Urinary incontinence is the unintentional or involuntary passing of urine. There are many causes of urinary incontinence, the most common being related to pregnancy, childbirth and menopause. Other causes can include infection, medication, weak bladder muscles, complications from surgery or chronic diseases such as diabetes.
Women experience urinary incontinence twice as often as men. Pregnancy and childbirth, menopause, and the composition of the female urinary tract account for this difference. Both women and men can have trouble with bladder control from neurological (nerve) injury, strokes, multiple sclerosis, birth defects and physical problems associated with ageing. Older women have more bladder control issues than younger women do. Loss of bladder control in women can be attributed to problems with the muscles that help to hold and release urine and can be made worse by menopause.
Accidental leaking of urine can be caused by extra weight. If you are overweight, diet and exercise may help you lose weight and this may improve urinary incontinence.
Some foods and drinks can cause incontinence, such as caffeine (in coffee, tea, cola drinks, chocolate) and alcohol. Restricting these foods and liquids in your diet may help reduce incontinence. Drinking too many fluids may also be a cause. Though we are taught that drinking lots of water is healthy, drinking too much can actually lead to problems. Unless you’re an elite athlete, keep your daily fluid intake (of all types of drinks) to around two litres – more if you’re exercising or in a hot environment. Make sure you consult with your doctor before making any major changes in your fluid intake.
There are a number of ways to treat incontinence:
Anticholinergic medicines (also known as antimuscarinic medicines) such as oxybutynin prevent urge incontinence by relaxing muscles of the bladder. The most common side effect of the medication is a dry mouth, although large doses has been know to cause blurred vision, constipation, an elevated heartbeat and flushing.
For stress incontinence, duloxetine may be considered as an alternative to surgery. It works by acting on the nerve signals that control the bladder’s sphincter muscle. Common side effects include dry mouth, nausea, fatigue and difficulty sleeping.
Oestrogen may be helpful in conjunction with other treatments for postmenopausal women with urinary incontinence.