Urinary incontinence is concerning as it is inconvenient and embarrassing. It’s the involuntary loss of urine. It’s not a disease but a symptom. There are many causes of incontinence. It is a common consequence of pregnancy and childbirth. However, it is not a problem restricted to just women. About one in 30 men under the age of 65 are affected compared to 42 percent of all women. It is a problem that is commonly hidden because many are embarrassed to admit to it.
Incontinence is not a normal part of aging however older adults may experience more disorders or diseases that contribute to incontinence.
CAUSES: There are different types and causes of incontinence. In some cases, the cause is unknown. Sometimes the reason may be as simple as too much caffeine intake or the result of something more complex such as cancer or a neurological disorder.
SYMPTOMS: The feeling of the sudden urgent need to go to the bathroom. Urine may leak before you reach the bathroom. A weak stream of urine may be produced. Urine may leak when you cough, sneeze, lift or exercise. Some people with urine incontinence also have overactive bladder which causes them to urinate frequently.
Risk factors for incontinence
- Diabetes
- Inflamed vaginal tissues in women
- Enlarged prostate in men
- Bladder inflammation or infections
- Bladder stones or obstruction
- Smoking
- Weight gain or obesity
- Chronic coughing
- Constipation and straining during bowel movement
- Pregnancy or childbirth
- Excess alcohol consumption
- Excess caffeine consumption
- Excess beverage or water consumption
- Certain medications
- Pelvic prolapse in women
- Hysterectomy in women
- Interstitial cystitis (bladder condition)
- Neurological disorders (traumatic brain injury, spinal cord injury, multiple sclerosis, stroke)
- Prostate cancer
- Bladder cancer
- Colon and rectal cancer
- Certain types of cancer treatment
Ongoing urine incontinence can result in the increased risk of skin infections or sores (ulcers). Chronic urine incontinence increases the risk for repeated urinary tract infections.
There are many forms of treatment depending on the type and cause, if known. However, prevention and following and maintaining the following will only help keep incontinence at bay. Maintaining a healthy weight, performing Kegel and pelvic floor exercises, not smoking, avoiding alcohol and caffeine can be helpful. The pelvic floor are muscles that run from the tailbone to the back of the public bone that support the bladder, uterus in women, and bowel. (Refer to Volume 1, Issue 12, June 2010, for more on the pelvic floor.) Exercising these muscles can help strengthen them and lessen, if not eliminate, urinary incontinence. These muscles can be contracted by imagining you have to go to the washroom but you’re in a long line and tensing up the necessary muscles while you wait in line.
Throughout all Pilates exercises the pelvic floor is exercised and as a result is being strengthened. This can only help in the prevention of incontinence.
Types of Incontinence
There are many types of incontinence. Not all types are due to weak pelvic floor muscles. Below are some of the more common types of incontinence.
Stress incontinence: Pressure-related physical activity such as sneezing, laughing, coughing, lifting heavy objects, standing up or exercising. Stress incontinence results when there is a problem with the pelvic floor muscles, sphincter or both. Occurs more often when the bladder is full. More common in women than men.
Urge incontinence: Occurs when the bladder muscles contract at the wrong times regardless of whether the bladder is full or not. It may result from bladder infections, inflammation, stones or cancer, spinal cord injury, stroke or an enlarged prostate gland in men. Occurs more frequently in women and older adults.
Overactive bladder (Irritable bladder): Extreme sudden urgent need to urinate, frequent urination, need to wake and urinate at night. Occurs when the bladder wall muscles contract before the bladder is completely full. The muscle wall contraction signals the brain that it’s time to go to the bathroom although the bladder is only partially full. In most cases the cause of overactive bladder is unknown. It may develop in people with Parkinson’s disease, strokes, or other neurological disorders. Urinary tract infections, structural abnormalities, inflammation, bladder stones, enlarged prostate in men, diabetes, excess alcohol or caffeine intake and certain medications can contribute to overactive bladder. More common in men over 65 or women in their mid-40’s.
Overflow incontinence: The bladder has difficulty emptying completely. This leads to persistent urine dribbling and a weak stream of urine when you do go to the washroom. Can be caused by a blocked urethra, injured bladder, prostate gland conditions in men, certain medications and nerve damage associated with diabetes.
Mixed incontinence: When people have more than one type of urinary incontinence it is termed mixed incontinence.
Functional incontinence: Physical or thought processing problem that prevents a person from getting to the bathroom in time. E.g. People with Alzheimer’s disease may not plan to go to the bathroom or people with physical imitation may not allow enough time to get to the bathroom.
Gross total incontinence: Inability to hold any urine at all in the bladder at any time. This can be the case with people with a spinal cord injury or urinary tract injury. Some are born with a structural abnormality such as an abnormal opening (fistula) near the urethra which can contribute to gross total incontinence.
Certified Stott instructor. Experience with teching, instructing, owning a Pilates studio and meeting people and postures.