What is urge incontinence?
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Urge incontinence is an uncontrollable loss of urine from the bladder following a tremendous urge to urinate. Sometimes, a large amount of urine is released, but most often, only a small amount of urine is lost.
What causes urge incontinence?
Often, urge incontinence is a result of a muscle (detrusor muscle) not functioning properly. Detrusor instability increases in incidence with age and is a common urologic problem. The actual cause of detrusor instability is unknown.
Urge incontinence can occur in people who have multiple sclerosis, Parkinson's disease, had a stroke, urinary tract infections, dementia, spinal cord injuries, bladder cancer and bladder stones.
How do I know if I have urge incontinence?
Symptoms of urge incontinence include the inability to hold urine once the urge to urinate occurs. You may experience the urge to urinate frequently throughout the day and may awaken at night with the urge to urinate.
How is it diagnosed?
Your primary care provider will take a detailed history of your symptoms and perform an examination to determine the cause of your incontinence. The primary care provider may ask to check your urine and blood for an infection or other causes.
Is there treatment for urge incontinence?
There are several available treatments for urge incontinence:
1. Behavioral Therapy
a. Bladder training-this consists of scheduling regular bathroom intervals. You must attempt to empty your bladder at each scheduled interval and ignore the urge to urinate in between these intervals. Bladder retraining is the primary behavioral approach used for the correction of urge incontinence. The goal is to increase the amount of bladder content tolerated before contraction of the detrusor muscles, and to establish fixed, voiding intervals that maximize dryness.
b. Kegel exercises-these are exercises that strengthen the muscles and prevent the leakage of urine. Your primary care provider will be able to instruct you. Kegel exercises, another type of behavioral therapy, can be a useful adjunct to bladder retraining. In order to realize maximum gains with the use of Kegel exercises, the patient is asked to perform at least 100-200 repetitions of Kegel contractions for 10 seconds each per day.2 This type of therapy works best if several instructional sessions are utilized and the number and duration of contractions are increased gradually as the patient becomes better at performing them.
2. Medication-there are several available medications to treat urge incontinence, ask your primary care provider.
3. Surgery-sometimes surgery is necessary when other types of treatment do not work.