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When your bladder calls the shots…
Yep it’s that feeling again, you have lost control, your body says you need to go, NOW, and no matter what you do, urine leaks before you get to where you need to go.
The National Institute for Health and Care Excellence (in UK) defines urge (aka urgency) incontinence as "involuntary urine leakage accompanied or immediately preceded by urgency (a sudden compelling desire to urinate that is difficult to delay)".
If you suffer, you will likely not be able to make it to a toilet without leaking a small amount of urine.
Your urge to urinate may be triggered by certain things; such as standing after sitting for a long time, or arriving home (latch key urgency).
Urge incontinence is one of the most common forms of incontinence. A third of adults who suffer from urinary incontinence suffer from both urge and stress incontinence together - it is then called mixed incontinence.
The group most vulnerable to developing urge incontinence are men older than 75 years old, with reports suggesting 42% of this group suffer. Women also suffer, however, with 31% of women over 75 suffering.
If left untreated you may begin to experience depression and social isolation, as you may no longer be comfortable leaving the house.
However urge incontinence can be treated, often without the need for pharmaceutical drugs or surgery. Therefore there is no need to consider it an inevitable part of ageing and you should seek treatment as soon as possible.
Symptoms of Urge Urinary Incontinence
You may be suffering from urge incontinence if you:
have a sudden or uncontrollable urge to urinate, often followed by leaking urine
visit the toilet more than 8 times in a 24 hour period
often do not make it to the toilet before beginning to urinate
often wear incontinence pads to catch leaks before you reach a toilet
feel the sensation to urinate when you change position; such as standing after sitting for a long period
feel the sensation to urinate with a sensory stimulation; such as running water, cold weather or arriving home (latch key urgency)
Should you be experiencing any of the above symptoms, speak to your GP for a formal diagnosis before seeking treatment.
Causes of Urge Urinary Incontinence
Urge incontinence is caused by involuntary bladder contractions that occur as the bladder fills, but is usually not yet full (which is when you should normally experience the urge to empty it).
The bladder contracts involuntarily if you are suffering from an overactive, unstable detrusor muscle - the main muscle behind the bladder that is responsible for its contractions. This muscle can be made unstable if it becomes irritated or if you lose the conscious ability to relax it.
Urge incontinence can also occur when the bladder is directly stimulated by irritation, inflammation or infection. If this is the cause then the incontinence is considered sensory and the cause of the stimulation should be treated alongside the symptoms of the incontinence.
What can cause Urge Incontinence?
Overactive Bladder – Your bladder wants to squeeze out urine and you are not ready, sometimes your bladder might not even be full so there is a bit of ‘frequency’ there too.
Diuretics - Such as caffeine, spicy food and alcohol, increase your urine production, causing you to feel the urge to urinate more frequenty. Caffeine includes everything from tea, coffee and coke to caffeine in pain killers can really irritate your bladder resulting in you losing bladder control.
Urinary tract infection (UTI) - Suffering from a UTI can stimulate the urge to urinate as it irritates both the bladder and urethra.
Bladder stones - These crystals develop if you frequently have urine in your bladder, even after you urinate. These then irritate the bladder, stimulating the urge to go.
Nerve issues - Diseases such as multiple sclerosis and Parkinson's disease affect the nerves that are linked to the bladder, removing your ability to consciously relax and contract the detrusor muscle.
Menopause - It is thought that the vaginal atrophy (dryness) that occurs as a result of the drop in oestrogen during menopause, irritates the bladder, leading to urge incontinence.
Excess Weight - if you are overweight you have a 50% higher chance of suffering with incontinence problems, your pelvic floor just can’t take the strain.
How to Stop Urge Urinary Incontinence
Once your GP has diagnosed you with urge incontinence, you will discuss an appropriate programme of treatment which resolves the symptoms alongside treating the original cause(s).
Conservative Urge Incontinence Therapies
Conservative therapy's, such as lifestyle changes and non-surgical medical treatments, resolve 25% of incontinence cases, and are the first course of treatment.
