Urinary Incontinence (UI) / Involuntary Urination
WHAT IS URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION?
Urinary incontinence is the involuntary loss of urine, it is referred to as urinary incontinence (UI). This loss of urine can happen when someone laughs, sneezes, coughs, lifts something heavy, or during sexual activity. This involuntary urination could amount to just a few drops of urine or a large amount of urine. This occurs at least twice as often in women than it does in men, and it can range from being slightly annoying to totally debilitating.
From the moment you contact Loma Linda University Health, we do everything we can to make sure your urinary incontinence treatment runs smoothly. Our goal is to make your experience as convenient, comfortable and stress-free as possible.
WHAT ARE THE SYMPTOMS OF URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION?
Some of the symptoms of urinary incontinence may include:
- Urine leakage when coughing, laughing, sneezing, exercising or lifting something heavy (also known as stress incontinence).
- A sudden urge to urinate followed by involuntary urination (also known as urge incontinence). This may be caused by something as minor as a urinary tract infection, or something more serious such as diabetes or a neurologic disorder.
- Frequent or constant dripping of urine (also known as overflow incontinence). This is due to a bladder that doesn't empty completely.
WHAT CAUSES URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION?
Urinary incontinence (UI) / involuntary urination is sometimes caused by an easily treatable medical condition, such as a urinary tract infection or constipation.
UI can also be caused by a heavy intake of alcohol, caffeine, carbonated drinks, and sparkling water, as well as drinks made with artificial sweeteners.
Certain foods can cause involuntary urination. Some of these foods include chocolate, chili peppers, and heavily spiced foods, or foods with a lot of sugar or acid content, especially citrus fruits.
Also, heart and blood pressure medications, sedatives and muscle relaxers, and large doses of vitamin C can cause urinary incontinence.
HOW IS URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION DIAGNOSED?
Diagnosing urinary incontinence begins with an exam and medical history. Tests may also be ordered to check for an infection. Patients may be asked to keep a bladder diary to record fluid intake, overall urination and the frequency of involuntary urination. In some cases, a doctor may recommend additional tests such as urodynamic testing and pelvic ultrasound.
HOW IS URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION TREATED?
Possible treatments for urinary incontinence (UI) could include non-surgical treatments, use of devices or surgery.
Nonsurgical Treatments
Kegel exercises – Exercising the muscles of the pelvis such as with Kegel exercises are the first-line treatment for women with stress incontinence. This may also be helpful in those with mixed incontinence.
Weight management – Weight loss is recommended for those who are overweight.
Bladder training – Efforts to increase the time between urination, known as bladder training, is recommended in those with urge incontinence.
Weighted vaginal cones – These are inserted into the vagina starting with the lightest weight, then working up to a higher weight. The idea is to hold these inside the vagina instead of letting them drop out. This method trains and strengthens the vaginal muscles.
Biofeedback – Biofeedback uses measuring devices to help the patient become aware of the body's functioning. By using electronic devices or diaries to track bladder and urethral muscle contraction, the patient can gain better control over these muscles.
Time voiding – In time voiding, the patient fills in a chart of times when voiding and leaking. From the patterns that appear in the chart, the patient can plan to empty the bladder before a leak occurs.
Devices
Collecting systems (for men) – These consist of a sheath worn over the penis funneling the urine into a urine bag worn on the leg. These products come in a variety of materials and sizes for individual fit. Studies show that urisheaths and urine bags are preferred over absorbent products.
Absorbent products (including panty shields, protective underwear, adult diapers, and underpants) – These are the best-known product types to manage incontinence. They are easy to purchase and need little to no fitting. The disadvantages with absorbent products are that they can be bulky, leak, have odors and can cause skin breakdown.
Fixer-occluder devices (for men) – These devices are strapped around the penis, softly pressing the urethra and stopping the flow of urine. This management solution is only suitable for light or moderate incontinence.
Indwelling catheters (also known as foleys) – These are frequently used in hospital settings or if the user is not able to handle any of the above solutions her- or himself. The indwelling catheter is typically connected to a urine bag that can be worn on the leg or hang on the side of the bed. They need to be changed on a regular basis by a healthcare professional. It’s not uncommon to develop a urinary tract infection with the use of indwelling catheters.
Intermittent catheters – These are single-use catheters that are inserted into the bladder to empty it, and once the bladder is empty they are removed and discarded.
Medications
Several medications exist to treat urinary incontinence, including:
- Fesoterodine
- Tolterodine
- Oxybutynin
While these appear to have a small benefit, the risk of side effects is a concern. For every ten or so people treated by medications, only one will become able to control their urine. Medications are not recommended for those with stress incontinence and are only recommended in those who have urge incontinence who do not improve with bladder training.
The benefit of medications is small and long-term safety is unclear.
Surgery
Surgery may be used to help stress or overflow incontinence. Common surgical techniques for stress incontinence include slings, tension-free vaginal tape and bladder suspension among others. Urodynamic testing seems to confirm that the surgical restoration of vault prolapse can cure motor urge incontinence. In those with problems following prostate surgery, there is little evidence regarding the use of surgery.
WHAT ARE THE COMPLICATIONS OF URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION?
Complications of chronic urinary incontinence can include:
- Skin problems, including rashes, skin infections and sores
- Recurrent urinary tract infections
- Depression and anxiety
WHO IS AT RISK FOR DEVELOPING URINARY INCONTINENCE (UI) / INVOLUNTARY URINATION?
Those at the greatest risk for urinary incontinence include:
- Pregnant women
- Women giving birth vaginally
- Aging men and women
- Perimenopausal and postmenopausal women
- Women who have had a hysterectomy
- Men with an enlarged prostate
- Men with prostate cancer
- Those with a urinary obstruction such as a tumor or stones
- Those with neurological disorders
NEXT STEPS
Seek medical intervention. If you are suffering from urinary incontinence / involuntary urination, seek medical intervention. Being proactive is important, and it starts with a medical evaluation. To request an evaluation at Loma Linda University Health, contact your provider or schedule the appointment through MyChart.