Urinary incontinence

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Urinary incontinence is very common and means that urinary leakage occurs at various times. It is rarely a sign of any serious illness. There is much you can do to reduce the hassle but sometimes treatment is needed.

This text is about urinary incontinence in adults. Children may also have urinary incontinence problems. You can read more about this in the texts  children who pee during the day  and  bedwetting.

symptoms

In urinary incontinence, it is common to have one or more of the following symptoms:                    

  • It leaks urine when you suddenly feel pissed off.
  • You need to pee often, even at night.
  • It leaks urine in small splashes
  • It leaks urine when you strain. This can be, for example, if you sneeze, cough or jump. 

When and where should I seek care?

Contact a health care provider if you have urinary incontinence. If it is a weekend, you can wait until it is everyday. Many health centers can be contacted by  logging in .

Different types of urinary incontinence

There are several types of urinary incontinence.

Stress incontinence

Exercise incontinence means you have trouble keeping tight when the pressure in your stomach and bladder becomes too high. For example, you may be leaking urine when you cough, sneeze or jump.

It can leak small splashes of urine without you feeling the need to urinate. This type of incontinence is more common in  women.

Urge incontinence

Urgent incontinence means that you suddenly feel pissed off and have difficulty keeping up. It is common for you to urinate often. This type of incontinence is more common in women.

Mixed incontinence

It is common to have a mixture of urge incontinence and urge incontinence. It’s called mixed incontinence. Mixed incontinence means that you both find it difficult to hold tight when you exert yourself and that you suddenly become pissed off and have difficulty holding you. This type of incontinence is more common in women.

Overflow

Overflow incontinence means that you have difficulty emptying the bladder completely. This causes the bladder to expand instead. When the bladder becomes overcrowded, the urine is squeezed out of the bladder through the prostate gland. The urine often leaks in small splashes. This type of urinary incontinence can cause damage to the kidneys and bladder if it is not detected in time. Transcontinental incontinence is more common in  men.  

What can I do for myself?

In the case of urinary incontinence, there are some methods and tips on things you can do yourself. 

Pelvic floor exercises

Pelvic floor training can help you who suffer from exercise incontinence or with incontinence.

Pelvic floor training strengthens the muscles around the rectum, vagina and urethra. It helps you stay tight as you strive.

In order for the workout to have a good effect, it is important that you train the right muscles. Read more about pelvic floor training and how you can do to find the right muscles here.

It usually takes up to six months before you can feel the results of the training. Sometimes things go faster.

Assistive products for pelvic floor training

There are aids for women that can make it easier to exercise the pelvic floor muscles. For example, there are plastic cones or balls that you insert into the sheath. This type of aid is available at pharmacies and continental clinics. A continence clinic is a clinic that specializes in taking care of inconvenience.

Do not hurry to the toilet                            

For those of you who sit down while kissing, it is important that you sit comfortably and give yourself time to pee.

The sensitive kissing reflexes can be affected if you are in a hurry when kissing. The reflexes can also be affected if you stay too long or you kiss often, for safety’s sake.  

Exercise and a good amount of drink

You should think about how much fluid you drink per day. A good benchmark is to drink so much that you pee one to two liters per day. Coffee and tea are fluid and make it more urine in the body. Sometimes it can help to drink less of these drinks.

Constipation can aggravate urinary incontinence. Fine with drink, plenty of fiber and exercise is good for constipation.

You who have exercise incontinence can try using a tampon in the vagina. It can make it easier to keep tight.

There are incontinence protections available at pharmacies

You can buy some accumulating incontinence protection at a pharmacy yourself.

There is also an aid that is supported by medical silicone that can help. The continental support is inserted into the vagina to push the urethra forward and upward, thus helping you with the urinary leakage.

Good to quit smoking

It is good if you stop smoking, if you smoke, because smoking cough makes the incontinence worse.

after Drop

Men can have trouble with drip. After drip, a small amount of urine remains in the urethra after you have been kissed. The urine then drips into your underwear. You who have trouble with the drip can try to pull a few fingers along the urethra, from the back of the purse and out along the penis when you have finished kissing. Then you can get the last drops. 

Sex in incontinence

Incontinence can make you feel insecure about having sex. If this is experienced as a problem, much depends on the attitude you and the person or people you have sex with. What you can try to do yourself are:

  • Pee before having sex.
  • Test different intercourse positions to reduce urinary bladder pressure.

Can I Prevent Urinary Incontinence?

It is not clear if urinary incontinence can be prevented. Regular  pelvic floor  training and exercise are likely to have a positive effect. 

Investigation

When you see your doctor, you will first tell you about your complaints. To find out what the urinary incontinence is and what type of urinary incontinence you have, your doctor does several examinations.  

Urine sample

First, you have  to pass a urine test  to find out if you have  blood in your urine  or a  urinary tract infection.  It is done because you may have temporary incontinence of a urinary tract infection that irritates the bladder.

Bladder Diary

Often, you are required to keep a so-called blue exhaust diary. This means that for a few days you measure how much you kiss and at what time.

