Overcoming Incontinence

By Dr Ahlam Busaber
Urologist, ‎Al Qassimi Hospital

“I want to tell women of all ages that incontinence is not a disease; it is a condition which accompanies some other treatable health problems”.

What is Incontinence?

Urinary incontinence is an uncomfortable condition which affects quality of life through the accidental or involuntary release of urine. It can happen when pressure is exerted on your bladder or you have a sudden urge to go to the bathroom, but can’t get there on time. Bladder control problems are very common; they don’t usually cause major health problems, but can be embarrassing.

Incontinence can be a short-term problem caused by a urinary tract infection, or a side effect of a certain medication or of constipation. It gets better when you treat the problem which is causing it, but can be a persistent condition caused by physical problems such as pregnancy, childbirth, age, menopause and surgeries which involve a woman’s reproductive system.

What are the most common types of Incontinence?

The two most common types of Incontinence are stress (light) and urge incontinence.

• Stress Incontinence: Also known as light incontinence, it occurs when you sneeze, cough, laugh, jog or do anything which puts pressure on your bladder, resulting in a slight leak. It is the most common type of bladder control problem among women. These bladder problems are caused by weak muscles in the lower urinary tract.
• Urge Incontinence happens when you have a strong need to urinate, but can’t reach the toilet in time. This can happen even when your bladder is only holding a small amount of urine. Some women may experience no warning whatsoever before they accidentally leak urine. Other women may leak urine when they drink water, or hear or touch it as its running.

Let us delve more into stress (light) incontinence, as it is the most common among women in our region:

What are the causes?

• Multiple pregnancies and post-pregnancy body changes
• Type of delivery method and pelvic surgeries
• Menopause and other hormonal diseases
• Obesity and diabetes
• Illnesses which cause chronic coughing or sneezing
• Excess consumption of caffeine and smoking
• High-impact activities over the years

What are the symptoms?

If you have stress incontinence, you may experience urine leakage when you:

• Stand up
• Get out of a car
• Exercise and lift heavy weights
• Laugh, cough and sneeze

You may not experience incontinence every time you do one of these things, but any pressure-increasing activity can make you more vulnerable to unintentional urine loss, particularly when your bladder is full.

When to see a doctor and how to treat it?

Speak to a urology specialist if your symptoms interfere with daily activities such as work, hobbies and social life, as most women can be helped or cured.

Remedies may simply include pelvic-floor exercises such as the Kegels, which help in strengthening your pelvic muscles, bladder trainings, the use of hygienic solutions which give you the safety and security you are looking for as well as applying some positive changes to your lifestyle.

How to do Kegel exercises:

• Squeeze the same muscles you would to stop your urine. Your belly and thighs should not move
• Hold the squeeze for 3 seconds, then relax for 3 seconds
• Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds
• Repeat the exercise 10 to 15 times a session. Do three or more sessions a day
• For best results, more than three sets of Kegel exercises should be done every day
  How to do bladder trainings
• Keep a diary as a guide to help you gain more control over your toilet visits
• Schedule bathroom visits by determining how often you are going to the bathroom based on your diary entries. Then, add about 15 minutes
• Use the bathroom at each scheduled visit, regardless of whether you actually feel the urge to go or not
• Gradually increase the amount of time between bathroom breaks
• Delay urination. When you feel the urge to urinate, hold it for another five minutes or so. Then, gradually increase the amount of time by 10 minutes, until you can last for at least three to four hours without having to go to the bathroom
• If you’re feeling a strong need to go, try distracting yourself by counting backwards from 100 to one or practicing relaxation techniques such as deep breathing

Positive changes you can apply

• Cut back on caffeine and fizzy drinks
• Eat high-fibre foods to help avoid constipation
• Don’t smoke
• Maintain a healthy weight
• Go to the bathroom at several set times each day, and wear clothes which you can easily remove
• Make your path to the bathroom as clear and easy as possible
• Keep track of your symptoms and any leaking with a bladder diary