Bladder And Bowel Incontinence
Incontinence is a loss of control of a personâs bowels or bladder which can cause accidental leakage of body fluids and waste. Incontinence can be more than a physical problem. It can disrupt your quality of life if its not managed well.
Fear, anxiety, and anger are common feelings for people dealing with incontinence. You may avoid being intimate or having sex because you are afraid of urine, gas, or stool leakage. Fear of having an accident may keep you from being physically active, enjoying hobbies, or spending extended time outside your home.
Anyone can have incontinence during and after surgery or some other treatments for cancer. Incontinence can also occur because of other non-cancer medical conditions. Be sure to talk to your health care team if you have difficulty controlling urination or bowels. Talking about incontinence can be embarrassing, but being open and honest with your health care team can help manage it.
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What Causes Young Adult And Teenage Incontinence
SUI is the most prevalent type of incontinence in women. A healthy pelvic floor is key to maintaining a leak-free bladder. Your pelvic floor consists of layered muscles that create a hammock-type support for your bladder and other pelvic organs. When these muscles are stretched out or damaged, the bladder is not strong enough to function properly, resulting in incontinence.
Childbirth and advanced age are leading contributors to urinary incontinence. However, in young women who havent been pregnant, exercise is the primary cause of teenage incontinence. High-impact sports, such as running, CrossFit, or jumping rope, can traumatize your pelvic floor. The increased pressure of lifting heavy weights or doing intense moves, such as repeated burpees and weighted squats, can damage your pelvic floor muscles. And when your pelvic floor cannot support the bladder adequately, the mechanisms for retaining and releasing urine are compromised, resulting in incontinence.
What To Think About
Many men who have urge incontinence or overflow incontinence also have an enlarged prostate gland . They may want to talk to a doctor about medicine, surgery, or other treatment to relieve their symptoms. For more information, see the topic Benign Prostatic Hyperplasia .
Urinary incontinence can be a problem following treatment for prostate cancer, including radiation therapy and removal of the prostate.
Treatment will be different for men who have total incontinence or who cannot comply with or tolerate specific treatments because of a serious illness or disease.
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Bladder Has Two Distinct Roles
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Effects Of Incontinence On Young People
University of Bristol research on continence problems in young people aged 11-20 years showed that embarrassment, fear of bullying and stigmatisation, and lack of understanding meant that some went to great lengths to conceal bladder and bowel issues, thereby risking:
- Serious distress
- Social isolation
- Underlying conditions going untreated .
The social assumption that continence problems only affected very young children, women or older adults caused participants to feel abnormal and misunderstood. A small number told friends, but all hid it at some level, and many did not want anyone to know. This led to worry about being discovered, at a time of development when fitting in with peers and society felt particularly important . However, many found effective ways of coping and those who told friends reported positive experiences and a sense of relief .
In terms of the healthcare experience, participants wanted to be supported to self-manage, reporting positive treatment experiences when there was good rapport with clinicians and they felt fully involved in decision-making . However, many felt frustrated about a lack of continuity of care and poor understanding of the wider impacts of continence problems on their lives.
Box 1. Case study: a young mans story
*The patients real name has been used, with his permission.
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When You Should See A Health Care Professional
You shouldnt have to wear a pad to soak up urine every day. Also ask yourself these questions:
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Is the urge to urinate interfering with your work because of leaking or frequent bathroom breaks?
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Do you map out where bathrooms are when you run errands?
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Is incontinence interfering with your sex life or intimacy with your partner?
These are all signs of a problem, and that it may be time for you to talk with a gynecologist.
Treatment Options For Urge Incontinence
Treatments for this type of condition also should address the underlying cause, such as better diabetic control weight loss or altering the lifestyle with limitation of bladder irritants, such as caffeine and carbonated beverages.
Medications that relax bladder muscles are commonly used as first-line therapeutic options. The most commonly reported side effects include dry mouth, constipation and low blood pressure. Recently, bladder muscle Botox injections are being used in patients who have severe symptoms. Injections offer reasonable improvements in symptoms for six months with common side effects being related to urine retention or frequent urinary tract infections.
Sacral nerve root modulation â the surgical implantation of a device that helps modulate the neuronal circuitry to render the bladder more receptive to urine with decreased urgency symptoms â is a viable option for women with severe symptoms, especially those who do not respond to conventional first- and second-line treatments.
