Urinary Incontinence

The National Institutes of Health have estimated that over 10 million adult Americans (70% of whom are women) have urinary incontinence. Unfortunately, the makers of protective adult undergarments, diapers that is, would like us to believe that this is a normal part of life that must be dealt with, of course using their products. However, this is not a normal condition, and most of the time this problem can be cured, or at least greatly improved. Consider this: over $10 billion per year is spent on this condition, however, only 1% of that amount goes to the diagnosis and treatment of this condition, while a full 60% is spent on palliative measures, such as adult diapers or protective pads.

According to the International Continence Society, the definition of urinary incontinence is the involuntary loss of urine that becomes a social or hygienic problem for the individual, and which is observed clinically. Many women will experience an occasional leakage that is simply annoying or inconvenient for them, these individuals would not be considered incontinent.

There are several different types and causes of urinary incontinence, and for the most part, effective treatment exists. This problem can often be improved or cured, usually using relatively simple, nonsurgical methods. Some of the most common types of this disorder include: stress incontinence, urge incontinence, and mixed incontinence.

Stress incontinence occurs under conditions of increased intra-abdominal pressure. This means that these individuals will leak urine when they cough, sneeze, or laugh, or even during certain physical activities such as exercise. This is the most common form of urine loss in women. Treatment of this condition includes the use of special bladder-strengthening exercises called Kegel exercises. Women who perform these exercises regularly are cured up to one-third of the time, while the remainder will enjoy at least some improvement. Additional treatment measures include medication in certain cases, and surgery for those who either have severe problems, or who have failed these more conservative measures.

Urge incontinence is the loss of urine associated with a sudden, strong urge to urinate. It could also refer to the sudden, unexpected loss of large amounts of urine. Although stress incontinence is the most common form of urine loss in women overall, urge incontinence is the most common form of urine loss in older women. It is caused by inappropriate bladder muscle contractions, or basically, bladder spasms. Treatment for this condition is non-surgical. It involves the use of certain medications, as well as placing the patient on strict schedules of when to urinate in order for them to regain control of their bladder muscles.

Mixed incontinence refers to a combination of the above two conditions. It requires special urologic testing for diagnosis.

The key point to remember here is that the involuntary loss of urine is not a normal part of the aging process, and in fact, very effective treatment exists. If you suffer from these symptoms, please discuss it with your physician because help is available.

References:

Bibliography

1. Urogynecology and Urodynamics, Theory and Practice, Fourth Edition, Donald R. Ostergard, M.D.and Alfred E. Bent, M.D., Williams & Wilkins, Baltimore, 1996.

2. Novak’s Gynecology, Twelfth Edition, Jonathan S. Berek, MD, Williams &Wilkins, Baltimore, 1996.

3. "Urinary Incontinence", ACOG Technical Bulletin #213, October 1995.