Incontinence: No time for suppressing the problem
For an infant, bedwetting is considered normal as the child is not toilet trained. However, for those who are, it becomes embarrassing with increasing age. Involuntary loss of urine or incontinence is considered common, especially as people age, but that is anything but true — incontinence, at any age, is not normal.
In men, it may happen due to age and neurodegenerative diseases such as Parkinson’s, dementia, multiple sclerosis, or stroke. However, in women, incontinence is a major unrecognised problem due to socio-cultural implications. They are in denial and in most cases, suffer silently. Women with advancing age have overactive bladders, especially in diabetics, but it is managed by medications. Here are some common types of incontinence:
Stress incontinence: This kind is the most common one and happens in women who have normal delivery during childbirth. This is due to the stress on their pelvic muscles during delivery — they become weak. Nearly half of the women above the age of 50 who have also given birth face stress incontinence. Those who have elected caesarean delivery usually have lesser chances of developing this condition. There are grades of this kind of incontinence, grade 3 being the highest, where a leak happens even if someone is getting up from a lying down position.
Urgency incontinence: The term refers to a sudden and strong need to urinate and is also referred to as an unstable or overactive bladder, or detrusor instability. The cause of urge incontinence isn’t understood well. But in all likelihood, chances increase as we age. Symptoms may get worse at times of stress and by caffeine in tea, coffee and fizzy drinks or alcohol. Constipation (not being able to empty the bowel or having difficulty doing so), an enlarged prostate gland or simply a long history of poor bladder habits may also cause this kind of incontinence. Mixed incontinence: Since mixed incontinence is typically a combination of stress and urge incontinence, it shares symptoms of both. One can experience urine leakage as they sneeze, cough, laugh, do jarring exercise, lift something heavy, after a sudden urge to urinate, while sleeping, after drinking a small amount of water, touching water or hearing it run.
Continuous incontinence:
It is a type of incontinence in which there is continuous leakage of urine, which may occur due to lack of Sphincter control or Fistulae (abnormal communication between urinary tract and vagina).
Some of the diagnostic tests and treatments for incontinence include: Bladder Diary: It is a chart depicting the amount of fluid taken and the amount of urine voided.
Bladder stress test: The doctor checks to see if you lose urine when coughing. This could indicate stress incontinence. Ultrasound: An imaging test performed to visualise inner organs such as the bladder, kidney, and ureters. Uroflowmetry: Graphical representation of urine flow.
After ascertaining the gravity of the case, it is decided whether a surgical or non-surgical intervention is needed. Non-surgical ways consist of behavioural therapy, which includes decreasing the fluid intake and avoiding caffeinated beverages, pelvic floor exercises (Kegels), medical therapy and lastly, surgical therapy. Majority of patients can be managed by simple behavioural and medical therapy; only 10% need surgical therapy.
THE INVOLUNTARY LOSS OF URINE OR INCONTINENCE IS CONSIDERED COMMON, ESPECIALLY AS PEOPLE AGE