Urinary incontinence is a common health problem that can happen in both males and females, though some global studies have shown that women of all ages are more likely to experience it.
In this article, Dr. Chong Kian Tai, Urologist at Farrer Park Hospital, will share insight on the topic and more on the causes and ways to manage or prevent the condition.
What is Urinary Incontinence?
Urinary incontinence is a condition where a person passes out urine involuntarily. They are uncontrollable and often cause embarrassment or inconveniences.
When asked if people who frequent the bathroom often after drinking small amount of water has urinary incontinence, Dr. Chong shared that it could be one of the symptoms and that there are many causes of urinary incontinence. However, it is essential to first understand how urination is controlled.
“The starting point to controlling urine flow begins with our brain. It initiates the signal for us to urinate. When a person is about to urinate, two things happen. Firstly, the bladder will squeeze or contract. Secondly, the urethra will relax and open up. If the urethra does not relax, urine will not be passed out no matter how hard the bladder squeezes. On the other hand, if the urethra accidentally relaxes at the wrong time, that is how urinary incontinence happens,” Dr. Chong explained.
Causes of Urinary Incontinence
When the pelvic floor muscle that controls the urethra is not contracted, urine will leak out. To illustrate how the process works, Dr. Chong painted a classic example that many women can relate to: queuing to use the bathroom in shopping malls. While queuing, women have to hold their urine in with their urethra and pelvic floor muscle tightened; releasing it only when they are sitting in the bathroom.
When urine leaks out uncontrollably, there are a few possible main reasons:
- Pelvic floor muscle is weak, which accidentally relaxes to leak urine
- Pelvic floor muscle is tight, but the bladder is more sensitive to urine and squeezing extra hard – Those with a sensitive or in other terms, overactive bladder, will feel an urgency to go frequently to the bathroom to relieve their urine. Leaking urine at this time is called ‘urge incontinence’.
- Impaired control of the brain – Those who suffers from stroke or have a brain tumor will not be able to control their urine even though their urinary system is perfect.
“If the brain, bladder, urethra and pelvic floor muscle do not function together, that is when problems would occur. A detailed analysis by a urologist is required to determine the actual cause and treatment for urinary incontinence,” added Dr. Chong.
For men, ‘overflow incontinence’ is most common. It can occur in some stroke patients because they may not feel that their bladder has reached full capacity, and urine leaks out when the bladder is full. Some men with an enlarged prostate (benign prostate hyperplasia) can also experience chronic urinary retention and cause the bladder to not empty their urine completely. This can be a major problem as it may cause kidney failure.
Other Types of Urinary Incontinence
Besides ‘urge incontinence’ or overactive bladder, other types of urinary incontinence include:
- Stress incontinence – Occurs with women leaking urine through everyday actions like coughing, laughing or lifting of heavy goods. These actions though seemingly normal, can put pressure on the bladder and cause urine to leak.
- Functional incontinence – Occurs when there is physiological, pathological or psychological impact. For instance, a person who is on other forms of medication or other health issues may experience functional incontinence.
- Mixed incontinence – Occurs when a mixture of various incontinence types affect the bladder, urethra outlet tract and brain signals. These components need to be identified individually before a treatment solution is recommended.
When asked how it can be avoided or treated, Dr. Chong said: “To treat stress incontinence, physiotherapy with Kegel exercises is an important way. Kegel exercises are done to strengthen the pelvic floor muscle. When done regularly, results can be seen from as fast as a couple of weeks to a few months.”
“As for patients with ‘urge incontinence’ and overactive bladder, we have medicine to treat it. One pill a day can help most patients to control it,” added Dr. Chong.
How to Prevent Urinary Incontinence
Some patients over-drink with too much fluids and keep going to the bathroom. When asked about tips on how everyone can take to prevent the condition, Dr. Chong said: “Do not drink too much water. Six to eight cups of water a day is enough. Besides the water we drink, the foods we eat such as fruits, vegetables and soup also contain water.”
“It is also advisable to reduce the intake of coffee or tea as they might stimulate an overactive bladder, causing frequent visits to the washroom. Another way is to perform Kegel exercises to strengthen the pelvic floor muscle. This can help to better control the urethra without unwanted urine leak,” Dr. Chong added, “If your condition does not improve, please see a specialist who can help you.”