Urge Incontinence – Causes, Symptoms and Treatment

A sudden urge to urinate but leaking a few drops by the time you reach the restroom is called ‘Urge Incontinence’. Urge incontinence is sometimes referred to as ‘Overactive bladder’ (OAB) but OAB is little different that there need not be necessarily urine leaking. Urge incontinence is just a symptom of a problem that is present in the pelvis region.

Causes of urge incontinence

The irregular behaviour of the sphincter muscles (around the urethra) are the cause of urge incontinence. Usually, the sphincter muscles hold the urethra tight so that the urine doesn’t leak out from the bladder. At the same time, the muscles around the bladder are in relaxed state without applying any pressure on the bladder. In case of people suffering from urge incontinence, the irregular contraction of muscles around the bladder overpowers the sphincter muscles and pushes the urine out resulting in incontinence.

The causes of abnormal behaviour of the muscles around the bladder and the urethra can be due to any of the following conditions:

1. Damage to the nerves due to various reasons. A previous surgery or injury in the pelvis region or diabetes, stroke can cause nerve damage.
2. Improper communication of the bladder status to the brain due to damage of the spinal cord or nerves in the spinal cord.
3. Irritation of the bladder can also result in unexpected contractions.

Symptoms of urge incontinence

The urge to urinate irrespective where you are and in what state (awake or sleeping etc) and leakage of urine by the time you start urinating.

Who are risk of developing urge incontinence?

Women are always at higher risk of developing some kind of incontinence than men. This is due to the fact that they carry the baby and deliver them which puts a lot of stress on the pelvic muscles that gets weaker and damaged during this process.  Apart from that, following people are at higher risk of developing urge incontinence:

1. Older people. (Every muscle in the body including that in the pelvis region becomes weak)
2. Women (and men) who delivered baby via C-section
3. People who underwent a surgery or had an injury to the pelvis region
4. Aged people as well as younger people whose nerves are damaged do to other medical conditions.
5. People with cancer of the prostate or bladder cancer.
6. People suffering from UTI (Urinary Tract Infection).
7. Constipation also puts chronic stress on pelvic muscles.

Treatment of urge incontinence

Urge incontinence is treated with the following:

1. Behavioural therapy
2. Medicines
3. Electrical stimulation (of the nerves)

Behavioural therapy

Behavioural therapy includes:

1. Timed voiding – You need to make a note of the timings when you feel the urge to urinate. Once you note these timings for few days, you may find a pattern. If you can follow the pattern and empty your bladder before you feel the urge, you can avoid urine leakage.
2. Bladder Training – Training the bladder to empty itself at regular intervals. Doing this can train the bladder and signal it to hold the urine when it is not the right time to urinate.
3. Kegel exercises – This is a very popular and easy exercise anyone can do either while lying on the floor or sitting in a chair. All you need to do is, hold the muscles that support the bladder and urethra tightly in your pelvis region. First you need to identify the muscles, for that, all you need to do is, pretend that you are stopping the flow of urine. It is the same muscles that you need to strengthen.

Step 1 – Hold the muscles (as if you are trying to stop urinating) for 5 seconds.

Step 2 – Relax the muscles

Step 3 – Repeat step 1 ten times. That makes it 1 set.

Step 4 – Repeat Step 1 – 3 five times in a day.

Practice this for five times in a week and very soon you will see the symptoms of urge incontinence fading away.

1. Using weighted cones – This is another technique to strengthen the pelvic muscles. Insert the tampon shaped cone with minimal weight and try to hold it from falling off. Hold it for 5 seconds and then relax. Repeat it for five sets similar to the kegel exercise as mentioned above. As you practice, increase the weight of the cone to add more strength to your pelvic muscles.
2. Your fluid consumption should vary by the season and by day or night. Avoid having water before going to bed. That doesn’t mean that you should dehydrate yourself by having little fluids, you need to watch your liquids intake and patterns of incontinence so that you will get an idea of what’s happening in your body.
3. If you are overweight or obese, work on it to get back to health weight. Being overweight puts a lot of stress on the pelvic muscles.
4. Avoid lifting heavy objects, if you are working out, try not to put pressure in the pelvis region.

Medicines for urge incontinence

Please see a good urogynecologist or a gynecologist to address the problem of urge incontinence. He/she may suggest other ways of strengthening of pelvic muscles.

Electrical stimulation of the nerves

1. Sacral nerve stimulation – An electronic device will be implanted in the back through a minimally invasive surgery. This device delivers electric signals to the sacral nerve that helps in controlling the abnormal contraction of bladder muscles.
2. Percutaneous Tibial Nerve Stimulation – An electric current is applied to the tibial nerve in the person’s ankle which affects the bladder contractions.

Surgical procedures to treat urge incontinence

The surgical procedures may aim at any of the following to treat urge incontinence:

1. Increase the capacity of the bladder
2. Limiting the nerve impulses
3. Diverting the flow of urine by creating other channels.

Incontinence of any type is a very common problem in woman and there is nothing to hide and suffer in silence or feel ashamed. It is a completely treatable condition. All you need to do is get in touch with a good gynecologist near you and have the problem addressed. If you can start with kegel exercise to strengthen your pelvic muscles, you will already be half way through in addressing your incontinence problem.