Millions of people each year are affected by incontinence, a loss of control of the bladder. This is embarrassing at any age. However, it is more so the younger you are. There is more than one type of incontinence, urge incontinence being one of the most common with a variety of causes. Understanding this medical condition, along with its causes and symptoms, makes it easier to manage and treat.
What Is Urge Incontinence?
Before you can understand what urge incontinence is, you must first understand how your bladder functions. You have what are known as sphincter muscles that control the flow of urine from your bladder. In a healthy bladder, these muscles are strong and able to function properly. However, when you suffer from urge incontinence, also known as an overactive bladder, your bladder has abnormal bladder contractions that your sphincter muscles are not strong enough to control. You have a sudden, intense urge to urinate, and before you realize it, you have involuntarily urinated. Your bladder is only giving you a few seconds – maybe a minute – to reach a bathroom. Urge incontinence can occur at any age. However, it is most common in older adults; approximately one in 11 adults in the United States are affected by this condition.
One of the major muscles in the bladder is the detrusor muscle – it is responsible for one of the main steps in the normal urination process. Its contracting and relaxation, which helps prevent urge incontinence when occurring properly, is controlled by your nervous system. Although the normal human adult bladder can hold 600 cc of urine, abnormal contraction of the detrusor muscle will result in urge incontinence regardless of the amount. There are a number of nervous system disorders or abnormalities that result in overactive bladder. These include spinal cord injuries, Alzheimer's disease, Parkinson's disease, strokes, dementia, multiple sclerosis and diabetic neuropathy.
Although your nervous system plays a vital role, there are other possible causes. These include bladder cancer, bladder stones, bladder infection and inflammation of the bladder. There are some causes for men that women do not experience. These include bladder obstruction due to an enlarged prostate and changes in the bladder because of a condition known as benign prostatic hypertrophy.
It should be noted that urge incontinence tends to affect women and elderly, although many times no cause is found, according to PubMed Health.
Diagnosing Urge Incontinence
Your doctor has many ways to diagnose this condition and it all begins with an office visit and general physical. During this time he will ask about your medical history and any symptoms you are experiencing. These are clues that lead him to the answer. Getting up to urinate at least three times at night, or urinating at least eight times daily, along with loss of bladder control, are all signs of overactive bladder to your doctor.
At this point women may have to undergo a pelvic exam to check for dryness, infection or infection, while men may need an exam so the doctor can check the size, tenderness and texture of their prostate.
A urine analysis is also helpful; it checks for infections. Another exam known as a urine cytology checks for cancer cells. This is commonly ordered for people doctors are evaluating for overactive bladder.
Another common test is an ultrasound. This measures the amount of urine you have left in your bladder after urinating. It helps your doctor determine possible causes of urge incontinence such as an obstruction of urinary flow or weakened bladder muscles.
In some cases your doctor may also order an X-ray with contrast dye, or a urinary stress test.
Treating Urge Incontinence
Your doctor's choice of treatment for you depends on the severity of your symptoms and how they are affecting your life. The possible cause also plays a role. The three main forms of treatment are medication, bladder retraining and surgery.
Medication may work if you have an infection. In this case, antibiotics may easily cure the problem and your urge incontinence is gone.
In more severe cases, medication can help relax your bladder contractions, calming the spasms and improving the function of your bladder.
Bladder retraining is another treatment method. You schedule your bathroom times and do not stray from them. You may begin by going every hour, and regardless of how bad the urge, or even if you leak, you wait the full hour before using the bathroom. This strengthens your bladder muscles. As your urges lessen, increase your time between bathroom trips by a half hour. Do this until you are using the bathroom every three to four hours without any accidents in between.
For the most severe cases, surgery is an option. This may be for you only if you are able to store very little urine and have numerous abnormal contractions. The surgery increases bladder storage while decreasing pressure on your bladder.
Although there are a variety of effective treatment options, you must be patient. Positive results are not instantaneous, and you may need to try more than one treatment method before your ur incontinence is under control.