Bladder Retraining – also known as bladder drill or bladder training, bladder retraining is a simple solution. By creating a schedule of your loo visits you’ll be able to understand more about your bladder and how it works – ultimately you’ll be able to control your bladder rather than your bladder controlling you! For instance, set yourself the challenge to go to the loo every two hours, or another regular interval if you can’t wait that long. If your bladder signals for you to go before your scheduled time, use pelvic floor or Kegel exercises or relaxation techniques to control the feeling until the urge passes. Try the 'Quick Flick' technique. When you start to recognise what triggers your bladder, you will be able to train yourself to go less frequently, with longer and longer intervals between your scheduled ‘loo times’.
Lifestyle changes - For a lasting treatment for urinary incontinence, you will need to amend your lifestyle. This includes maintaining a healthy weight (BMI less than 30), avoiding constipation, and avoiding foods which increase urine production such as caffeine and spicy curry's (diuretics).
Weight – Even a modest 5-10% weight loss can help your urge incontinence and take the strain off your pelvic floor too!
Pelvic Floor Exercises – Kegels or pelvic floor exercises are essential. Results can take up to 3 months but strengthening your pelvic floor muscles means that your bladder and pelvic organs won’t sag and cause leaks. Kegels are considered to have the greatest success rate at treating urge incontinence, pelvic floor exercises are part of any treatment plan. Strengthen your pelvic floor over a 12 week programme, followed by weekly maintenance exercises, to better support your bladder and give you better control over your urethra. You will also benefit from an improved sex life and better bowel movements.
Caffeine and Alcohol – Reduce the amount you consume, but don’t reduce the amount of water you drink! Some women reduce the amount they drink thinking it will minimise loo visits... wrong! This simply makes your urine more concentrated and that can actually aggravate your bladder even more.
Biofeedback behaviour training - Using skin electrode pads or a vaginal probe, a Physiotherapist that specialises in Women's Health can confirm that you are doing your pelvic floor exercises correctly, or will be able to advise you on how to change the Kegels to make them more effective. This can be an invaluable addition to your pelvic floor exercise routine as many women do not correctly contract their muscles; leading to pelvic pain at worse, and a waste of their time at best.
Medication - You may be inclined to discuss what prescription drugs are available with your doctor as your first line of treatment, with the hope of a quick resolution with minimal effort. There are medications available from your Doctor that can help urge incontinence, however if your urge incontinence is due to a weak pelvic floor, the medication will only address the leaks and will not help strengthen your pelvic floor, so don’t forget to do your Kegels too! These medicines usually take up to 3 months to work and they are a long term medication (not just a course), they block nerve impulses to your bladder which relax the bladder muscle, so your bladder capacity is increased. However studies show that due to the nature of follow-up appointments and incontinence recurrence, drugs cannot be considered as a fool proof treatment for urge incontinence. Side effects include dry eyes and mouth and sometimes constipation.
Surgical Urge Incontinence Treatments
Surgery is reserved for those that are unable to treat their urge incontinence through the methods above. Usually as the damage to their muscles, bladder and/or urethra is irreversible.
Non-surgical sacral nerve stimulation - this can be achieved by using external electrode pads together with an electronic pelvic toner like the Kegel8 Ultra 20, which is classified as a Classll Medical Device in UK and has 20 clinically proven programmes.
Surgeries available (to date) include:
Bladder enlargement - Also known as augmentation cystoplasty, during this procedure the capacity of the bladder is increased by inserting a section of the bowel.
Urinary diversion - During this procedure, the normal flow of urine out the body is rerouted from the kidneys into an external drainage pouch or an artificial internal reservoir. It can be done temporarily (several days or weeks) to reduce pressure whilst a blockage is treated, or permanently if there is irreversible damage to the bladder.
Percutaneous implanted sacral neuromodulation - This form of sacral nerve stimulation is used to resolve issues with bladder function. It involves having an electric device permanently implanted under the skin, when you are under local anaesthesia.
Injections of botox (botulinum toxin) - In the same way as prescription drugs, botox injections aim to decrease the involuntary contractions of the detrusor muscle. Their affects weaken over time however, and therefore need to be repeated often.
Urge Incontinence is a warning sign to your body that you need to strengthen your pelvic floor muscles and, this is where a Kegel8 pelvic toner can help.
Take a look at the Ultra 20 pelvic toner for women to help you get strong, calm your bladder and take back control!
Get your Kegel8 Ultra 20 at Takealot by following this link - https://www.takealot.com/kegel8-ultra-20-electronic-pelvic-toner/PLID53468818
Original article: Kegel8 Website