Although urine incontinence is common, it is not normal. Therefore, appropriate evaluation is necessary to determine the type and cause of this problem. Treatment options are available to help women optimize quality of life. Discussing the issue with a health care provider is the first and most important step to consider.
Watch this video to learn more about urinary incontinence treatments including sacral neuromodulation therapy:
Topics in this Post
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Can Incontinence Be Prevented
Different events throughout your life can lead to many of the things that cause incontinence. The muscles that support your pelvic organs can weaken over time. For women, these muscles can also be weakened by big life events like pregnancy and childbirth. However, in the same way you work out to build strength in your legs or arms, you can do exercises to strengthen your pelvic floor muscles. Doing exercises to strengthen your pelvic muscles may not prevent you from having any issues with incontinence, but it can help you regain control of your bladder. Maintaining a healthy body weight can also help with bladder control. Talk to your healthcare provider about the best ways to maintain strong pelvic floor muscles throughout your life.
Q Why Do Younger Women Suffer From Urinary Incontinence
Teenagers and young women involved in sports are more likely to suffer from urinary incontinence. Women who are parachuters and gymnasts suffer from urinary incontinence as hitting the ground might cause weakening of the pelvic muscles. Some pre-existing or genetic issues also cause this problem. Weak pelvic muscles can run in the family. Activities like running or weightlifting can also make the pelvic floor muscles weak.
According to research, women who are sexually active also are more likely to report similar issues than women who are sexually inactive.
This clears up the common misconception that only pregnant and older women can suffer from this issue. Women who have not experienced childbirth can have weaker pelvic muscles too. But their issue can get worse after pregnancy. The risks of urinary incontinence are more among young women whose mothers suffer from similar problems.
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Overactive Bladder In Women
Women are more likely to report symptoms of OAB to their doctor. In fact, at least 40 percent of American women experience symptoms of overactive bladder. Many more may not report the experiences to their doctor at all.
Overactive bladder consists of a series of symptoms that cause you to need to urinate more frequently. These symptoms include
- feeling a sudden need to urinate
- not being able to control urination
- urinating at least two times every night
- urinating at least eight times every day
Its not clear what causes overactive bladder, but OAB becomes more common in women after menopause. That may be the result of estrogen deficiency. However, overactive bladder can occur at any age.
Overactive bladder is a common childhood condition, but not every accident or soiled bed is the result of OAB. Children frequently grow out of overactive bladder symptoms, but treatment can help prevent frequent urination or complications.
Symptoms of OAB in children include:
- an urgent or frequent need to urinate
- accidents or leaking urine
- urinating more than eight times in a day
- not feeling as if theyve emptied their bladder despite urinating
Symptoms of OAB become less common as children get older. With age, kids learn to properly control their bladder and recognize signals that they need to urinate. If symptoms of overactive bladder dont seem to be resolving or are getting worse, talk with your childs doctor.
Causes of OAB in children include:
- urinary tract infection
From Leaking Urine To Sudden Urges To Go: An Ob
You dont have to suffer in silence there are many treatment options available.
Whether its a few drops of leaking urine or a complete emptying of the bladder, incontinence is a bladder control issue that women are twice as likely to have as men. And by the time a womanhas made an appointment to talk about what shes dealing with, she has had enough.
Incontinence can be embarrassing, super annoying, and costly. But you dont have to suffer in silence there are many treatment options available.
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When To See A Doctor For Urinary Incontinence
In most cases, UI can be treated without surgery. If left untreated, UI can lead to sleep loss, depression, anxiety and loss of interest in sex. It might be a good idea to see your doctor if your condition is causing you to:
- Frequently urinate
- Feel tired from incontinence-related sleep loss
- Feel socially anxious about your urinary incontinence
- No longer participate in activities that bring you joy
- Miss out on big moments or lose productivity
Who Does Overactive Bladder Affect
Overactive bladder is most common in people 65 and older. Women may have OAB at a younger age, usually around 45.
How common is overactive bladder?
Overactive bladder is common. It affects up to 33 million adults in the U.S., including as many as 30% of men and 40% of women. However, that number may be higher because many people may feel embarrassed and wont get help.
How does overactive bladder affect my body?
Overactive bladder symptoms can cause stress and affect your quality of life.
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What To Expect At Your Appointment
During your appointment, your healthcare professional will likely ask questions about your symptoms. Theyll probably want to know how long youve been incontinent, which types of incontinence youve experienced, and other details.
They may also ask about your daily habits, including your typical diet and any medications or supplements that you take.
Depending on your symptoms and medical history, they may also order additional tests, including:
- Collecting a sample of urine for analysis. Laboratory staff can check the urine sample for signs of infection or other problems.
- Measuring the amount of urine that you release when urinating, the amount left over in your bladder, and the pressure in your bladder. This information is gathered by inserting a catheter, or a small tube, into your urethra and your bladder.
- Conducting a cystoscopy. During this test, theyll insert a small camera into your bladder to examine it up close.
What Are The Variations Of Male Incontinence
There are six different types of urinary incontinence that can affect men.
Urgency incontinence: you feel a sudden urge to urinate that is followed by accidental leakage
Stress incontinence: leakage occurs as a result of quick movements or pressure like coughing or sneezing.
Overflow incontinence: leakage occurs because of a full bladder
Transient incontinence: this is usually the result of a temporary infection in the urinary tract or a side effect of medication
Functional incontinence: obstacles or physical disabilities keep you from getting to the bathroom in time, and accidental leakage occurs
Mixed incontinence: when the cause of your incontinence falls under two or more of the above types
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Urinary Incontinence In Older Adults
Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities. But incontinence can often be stopped or controlled.
What happens in the body to cause bladder control problems? Located in the lower abdomen, the bladder is a hollow organ that is part of the urinary system, which also includes the kidneys, ureters, and urethra. During urination, muscles in the bladder tighten to move urine into the tube-shaped urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder dont work the way they should, urine can leak, resulting in urinary incontinence.
Incontinence can happen for many reasons, including urinary tract infections, vaginal infection or irritation, or constipation. Some medications can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:
- Weak bladder or pelvic floor muscles
- Overactive bladder muscles
- Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinsons disease
- Diseases such as arthritis that may make it difficult to get to the bathroom in time
Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:
What Is Incontinence
Urinary incontinence is a condition that impacts many peoples lives. When you have incontinence, you may experience bladder control issues and leak urine. This leakage is often uncontrollable and can negatively impact your life.
Your urinary system is made up of the kidneys, ureters, bladder and urethra. These parts do several jobs. They filter, store and remove waste from your body. Your kidneys are the filters of your body. Waste products are removed from your blood by the kidneys, creating urine. The urine then moves down through two thin tubes called the ureters. The ureters connect to the bladder, where the urine will collect until its time to leave the body. Your bladder is like a storage tank once the bladder is full, the brain sends a signal that its time to urinate. Urine then leaves the bladder when a muscle opens up , allowing the urine to flow freely out of the body through the urethra.
When this system is working smoothly, you usually have time to get to a bathroom before needing to urinate and you dont experience any leakage of urine. Urinary incontinence can happen when these parts dont operate as they should. This can happen for many different reasons throughout your life.
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How Is It Treated
Treatments are different for each person. They depend on the type of incontinence you have and how much it affects your life. After your doctor knows what has caused the incontinence, your treatment may include medicines, simple exercises, or both. A few men need surgery, but most do not.
There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.
- Cut back on caffeine drinks, such as coffee and tea. Also cut back on fizzy drinks like soda pop. And don’t drink more than one alcoholic drink a day.
- Eat foods high in fibre to help avoid constipation.
- Don’t smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Stay at a healthy weight.
- Try simple pelvic-floor exercises like Kegels.
- Go to the bathroom at several set times each day, and wear clothes that you can remove easily. Make your path to the bathroom as clear and quick as you can.
- When you urinate, practice double voiding. This means going as much as you can, relaxing for a moment, and then going again.
- Keep track of your symptoms and any leaking of urine with a bladder diary. This can help you and your doctor find the best treatment for you.
If you have symptoms of urinary incontinence, don’t be embarrassed to tell your doctor. Most people with incontinence can be helped or cured.
Other Types Of Urinary Incontinence
- Overflow incontinence This occurs when a person is unable to empty their bladder completely and it overflows as new urine is produced. It’s often found in people with diabetes or spinal cord injuries.
- Mixed incontinence You show evidence of more than one type.
- Functional incontinence This type of incontinence has less to do with a bladder disorder and more to do with the logistics of getting to a bathroom in time. It’s usually found in elderly or disabled people who have normal or near normal bladder control but cannot get to the toilet in time because of mobility limitations or confusion.
- Nocturia The need to urinate twice or more during the night, usually affecting men and women over the age of 60. In men, nocturia can be a symptom of an enlarged prostate.
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