Bladder Articles

What types of urinary incontinence are there? 

The National Institute on Aging cites four different forms of continence issues: 

• 'Stress incontinence occurs when urine leaks as a result of pressure being put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-aged women. It also may begin later, around the time of menopause.
• 'Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
• 'Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
• 'Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.'

How do I know if I have urinary incontinence? 

This is a reminder that you should feel comfortable speaking to your GP about all aspects of your health. Remember, your doctor has most likely seen lots of people with incontinence. So, be as honest as you can so that the right treatment can be sorted for you.

Continence assessment will be dependent on the individual. A range of assessments and examinations are available. Some options in the initial stage of assessment include;

• A dipstick test: This will help see if you have a urinary tract infection. These also test for other proteins and check for blood. 
• A blood test: Helpful to check the health of your kidneys.
• Bladder diary: Taking note of how much you drink, how often you pass urine and how much urine you produce can help a healthcare professional understand your symptoms better.
• Pad test: You would need to wear a pad for between 1 and 24 hours. The amount of urine absorbed by the pad would then be weighed.
• Assessment of residual urine: Also known as 'post-void residual urine', this assesses the amount of urine left in the bladder after urinating. This can be measured with the aid of a bladder scan or ultrasound.
• A physical examination: This will assess the bladder and pelvic floor muscles for women or examine the prostate for men. In women, stress incontinence can cause the bladder to swell into the vagina, this is called a cystocele. 
• Urodynamic investigations: These tests check the function of your bladder and urethra. After filling out a bladder diary, you will be asked to attend a hospital for several tests that measure the pressure of your bladder via a catheter, which is inserted into your bottom and urethra. 

Treating urinary incontinence

Similar to assessment, incontinence treatment is dependent on the individual and sometimes more than one treatment is needed. It should be noted that treatment does not always mean a cure, but instead helps to improve your incontinence symptoms. Treatment varies from bladder training, medication or exercises to help strengthen muscles surrounding the bladder. As a last resort, surgery may be an option. 

You can find out more about non-surgical and surgical treatments on the NHS website. 

Lifestyle advice

Along with the above treatments, changes in your lifestyle can help manage incontinence. Normalising fluid intake and reducing caffeine consumption can improve symptoms in people living with overactive bladders who may be drinking over 3 litres per day.

Ideally, an adult should be drinking between 2 –2.5 litres of fluid per day, as long as there are no other contraindications.

If you are drinking less than 1.5 litres per day, increasing your fluid intake will be beneficial, once again provided there are no other contraindications. Further lifestyle advice for consideration is to make sure you have a healthy diet. This should be adopted to encourage regular, easy bowel movements. Being constipated can often make symptoms of urinary incontinence worse.