Urge incontinence is a condition where a person suffers an over-whelming urge to pass urine that they cannot control, resulting in involuntary urination and leakage. Although not a disease in itself, there is often an underlying problem that’s causing it. A person with urge incontinence may have an over-active bladder which contracts spontaneously, causing the person to leak urine when they didn’t intend to. There are many possible causes of urge incontinence. Here are some of the most common:
- High intake of caffeine and/or alcohol
- Excessive fluid intake, in general > 2 litres per day unless specificallly required
- Drug side-effects, most commonly anti-depressants, anti-histamines, anti-psychotics
- A result of poor bladder habits
- Overactive bladder muscle
- Nerve damage to the bladder
- Bladder cancer
- Bladder stones, which block the passage of urine and irritate the bladder
- Spinal cord injury that affects the pelvic region
- Difficult pregnancy which causes bladder muscles to weaken
- Prostate cancer treatment side effects that affect the bladder
- Side effects of other surgery which can affect bladder muscles
- Fallng estrogen during menopause which can affect pelvic floor tissue
- Loss of control over the urinary sphincter
- Tumors or obstructions along the urinary tract
- Urge incontinence is often linked to neurological diseases such as Parkinson’s disease, stroke, multiple sclerosis or any kind of disease that affects a person’s brain or nervous system and their ability to store urine. Another common cause is diabetes.
- Side effects of prostate cancer treatment can cause urge incontinence.
- Someone who has a severe urinary tract infection can also suffer from urge incontinence.
- Urge incontinence can also be an early sign of bladder cancer.
Who Are at Risk of Urge Incontinence?
Urge incontinence can affect anyone but these groups of people are more prone:
- Older adults
- Obese individuals
- Women who have undergone C-section or pelvic surgery
- People who smoke on a daily basis
- People with a family history of incontinence
How Is Urge Incontinence Usually Treated?
Not all people with urge incontinence require medical treatment. Some can manage quite well and get on with their lives. However, when urge incontinence becomes too much of a discomfort, it’s probably time to see the doctor or make necessary lifestyle changes. Here are the usual treatment options for people suffering with urge incontinence:
- Reduce or ideally elimate caffeine from the diet
- Limit fluid consumption to 1.5 – 2 litres per day
- Reduce or eliminate alcohol and/or smoking
- Manage your weight and/or diabetes as well as possible
- Limiting spicy, acidic and sugary foods can help alleviate temporary urge incontinence
- Pelvic floor muscle therapy to strengthen pelvic muscles
- Bladder re-training to help manage urge
- Avoidance strategies
Mecial investigations that may be required
- Urinalysis to exclude urinary infection and/or blood in the urine
- Bladder diary to assess how much you drink and how much urine you produce
- Urinary flow test and post-void bladder scan to assess voiding and emptying
- Urodynamic Studies to assess bladder pressure and function
- Cystoscopy to view the inside of your water pipe and bladder
- Pelvic and abdominal ultrasound scan to check for physical abnormalities
- Cystogram to reveal other abnormalities in the urinary tract
- X-rays to check for bladder and/or kidney stones
Medical treatments if required
- Medicines to help relax the bladder muscle. These work by reducing the amount of nerve activity in the bladder. The most commonly prescribed is called oxybutinin. A more modern version is solifenacin or vesicare, but this requires a special funding application.
- Bladder botox injections, which partially paralyse the the bladder muscle and reduce urgency and urge incontinence.
- Sacral nerve stimulation, which requires a surgically implanted device that delivers electrical impulses to the sacral nerves that regulate bladder activity.