Urinary Incontinence Welcome to the Affordable Drugs urinary incontinence information page. Here you can learn about what urinary incontinence is, causes of urinary incontinence, urinary incontinence treatments and more. You can also find the best available prices on urinary incontinence medications. The information contained on this page is not intended to replace the professional advice of your physician.
What is Urinary Incontinence? Urinary incontinence is a loss of a person's bladder controlling resulting in accidental urine leakage. This common problem can range from small amount of urine when laughing or sneezing, to the release of large amounts of urine that is almost impossible to control. Urinary incontinence is more common in those over the age of 50 and typically effect women more than men. Although this can be an embarrassing and self conscious problem, it can be treated. To determine what method of treatment is right for you, there is a need to find the cause of your incontinence. For women, common causes could be from the drying and thinning of the vagina post menopause and stretched and weakened vaginal muscles due to childbirth. For men, problems such as an enlarged prostate or prostate surgery could be the causes. Other common causes are specific medications, a build up in stools, obesity, urinary track infections, and diseases such as Alzheimer's, diabetes, and multiple sclerosis.
There are 5 main types of urinary incontinence including stress, urge, overflow, functional and mixed:
Stress incontinence is when you have a urine leakage due to a sudden push on the stomach muscles. This can be due to lifting something heavy, coughing, sneezing or laughing. It can also be due to weakened muscles from childbirth.
Urge incontinence is when a strong urge to urinate comes suddenly and usually only seconds before you actually urinate. This commonly occurs in the elderly and most people don't have time to get to the toilet before urinating. This can sometimes be the result of a UTI or an overactive bladder.
Overflow incontinence is when the bladder is too full and you begin to leak small amount of urine uncontrollably. You may feel that you are unable to completely empty the bladder, resulting in straining. This can be caused by a block or enlarge prostate in men. It's also common in those with diabetes.
Functional incontinence is when you have normal control over the bladder but you may not be able to get to the toilet in time. The reason for delay may be caused by mobility issues or because of certain conditions such as arthritis.
Mixed incontinence is when you have more than one of the above mentioned types of urinary incontinence.
Treatment will depend on which type of incontinence you may have and at which extreme. If the underlying problem is caused by another medical condition or disease, treating the underlying disease will also treat the incontinence. If the problem is due to weakened muscles due to childbirth or aging, kegel exercises can be done to tighten the vaginal muscles. Kegel exercises are done when you are urinating on the toilet. To tighten the vaginal muscles, simply try to stop your urine flow by squeezing your stomach and buttock muscles. Hold for a count of about 10 seconds and release. Relax for another 10 seconds and repeat. This exercise should be done about 3 times a day in sessions of 10 to 20 stops.
Bladder training is also a choice for those with minor incontinence problems. Simply timing yourself to use the toilet every 30 minutes or 2 hours can help to avoid accidents.
Stress Urinary Incontinence Many people suffer in silence from stress urinary incontinence. This disorder afflicts a variety of people, though women that have had children tend to be one of the highest demographics to suffer from it. Many people are embarrassed by their disorder, therefore refusing to speak with their physicians about the issue. This is a very real medical problem that you should not be embarrassed about. Treatments are available. Stress urinary incontinence is a disorder in which the muscles surrounding the bladder are weakened and allow urine to pass through the urethra unintentionally. Involuntary urination occurs with this disorder whenever the pelvic floor muscles are stressed, such as when you cough, laugh, or sneeze. The severity of the incontinence can vary, from being very mild to quite severe. The treatment that you are your physician choose to pursue will likely be based upon the severity of your individual case.
If you have a fairly mild case of stress urinary incontinence, your doctor may suggest that you go Kegal exercises to strengthen the muscles that control your bladder. Men can perform Kegal exercises by stopping and restarting the flow of urination. This tends to be a difficult task for men, so do not be discouraged if you are unable to fully stop urinating when you first try this exercise. It will take some practice to train these muscles. Women, on the other hand, can perform Kegal exercises anytime they choose. Work on pulling the muscles right above your pubic bone to your back. This should produce the same sensation that is felt when you stop your urine midstream.
More severe cases of stress urinary incontinence may require more intense treatment. Surgery is a common treatment for people in this predicament. Generally, a surgeon will suture the muscles around the bladder closer together, therefore making them tighter. Usually, the patient will have a Foley catheter in place for several days after the operation. The patient will usually stay in the hospital for several days while the muscles of the bladder are retrained. It is a long and difficult process, but many patients say that the rewards of curing urinary stress incontinence are well worth it. Speak with your doctor about your individual case and your personal treatment options if you suffer from this disorder.
