INCONTINENCE, URGE

 Basic information

description

Urge incontinence involves a need or urge to urinate followed by an involuntary loss of urine. It occurs more often in older adults and in women more than men. The condition may be referred to as overactive bladder.

FREQUENT SIGNS & SYMPTOMS

• Loss of urine right after feeling an urge to urinate. It may be a few drops to complete bladder emptying.
• Symptoms may occur with sudden change in position or activity, hearing or touching running water, drinking a small amount of liquid, and during sleep.
• Key-in-lock syndrome may occur. This happens when you rush home, put a key in the door lock, and experience a sudden bladder contraction and urine leakage.

causes

The usual cause is a spasm or contraction of the bladder muscle. It squeezes at the wrong time, earlier than it should, and causes the leakage. The spasm may result from bladder nerve damage, other nerve problems, or problems of the bladder muscles. The bladder may be described as spastic, overactive, or unstable.

risk increases with

• Repeated vaginal childbirth.
• Adults over 60. Women more than men.
• Hormonal changes in women after menopause.
• Obesity.
• Surgery or radiation of the genitals or urinary tract.
• Urinary-tract infection, stone, cancer, or obstruction.
• Certain neurological (nervous system) disorders.

PREVENTIVE MEASURES

• There are no specific preventive measures. To reduce your risks: maintain a healthy weight, exercise daily, don't smoke, and limit alcohol and caffeine intake. Get physical exams to detect early problems.
• Strengthen pelvic floor muscles with Kegel exercises:
  • The first step is to identify pelvic floor muscles. When urinating, stop the flow by squeezing the pelvic floor muscles. Another way is to insert a finger into vagina (women) or rectum (men), then tighten the muscles around the finger. Repeat each method until you are sure you can feel which muscles are involved.
  • The exercises can be done any time and any place, lying down or sitting up. Start by emptying the bladder.
  • Tighten pelvic floor muscles. Hold for a count of 10.
  • Relax the muscles completely for a count of 10.
  • Perform 10 exercises, 3 times a day (morning, afternoon, and night). Don't do more than this.
  • It may take 6 weeks to 3 months for improvement.

expected outcomes

Treatment can help reduce symptoms.

possible complications

Medical problems are rare. It can affect quality of life.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your incontinence symptoms. Medical tests of blood and urine may be done to check for other conditions. Additional tests may be done to help diagnose specific urinary-tract problems. You may be asked to keep a diary about your urination patterns.
• Treatment may involve drugs for bladder spasms or infection, weight loss, smoking cessation, Kegel exercises, pessary, other types of therapy, or surgery.
• Other therapies include biofeedback, electrical stimulation, bladder training, magnetic innervation, or special weights to strengthen pelvic muscles.
• Have quick access to a toilet. Urinate on schedule.
• Learn and practice Kegel exercises. Try to use the squeezing technique just before any activity that brings on the urinary urge (running water or drinking water).
• Wear absorbent underpants or incontinence pads.
• A pessary (support device) to fit inside the vagina to support the uterus or other types of devices including urethral plugging or stenting may help.
• If other methods fail, surgery helps some. Even with surgery, some leakage may continue.
• To learn more: National Association for Continence; (800) 252-3337; website: www.nafc.org.

medications

• Drugs to control bladder spasms may be prescribed.
• Estrogen therapy may be prescribed for women.
• Drugs for infection if needed.

activity

No limits. Exercise on a regular basis to improve health.

diet

• Start a weight-loss program if you are overweight.
• Limit caffeine and alcohol. Reduce overall fluid intake.

 notify our office if

You or a family member has urge incontinence symptoms.

Special Notes: