Urinary incontinence can severely interfere with your day-to-day activities. But you’re not alone in this battle of the bladder. Affecting over 13 million Americans,1 urinary incontinence involves a reduced ability to control the flow of urine. It occurs mainly when the urinary sphincter, the muscle that facilitates the voluntary exit of urine, is either weakened or completely damaged, causing the urine to flow involuntarily. The severity of the leakage can range from a mild dribble to a full release of the bladder’s contents. People with urinary incontinence often suffer emotional stress and poor self-esteem as a result.
Who Is At Risk And Why?
Urinary incontinence can affect anyone, regardless of age or gender. However, women are twice as likely to have urinary incontinence than men.2 Also known as enuresis, it can occur due to genetics, anxiety, or structural abnormalities in the bladder or urethra. Because of the physiological changes associated with aging, older people are also at a higher risk.
Patients with neurological diseases like Parkinson’s or multiple sclerosis are more susceptible to urinary incontinence. Certain types of cancer may cause incontinence, particularly those in the pelvic region (like prostate, bladder, or colorectal cancer), brain or spinal cord (which affects the nerves), or cervix or breast (which impact reproductive organs and hormones). Cancer treatments such as radiation, chemotherapy, or hormone therapy can also increase the risk.3
Medications such as diuretics, sedatives, and antidepressants can trigger the condition, and so can vitamins B and C if taken excessively. Even some lifestyle choices may lead to incontinence, including smoking and consuming excessive amounts of alcohol, caffeinated drinks, or artificial sweeteners.4
What Are The Most Common Types?
There are a few different types of urinary incontinence due to varying factors, including physical pressure, damaged nerves and muscles, and other conditions or disabilities.
Physical pressure exerted on the pelvis by activities like sneezing, coughing, exercising, or laughing can result in urine leakage. This is the most common type of urinary incontinence, and more prevalent in women who have gone through childbirth, because it weakens the pelvic floor muscles. One study shows that women with four or more babies are at an increased risk.5 Obesity, especially excess weight around the middle, can strain pelvic muscles, while medications such as alpha blockers and ACE inhibitors also pose the risk of stress incontinence.6
Due to damaged nerves and muscles in the bladder, a person may have a strong urge to urinate, so much so that they may not be able to hold it in time to reach a bathroom. Neurological diseases like Parkinson’s, multiple sclerosis, stroke, and spinal injury affect the nerves that signal proper urination.
Common in older men, this type of incontinence happens when the bladder never fully empties and thus leaks constantly. It may be due to the inability of the bladder muscles to squeeze properly or because obstructions like kidney stones or constipation block the urethra, the tube that removes urine from the bladder.
Certain conditions or disabilities (like dementia, arthritis, or using a wheelchair) can make it difficult for a person to reach the bathroom in time.
This includes a combination of stress and urge incontinence and is most common in women. In menopausal women, the lining of urethra thins as a result of the drop in estrogen levels, leading to involuntary urine leakage.7 Weakened pelvic floor muscles and reduced bladder capacity lead to mixed incontinence in older people as well. Men who have had pelvic fractures or prostrate surgeries suffer from this due to damage to the urinary sphincter.
How Is It Typically Treated?
Urinary incontinence can be treated right at home, with lifestyle modifications, exercises, and bladder training. Keeping a diary of your bathroom habits is a good first step. You can control the number of leaks and the urge to go by scheduling bathroom trips and adjusting fluid intake. Kegel or pelvic floor exercises are advised for controlling stress and urge incontinence since they strengthen the urinary sphincter and pelvic floor muscles. Research shows these exercises to be effective, especially when used with biofeedback, an instrument that electronically monitors bodily functions. This enables better physiological awareness and control of your bladder function.8 Significant lifestyle changes, like losing weight, quitting smoking, and cutting down on alcohol and caffeine, can also improve your control of your bladder.
If you find your condition interfering with your lifestyle, your doctor may prescribe drugs or some medical devices such as vaginal cones to strengthen pelvic floor muscles. For some women, a urethral insert is recommended. This is a medical device resembling a tampon that is placed in the vagina before doing strenuous work. Pessary, a stiff ring, is also used inside the vagina to prevent leakage. Sometimes, electrodes are placed in the vagina or rectum to stimulate and strengthen muscles. If your incontinence is immune to other treatments, your doctor may consider options for surgery.
Remember, incontinence itself is not dangerous, but it can be a symptom of a serious illness like cancer.9 Your doctor may use blood tests, urinalysis, ultrasound, and cystoscopy to rule out other possible illnesses.
Try The Alternative Way
Research shows that some alternative treatments like acupuncture, Ayurveda, hypnotherapy, yoga, and herbal remedies can help treat urinary incontinence.