Causes of Urinary Incontinence Although urinary incontinence is not discussed as freely as are other health conditions, it is not an uncommon problem. One of the first steps towards addressing urinary incontinence is to understand what causes it. There are several types of urinary incontinence, and each of them is associated with multiple potential causes. Stress incontinence is one commonly-occurring bladder condition. People who leak urine when they cough, laugh, strain, or lift are incontinent because physical pressure strains the opening of the bladder and the pelvic muscles. Women are vulnerable to stress incontinence as they become older. Aging bladder muscle tissue loses some of its elasticity. The strains of pregnancy and childbirth also weaken the pelvic floor, making older mothers especially prone to having bladder accidents. Obesity can aggravate other causes of urinary incontinence associated with physical stress.
Urgency incontinence, sometimes called overactive bladder, is also among the common causes of urinary incontinence. People who suddenly lose large volumes of urine experience uncontrolled spasms of the bladder muscles. Enlargement of the prostate gland, irritation of the lining of the bladder, or obstructions of the urethra, like kidney stones, cause this type of urinary incontinence. Excessive consumption of acidic drinks like sodas or fruit juices can inflame an already irritated bladder wall. Acid-affected bladder tissue can lead to an increase in the frequency of incontinent episodes. Neuromuscular syndromes such as multiple sclerosis, cerebral palsy, or traumatic brain injury also cause these problematic contractures of the bladder muscles.
A look at the common causes of urinary incontinence includes attention to overflow incontinence. Some people's urine leaks on a chronic basis, such that their bladders lose small amounts even immediately after they void. Overflow patients are unable to empty their bladders completely. Men should be aware that an enlarging prostate could contribute to overflow incontinence. Neurological problems might also result in urine overflow. Some nerve conditions can diminish a person's sensitivity to the urge to void. Diabetic neuropathy for example leads to overflow incontinence. Patients might also be screened for obstructions of the urinary tract like stones or tumors.
Finally, enuresis is a type of incontinence affecting older children or adults who experience involuntary urination during sleep. Bedwetting results both from increased urine production and from the inability to waken and empty the bladder. The causes of urinary incontinence during sleep include sleep disorders, seizures, excessive emotional stress, and psychological trauma. Sleep apnea interferes with the patient's breathing, causing exhaustion and abnormal sleep patterns that can lead to enuresis. Seizure activity causes the sphincter muscles to spasm, resulting in voiding accidents. People who have brief episodes of bedwetting might be reacting instead to an acute emotional stressor, or to extreme physical fatigue that disrupts normal urinary habits. Anxiety associated with severe psychological trauma can also contribute to bedwetting. Night terrors or flashbacks might prevent patients from remaining continent during the night.
Each type of incontinence is associated with bothersome and embarrassing symptoms. But identifying the causes of urinary incontinence opens a discussion that breaks the silence.
Urinary Incontinence Treatments When it comes to urinary incontinence treatments, there are certain factors that need to be taken into consideration before starting any treatment or medication. How severe the problem is as well as what caused it and the type of incontinence will be determining factors in how one will be treated. After your doctor gathers the information needed it may be likely that one or more of the following treatments and medications could apply to your situation. When it comes to urinary incontinence medications there are three types of drugs that are most widely used. These drugs are usually taken along with the performance of behavioral techniques. To treat mixed continence such as urge and stress incontinence together, Imipramine, also known as Trofanil, is the drug of choice. Topical estrogen is also included in urinary incontinence medications and can help reduce some of the symptoms of urinary incontinence. This may help rejuvenate and tone tissues in the vaginal area and urethra by applying a low dose of vaginal cream.
Prescription medications that could be helpful in treating urge incontinence fall under the category of anticholinergics. The drugs that fall into this category of urinary incontinence medications include trospium, oxybutynin, solifenacin, tolterodine, and darifenacin. All of these are used to calm an overactive bladder, and should provide help especially in the case of urge incontinence. When it comes to stress incontinence, however, these type of drugs are of no help.
A new drug called duloxetine, or Yentreve, is a possible treatment for stress incontinence that is currently under review by the FDA. This will be used specifically for women. It increases levels in the sacral spinal cord of both norepinephrine and serotonin which enhances pudendal nerve activity. During the urine storage phase of the micturition cycle the urethral spincters experience increased contraction presenting this to be a possible treatment for stress incontinence.
Currently stress incontinence is sometimes treated with estrogen and alpha-adrenergic agonists. Estrogen has not been approved by the FDA as a treament, however, and recent studies have also backed this decision as there was no proof found to support the fact that estrogen has improved any symptoms of stress incontinence. The alpha-adrenergic type of drugs are used to stimulate urethral closure. Although it has not been recognized as a treament by the FDA, it is said that the over the counter drug Sudafed, technically called Pseudoephedrine, could be recommended to help with stress incontinence on occasion. None of these drugs are strongly recommended for a treatment of stress incontinence, however, meaning that if duloxetine does get approved it will likely be the number one pharmacological treatment used for stress incontinence.