You who use incontinence protection can do a so-called diaper weighing test. Then you weigh the incontinence cover before and after you use it. The diaper weighing test provides the answer to how much urine you leak.

Examination of pelvic floor muscles

Women who have urinary incontinence problems can do a study of the pelvic floor muscles. The examination can be done by a doctor, midwife, urotherapist or district nurse. They can also see if your mucous membranes are fragile.

At a pelvic floor examination for the person who examines you insert two fingers into the vagina and feel. That way they can judge how much you can pinch.

Measurement of urine remaining in the bladder

If you have difficulty emptying the bladder, you can do a test to measure the amount of urine left in the bladder. It can be done with a  catheter  or with an  ultrasound examination . A catheter is a thin tube that is inserted into the bladder through the urethra.

Blood sample

You can also have  a blood test.  The blood test measures how the kidneys work.

Prostate examination and PSA blood test

Men who suffer from urinary incontinence may sometimes submit to a  PSA blood test.  PSA is a protein that is produced in the prostate gland and that accompanies the seminal fluid when you are triggered. A small amount of PSA is also found in the blood and this is the level measured with a PSA test.

The doctor also examines your prostate by sensing it with a finger through the rectum. It is also common for you to measure the power of the urethra. This is done by measuring how long it takes to get the first deciliter out of urine.

Other investigations

Sometimes more ultrasound examinations are done. Then the doctor examines your uterus, your ovaries and your kidneys or your prostate and your kidneys.

cystoscopy

You may also be able to do a  cystoscopy . Then a thin tube is inserted into the urethra and bladder. At the front of the hose is a small camera that transfers pictures to a screen.

Pressure measurement of the bladder

Sometimes a pressure measurement is also made of the bladder, also called urodynamic examination. Then insert the doctor into thin tubes in the urethra and bladder. With the help of the hoses, the pressure in the bladder is then measured during emptying and storage of urine. 

Treatment

Sometimes the inconvenience of incontinence becomes less of things you can do yourself. Sometimes treatment is needed.

The treatment you receive depends on the type of urinary incontinence you have.

Exercise incontinence treatment

The trouble with exercise incontinence can reduce with  pelvic floor training .

Operation

You can be operated on if you do not get better after six months of pelvic floor training.

A common operation is TVT, or Tension Free Vaginal Tape. In this type of surgery you will receive local anesthesia. You usually do not have to stay at the reception overnight but can go home the same day.

During surgery, the doctor makes two incisions over the pubic bone and one under the urethra, through the vagina. With a special needle, a thin band pulls them up on both sides of the urethra and up over the pubic bone. The band then supports the urethra when you cough or strain the pelvic floor, thus preventing urinary leakage. 

Drugs for exercise incontinence

Those who cannot or do not want to be operated on can get medicines for exercise incontinence.

The drugs have a moderate effect. Side effects such as nausea, dry mouth, insomnia and fatigue are common. 

Treatment for urinary incontinence

The treatment you receive depends on what is the cause of the inconvenience.

Women with urinary incontinence can have less trouble with  pelvic floor training.

bladder training

Blow training can help you who often feel pissed off but only pee small amounts. Small quantities are counted as less than two deciliters.  

Blast training is about trying to keep yourself and not pee for safety. Having the habit of peeing often to avoid leaks and exercises may have affected the bladder reflex system.

The training is based on the Blast Emission Diary. Based on the diary, you set goals for yourself. For example, a goal might be to pee at least two to two and a half deciliters each time or keep you extra 10 to 15 minutes when feeling a cramp.

Blast training does not help you who have urinary incontinence due to a prostate enlargement. It also does not help you who have urinary incontinence due to old age. 

Drugs for urinary incontinence

You can get medicines that soothe the bladder and that you do not need to urinate as often. The drugs work by blocking the nerve impulses from the brain that cause the bladder to contract. There are several different drugs but they all work in the same way.

The drugs can cause some side effects. For example, it can be dry mouth, constipation and difficult to adjust from looking up close to seeing up close. It is unusual but the drugs can cause you to get confused. The side effects can disappear if the dose is lowered. Talk to your doctor if you have any side effects.

Medicines for benign prostate enlargement  can help you who have urinary incontinence due to prostate enlargement.

You may need surgery

Some forms of urge incontinence are more difficult to treat. Then you can get medicine directly into the bladder.

Other special forms of urge incontinence are treated with an operation. For example, such an operation may be that you get an artificial end muscle at the urethra.

Urinary incontinence at high age

Those who have urinary incontinence at a high age may need to be reminded to urinate before the urge leads to urinary leakage. This also applies to those who have dementia or who have had a stroke. The urge often comes when the bladder is filled to a certain amount. Then you can prevent urinary leakage by peeing before that.

Overcontinent incontinence treatment

The treatment that you receive depends on what your overcontinent incontinence is.

An enlarged prostate is treated with surgery

You who have overcontinent incontinence due to an enlarged prostate can be treated with a prostate surgery. 

Before the operation, you will have a catheter inserted into the bladder through the urethra. A catheter is a thin, soft tube that empties the bladder on urine. The catheter stays in place until you have surgery.

