Bladder control or urinary incontinence (UI) is an issue for millions of Americans. While it is most common in the elderly, incontinence can occur in people of all ages. Women are twice as likely as men to experience UI.
What is Incontinence?UI is characterized by the inability to control the flow of urine. During an episode of incontinence, a small amount of urine (just a few drops) is passed, or a strong and extremely sudden urge to urinate is sensed followed by losing a large amount of urine. It is not uncommon for women to experience both symptoms.
The severity of UI varies greatly among people. For some, it is mildly bothersome, but for others, it can be virtually debilitating. Some people with UI are so fearful of the embarrassment their symptoms might bring that they avoid social interaction. Some UI sufferers are embarrassed to seek treatment, but it is important to get help: In most cases incontinence can be treated and controlled, if not cured.
UI occurs because of problems with the muscles and nerves that hold or release urine. The body stores urine in the bladder, which is a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass. Incontinence occurs if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine.
The Weight ConnectionBeing overweight can increase your chances of experiencing UI due to the accumulation of extra weight in the midsection. When you carry excess weight in your abdominal area, the extra pounds put added pressure on your bladder. The extra pressure makes your bladder more likely to leak. The type of UI that stems from increased pressure on the bladder causing you to leak urine is referred to as stress incontinence. Actions that typically prompt episodes of stress incontinence include laughing, sneezing, coughing or kneeling.
Obesity can noticeably worsen UI if you had symptoms prior to gaining weight. The good news is losing weight can often reduce its severity.
If You Experience UIBeing overweight is only one risk factor for UI. It can be caused by a number of medical issues such as diabetes or shingles, taking certain medications, pregnancy and childbirth, and surgery. Your UI symptoms may be caused by a number of different reasons. It is important that you discuss your symptoms with your doctor rather than attributing your symptoms solely to being overweight so any underlying problems are identified and/or eliminated.
Your doctor may suggest you keep a bladder diary over the course of several days so you can track your symptoms. Some typical questions you may be asked to answer include:
- What happened immediately before the episode occurred? For example, did you cough or sneeze?
- Did you drink any beverages prior to the episode?
- Were you sedentary or active prior to the episode? If active, what exactly were you doing?
Possible TreatmentsIf there are no other underlying causes, losing weight may decrease your UI episodes. Overall health benefits can begin being seen in patients who lose just 10 percent of their current body weight, so you may see improvement by just losing a small amount of weight. Controlling your weight in the long-term may even completely eliminate your UI symptoms. The more weight you lose from your midsection, the less pressure is on your bladder.
If weight loss doesn't help enough, there are many other options. Dietary changes, such as avoiding caffeine, can help. Women may find Kegel exercises helpful. Behavior modification, biofeedback, prescription medications, and injections may also be appropriate.
In some cases, surgery is needed to properly alleviate the symptoms of stress incontinence.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/National Kidney and Urologic Diseases Information Clearinghouse Urinary Incontinence in Women. Oct 2007. Retrieved 1 July 2008.
Simon, Harvey MD. A.D.A.M. Illustrated Health Encyclopedia. Urinary Incontinence. 15 June 2007. Retrieved 1 July 2008.