Behavioral techniques could turn out to be the only treatment one may need and is the least invasive of any urinary incontinence treatments. Bladder training could be one way to overcome this disease and it is possible that it could also be used in combination with other remedies. Another behavioral technique is scheduled bathroom trips. With this plan someone would urinate by watching the time on the clock. Instead of waiting for the urge, the patient simply waits until it is "time to go". The last behavioral technique is fluid and diet management. A reduction in the consumption of liquids, such as alcohol and coffee, as well as more physical activity and the loss of weight can also prove to be effective urinary incontinence treatments.
Physical therapy is another treatment option for this type of problem. Pelvic floor muscle exercises can help strengthen the muscles that have a hand in controlling urination. These are especially effective for people dealing with stress incontinence, although they can help with urge incontinence as well. These pelvic floor exercises are known by the term Kegels. Electrical stimulation is another method of physical therapy that can be a helpful urinary incontinence treatment. This treatment however could take several treatments and possibly a few months to be effective.
There are urinary incontinence treatments that are specifically for women and include the use of medical devices. Urethral inserts are not for everyday use and are available by prescription only. This device prevents urine from leaking out and are mostly used for predictable incontinence occurring during specific activities. Another medical device that could be prescribed is called a pessary. This is a stiff ring that can be worn all day and needs to be inserted inside the vagina to avoid leakage. Other urinary incontinence treatments include interventional therapies. These therapies include bulking material injections, radiofrequency therapy, a sacral nerve stimulator, and botulinum toxin type A injections.
If none of these urinary incontinence treatments are effective, it is possible that surgery could be the only other option. A few of the most common surgical procedures are sling procedures, artificial urinary sphincter surgery, and bladder neck suspension.
Urinary Incontinence Medications Urinary incontinence is a medical condition in which a person loses control over the ability to pass urine. There are two types of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence occurs during the course of particular activities such as exercising, laughing, sneezing, coughing, etc. This type of incontinence involves a bladder problem in which the urethral sphincter is not strong enough to control urination when abdominal activity increases pressure on the bladder. Stress incontinence may result from weak pelvic muscles that typically provide bladder support or from urethral sphincter malfunction. Urge incontinence manifests in a strong and sudden urge to urinate combined with an instant contraction of the bladder and involuntary urine loss. Urge incontinence can affect people of any age and gender, however, it is more common in women and the elderly. Urinary incontinence medications work to increase the strength of the urinary sphincter and pelvic muscles. Other medications also relax the bladder, thereby allowing it to contain more urine. Most urinary incontinence medications are most helpful for the treatment of urge incontinence although there are some that are effective for minimizing the effects of stress incontinence. Anticholinergics treat urinary incontinence by inhibiting involuntary bladder contractions, by increasing bladder capacity, and by delaying the initial urge to urinate. These medications include oxybutynin (Ditropan and Oxytrol), tolterodine (Detrol), hyoscyamine (Levbid and Cystopspaz), trospium (Sanctura), darifenacin (Enablex) solifenacin(Vesicare), and fesoterodine (Toviaz). Urinary incontinence medications such as these are capable of producing significant improvements, however, they are accompanied by the risk of certain side effects. The most common side effect of these drugs is dry mouth. Other possible anticholinergic side effects include dry eyes, headache, constipation, heartburn, and rapid heart rate. Those who wear contact lenses may especially suffer from drying of the eyes and are advised to begin treatment with low doses and gradually increase the amount over time. Older people who suffer from dementia or from degenerative mental diseases such as Alzheimer's disease can experience forgetfulness, confusion, and a potentially accelerated rate of declining mental function. Hallucination is a possible side effect in children and older adults.
Another common treatment is the estrogen hormone. Women's bladders and urethras contain estrogen receptors. Estrogen is important in maintaining the flexibility and strength of tissues in these areas. Post-menopausal women produce less estrogen, which can result in incontinence problems. Estrogen-based urinary incontinence medications are available in topical forms such as vaginal creams, rings, or patches. These estrogen treatments can tone and revive the urethral areas and mitigate some of the symptoms of both stress and urge incontinence. Hormone replacement therapy and oral estrogen is no longer employed for the treatment of urinary continence because they function differently from topical estrogen and might actually worsen symptoms of incontinence. When topical estrogen is properly used, there are generally no side effects involved. However, estrogen treatments are usually combined with other urinary incontinence medications that may have side effects.
Imipramine (Tofranil) is another type of urinary incontinence medication. It is a tricyclic antidepressant that causes the bladder muscle to relax while making the smooth muscles at the neck of the bladder contract. This is an effective treatment for those suffering from a mixture of stress incontinence and urge incontinence. Imipramine can result in drowsiness, so it is commonly used at night time and for the treatment of children who suffering from chronic bed-wetting (nocturnal enuresis). Side effects of imipramine are rare but can include irregular heartbeat and dizziness upon standing up quickly. Older adult and children might be particularly susceptible to these side effects. Other possible side effects include dry mouth, blurry vision, and constipation.
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