Sometimes it is not possible to operate. This may be because the risks become too great because you have another illness as well. Then the catheter will stay longer. It is usually replaced every three months. Having a catheter for an extended period of time almost always means that there will be bacteria in the urine, which can cause urinary tract infection.

The urethra may need to be widened

Urinary incontinence due to  urethral constriction is  treated by dilating the urethra. The doctor can do this in conjunction with a  cystoscopy examination.  At a cystoscopy, the doctor inserted a narrow tube into the urethra. On the hose is a small camera. The tube is then often connected to a monitor that shows the inside of the urethra and bladder.

You may need to learn how to drain the urine yourself

You who have urinary incontinence due to a neurological injury may need to learn how to drain the urine yourself. You should do this three to four times a day using a narrow catheter.

What happens in the body?

The bladder functions both as a container for the urine that is formed and as a pump when the bladder is emptied. When the bladder is properly stretched by urine, nerve impulses are sent to the brain and you feel pissed off. Once you have found a suitable place to urinate, the bladder signals will contract. At the same time, the muscles in the pelvic floor relax and the end muscle opens, allowing you to pee.

Between the toilet visits, there is low pressure inside the bladder and higher in the urethra. If the pressure in the bladder exceeds the pressure in the urethra, urinary leakage occurs.

What is the cause of urinary incontinence?

Urinary incontinence can have many different causes. It is a very common problem and is rarely a sign of any serious illness. For many, this is a minor problem, but for some it is a condition that greatly impairs the quality of life.

Exercise incontinence is more common in you as a born child

Urinary incontinence is more common in those who have given birth. This is because the pelvic tissues, around the urethra and bladder are affected by being pregnant and giving birth to babies.

It is also more common to have urinary incontinence if you have difficulty pinching the muscles of the pelvic floor or if you have an appearance.

Urinary incontinence is also more common in women who have  asthma , chronic respiratory tract obstruction, smoke, have severe obesity or have long-term  constipation.

Temporary effort incontinence

It is common to get temporary exercise incontinence during a pregnancy or if you have a  cold  with a  cough.

Exercise incontinence in men

Exercise incontinence is uncommon in men but can occur after an operation of the prostate.

Urinary incontinence is common in certain neurological disorders

Urinary incontinence is common at high age and in certain neurological disorders such as dementia, Parkinson’s disease and after stroke. This is because the signals between the bladder and the brain work poorly. This means that the time from feeling pissed to urinary bladder emptying will be shorter. You may thus find it more difficult to go to the toilet when you need to kiss.

Other common causes of urinary incontinence are  benign prostate enlargement  or other changes in the urethra.

An enlarged uterus can also cause distress. This can happen, for example, if you have a benign uterine muscle node, a so-called  myoma.

It is uncommon but dense and painful cramps can be a symptom of a tumor or  stone in the bladder.

Another uncommon cause of temporary urinary incontinence is an  ovarian cyst  or tumor. Frequent cramps that are also painful may be due to  prostate cancer.

Temporary urge incontinence

You may get temporary urinary incontinence if you have a  urinary tract infection  that irritates the bladder. The bladder can also be irritated without the doctor finding the reason.  

Överrinninginkontinens

Overgrowth incontinence usually occurs in men. It is very uncommon for women to have urinary incontinence.

The most common cause is that an  enlarged prostate  compresses the urethra, making urine difficult to pass. Another reason may be that you have a  urethral constriction.  Overflow incontinence can also occur after you have been involved in an accident that has damaged the urethra.  

Urinary incontinence in the elderly                         

Incontinence can come if you, as the elderly, change the environment and for example are in hospitals. Sometimes it may be because you are temporarily confused or simply feeling worse. It may also be because you have difficulty finding the toilet, have difficulty buttoning up or cannot get help to the toilet.

It is important that you who are older and are in a hospital or nursing home get help to come to the toilet regularly before the bladder is filled. Peeing regularly can prevent incontinence.

Some medicines can make the problems worse

Some drugs can make incontinence worse. This is especially true of liquid drugs.

Other medicines can make it harder to urinate and to empty the bladder properly. This applies for example to medicines for depression and some medicines for cough.

Some medications can cause confusion in the elderly. For example, it can be sedative drugs and medicines for sleep disorders. These drugs can also increase the risk of incontinence. 

Aid

Some do not completely get rid of the trouble. Then you can often live an active life with the help of aids.

Incontinence protections of various sizes, and urine are examples of different aids. Here you can read about how it is possible to get incontinence aids .

Influence and participate in your care

You can  seek care at any medical center or open specialist clinic  you want throughout the country. Sometimes referral  to the open specialized care is required  .

You should understand the information

In order for you to be involved in your care and treatment, it is important that you  understand the information you receive  from the healthcare staff. Ask questions if you don’t understand. For example, you should receive information about treatment options and  how long you may have to wait for care and treatment .

If you need  tools  , you should get information about what is available and how to get it.

Your consent is important

Once you have received information about what options and options for care you have, you can give your consent or in some other way express a yes. This also applies to  you who are not of legal age .  

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