Leaky bladder, overactive bladder, urine leakage while coughing and sneezing, frequent urination, leaking bladder – these are all symptoms of urinary incontinence. Urinary incontinence or UI is an involuntary passage of urine. It is a common problem thought to affect millions of people1. Urinary Incontinence may lead to unintentional passing of urine, which is also loss of bladder control or inability to hold urine while doing any activity otherwise normally possible.
More than its physiological impact, it is a distressing problem that has social repercussions and impacts quality of life, in general.
Who can get a leaky bladder?
Urinary incontinence is commonly seen among women, elderly people and those with an underlying neurological problem.
Can I control urine leakage?
Controlling urine leakage is possible depending upon what type of leakage is it. Urinary incontinence can be:
- Temporary, which can be managed or treated and
- Persistent which may be a result of a neurological damage or a condition which cannot be completely treated but can be managed by planning or training the muscles to avoid any accidents.
UI is treatable, if it is caused due to:
- Delirium
- Infection
- Atrophic urethritis and vaginitis
- Pharmaceuticals or drugs causing irritation
- Excessive urine output secondary to other condition
- Restricted mobility
- Stool impaction
Sometimes Urine infection comes with pain in pelvic area. Read more about pelvic pain in women by clicking here.
How to stop urine leakage when coughing or sneezing?
There are a few simple things you could do as self-management for urine leakage. Some of these home remedies include:
- Follow a strict schedule for drinking fluids and using the washroom. This would help in avoiding accidents.
- Weight reduction is also known to help as it reduces extra load on the pelvic floor musculature.
- Avoid constipation. Eat foods which help in easy voiding (passage of stool) which in turn will help the pelvic floor musculature.
- Avoid drinking alcohol, caffeine products and smoking. These are known to irritate the bladder causing overactive bladder.
- Train the pelvic floor with exercises. Kegels is a set of exercises which help in retraining the weak pelvic floor muscles.
What to do if there is urinary incontinence?
If you are suspecting a case of urinary incontinence, here is a list of Do’s and Don’ts to follow.
- Do, exercises for strengthening the pelvic floor.
- Do, low impact overall body exercises.
- Do, avoid constipation.
- Do, follow scheduled voiding timings, keep balanced fluid intake.
- Don’t drink alcohol, caffeine and other irritants.
- Don’t delay getting help.
How can I control urine leakage?
To control urine leakage, one should consult a qualified medical practitioner when:
- The frequency or the feeling of urinating is disturbing your day-to-day activities.
- Home Remedies don’t seem to be working (refer the section above)
- It is not possible to control the urge to pee or any exertional activity / sneezing / coughing is causing a lot of leakage.
- When this problem has given rise to infection or irritation of the region
What is the treatment for Urinary incontinence?
The problem related to urinary incontinence can be treated with one or more of the following treatment options:
1. Medication:
General physician, Gynaecologist and/or Urologist will help identifying the underlying cause of UI. He/ She will also prescribe medications to counter any infections or possible secondary factors.
2. Pelvic floor retraining:
A physiotherapist will help you strengthen the pelvic floor musculature with an exercise based treatment programme. (see the next section to know what is included in physiotherapy treatment)
3. Invasive procedures:
Medical devices like a urethral insert and pessary can be of help to avoid leakage. Sometimes, one may be advised to undergo a surgery like sling procedure and bladder neck suspension for the same.
Apart from these, biofeedback by electrical stimulation can be of great help too.
How will a physiotherapist treat Urinary incontinence?
At ReLiva, physiotherapy treatment for urinary incontinence would include the following:
- Tips to make lifestyle changes that will avoid unwanted incidents until recovery (better control on urination) is attained.
- Pelvic floor retraining with an exercise program including systematic use of kegels, weighted cones, core strengthening for pelvic floor, tightening and relaxing of the pelvic floor etc.
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Is it normal to have urinary incontinence?
No, lack of urine control is not normal. But if the underlying cause is temporary it can be managed by following the above treatment protocol.
What causes urine leakage in females?
Stress incontinence4 that occurs due to weak pelvic floor muscles (due to multiple pregnancies in case of women) is the most common cause for Urinary incontinence among women.
Prostrate issues, however remain the most common cause for poor bladder control among men.
Does pregnancy cause urinary incontinence?
Not all pregnancies lead to UI but sometimes with damage to the vaginal muscles or pelvic floor, natural delivery can be a predispose to UI. This can be avoided by doing prenatal exercises with a qualified prenatal expert like those at FabMoms. A good prenatal exercise program will include strengthening of the pelvic floor musculature.
What is causing a urine leakage?
Urine leakage may be caused due to many reasons, basis which we classify it in the following 4 types of Urinary Incontinence:
1.Stress Incontinence:
This type of incontinence is most common4 among women and occurs due to stress caused to the pelvic floor musculature during normal processes in a life of a woman, like Childbirth or Menopause. Sudden extra load or stress on the pelvic floor can cause person to urinate involuntarily when triggering factors like coughing, sneezing, laughing or lifting heavy weights during an exercise are involved.
2.Urge Incontinence:
As the name suggests, in this type, there is a constant urge to go the bathroom, or the feeling of anxiety to make it to the bathroom on time is always present. Urge Incontinence is also termed as an Overactive Bladder. This type of incontinence is commonly seen among elderly women, also seen among people with neurological conditions like Stroke, Alzheimer’s etc.
3. Overflow Incontinence:
In this type of incontinence there is an overflow of the urine in case of incomplete emptying of the bladder in one go which leads to leaking of urine after when the person is…. It is commonly seen more among men than women.
4. Functional Incontinence:
This type of incontinence occurs in case of any functional impairment which can be physical or mental which delays you or holds you back in time to make to the washroom. It can occur in any age group but mainly seen in the elderly with walking disability or chronic diseases involving the joints.
5. Mixed Incontinence:
As the name suggests there can be more than one type involved together in this type which can cause the leakage of urine.
Is it possible to get rid of UI ?
Yes, it is possible to get rid of UI in some treatable cases.
Will I get Urinary Incontinence?
The risk factors2 for Urinary incontinence include the following:
- Age
- Obesity
- Pregnancy and mode of delivery3
- Hysterectomy
- Ethnicity and race
- Mobility
- Diabetes
- Dementia
- HRT (Menopausal replacement Therapy)
- Infections
If you or a loved one has had an accident with urine leakage or facing an issue of the same nature, do not delay any further. Seek help. Call us at +91 9920991584 right away and we will connect you with a nearby physiotherapist and get started with your recovery.
This article is based on the contribution from Dr Shamolina Dound (PT). Dr Shamolina is an experienced sports physiotherapist. She works closely for recovery of adults as well as children; athletes and sports persons.
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Scientific References:
1. Irwin et al. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011 Oct;108(7):1132-8.
2. Milsom et al. Epidemiology of Urinary Incontinence (UI) and other Lower Urinary Tract Symptoms (LUTS), Pelvic Organ Prolapse (POP) and Anal (AI) Incontinence. In: Incontinence, Editors Abrams, Cardozo, Wagg and Wein, 2017.
3. The prevalence of stress urinary incontinence was 10.1% in nulliparous women, 15.9% in caesarean section and 21.0% in vaginal delivery group in a study conducted.https://www.ncbi.nlm.nih.gov/m/pubmed/14634552/