Acupuncture stimulates the nervous system, encouraging the production of neurotransmitters and thereby regulating normal bladder function.10 It also improves bladder capacity and assists in relieving stress and urge incontinence.11
One study has found that regular yoga therapy substantially reduced stress incontinence. Common yoga poses like Chair Pose (Utkatasana), Triangle Pose (Trikonasana), and Squat Pose (Malasana) were found to help people with urinary incontinence.12 Meditation also helps lower stress, which can be invaluable for those suffering from anxiety and depression due to their leaky bladders.
A recent study shows that extracts from the seeds of cucurbita maxima, a type of pumpkin, can treat an overactive bladder.13 While the mechanisms involved need further study, sitosterols found in the seed oil are thought to play a role in alleviating urinary tract disorders.14 Ayurvedic regimens such as dinacharya (daily regimen), _panchakarma (detoxification therapy), and _rasayana (rejuvenation) can also assist in managing the root cause of incontinence linked to conditions like arthritis, dementia, obesity, and diabetes.15
Herbs like gosha-jinki-gan, hachi-mi-jio-gan, buchu, cornsilk, cleavers, and horsetail are currently being studied to test their potential to treat incontinence.16
Hypnotherapy may not help incontinence directly but assists in dealing with the psychological and emotional distress associated with it, thus modifying behavior and alleviating symptoms.17
Having urinary incontinence is undeniably stressful. And while it may be embarrassing to talk to your doctor about your bathroom habits, it is vital to seek treatment if you want to improve your quality of life. Just remember, it’s possible to manage the condition, and, with millions of Americans suffering right alongside you, there may be comfort in knowing you’re not alone.
|↑1||Urinary Incontinence in Adults: Clinical Practice Guideline Update, US Agency for Healthcare Research and Quality.|
|↑2||Urinary Incontinence, U.S. National Library of Medicine.|
|↑3||Urinary Incontinence, American Society of Clinical Oncology.|
|↑4||Urinary Incontinence, NHS UK.|
|↑5||Thomas, Thelma M., Kay R. Plymat, Janet Blannin, and T. W. Meade. “Prevalence of urinary incontinence.” Br Med J 281, no. 6250 (1980): 1243-1245.|
|↑6||Drugs That May Cause Or Worsen Urinary Incontinence, Merck Manuals.|
|↑7||Urinary Incontinence, The North American Menopause Society.|
|↑8||Burgio, Kathryn Larsen, J. Courtland Robinson, and Bernard T. Engel. “The role of biofeedback in Kegel exercise training for stress urinary incontinence.” American Journal of Obstetrics and Gynecology 154, no. 1 (1986): 58-64.|
|↑9||Types of Urinary Incontinence, Patient Education Center, Harvard Medical School.|
|↑10||Urinary Incontinence, British Acupuncture Council.|
|↑11||Hudson, Tori. “Acupuncture and urinary incontinence.” Townsend Letter for Doctors and Patients 269 (2005): 142-143.|
|↑12||Huang, Alison J., Hillary E. Jenny, Margaret A. Chesney, Michael Schembri, and Leslee L. Subak. “A group-based yoga therapy intervention for urinary incontinence in women: a pilot randomized trial.” Female pelvic medicine & reconstructive surgery 20, no. 3 (2014): 147.|
|↑13||Nishimura, Mie, Tatsuya Ohkawara, Hiroji Sato, Hiroshi Takeda, and Jun Nishihira. “Pumpkin seed oil extracted from Cucurbita maxima improves urinary disorder in human overactive bladder.” Journal of traditional and complementary medicine 4, no. 1 (2014): 72.|
|↑14||Friederich, M., Theurer, C., & Schiebel-Schlosser, G. (2000). [Prosta Fink Forte capsules in the treatment of benign prostatic hyperplasia. Multicentric surveillance study in 2245 patients]. Forschende Komplementarmedizin und klassische Naturheilkunde= Research in complementary and natural classical medicine, 7(4), 200-204.|
|↑15||Chandola, H. M. “Lifestyle Disorders: Ayurveda with Lots of Potential for Prevention.” Ayu 33.3 (2012): 327.|
|↑16||Chughtai, Bilal, Elizabeth Kavaler, Richard Lee, Alexis Te, Steven A. Kaplan, and Franklin Lowe. “Use of herbal supplements for overactive bladder.” Reviews in urology 15, no. 3 (2013): 93.|
|↑17||Freeman, R. M., and K. Baxby. “Hypnotherapy for incontinence caused by the unstable detrusor.” Br Med J (Clin Res Ed) 284, no. 6332 (1982): 1831-1834.|