  • Urinary Incontinence in Men – National Institute of Diabetes and Digestive and Kidney Disease – Accessed on May 7, 2016 – http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-incontinence-in-men/Pages/facts.aspx
  • Urinary incontinence – Causes — NHS — Accessed on May 7, 2016 – http://www.nhs.uk/Conditions/Incontinence-urinary/Pages/Causes.aspx
  • Urinary incontinence in men – UptoDate — Accessed on May 7, 2016 – http://www.uptodate.com/home.
  • Overactive bladder –HealthCommunities — Accessed on May 7, 2016 – http://www.healthcommunities.com/overactive-bladder/primary-secondary-incontinence.shtml

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