What is Urge Incontinence?
- On May 4, 2018
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Urge incontinence is often underresearched and misunderstood. However, it is actually the second most common type of incontinence after stress incontinence. Studies even show that urge incontinence gives a significantly greater reduction in health-related quality of life.
Urge incontinence is often defined as the involuntary loss of urine that occurs after a person has a strong and compelling urge to urinate. A distinction is made between symptoms of urge and stress incontinence to create a clear contrast between the two. Urine leakage from stress incontinence is related to an increase in abdominal pressure, whereas urine leakage in urge incontinence is related to a feeling of urgency. The word “urge incontinence” can make trigger distinction easier to remember. In those with urge incontinence, signals or muscle damage trigger unwanted spasms of the muscles in the bladder wall, creating the strong urge to urinate. The condition can cause frequent interruptions in a person’s life, often making it difficult to even carry out daily tasks. A urological surgeon at Bristol Urological Institute told Nursing Times, “it is moving to hear from patients how stressful and limiting this condition is on their everyday functioning”. Urge incontinence can even cause people to urinate more than 8 times per day and have to get up for the bathroom more than twice overnight. Leakages from urge incontinence are often extremely rapid.
In urge incontinence sufferers, unusual triggers can cause leakages. Situations such as a hearing running water from a tap, washing dishes or even turning a key in a door can trigger the urge to urinate. As with most types of incontinence, triggers can also include caffeine, spicy foods, certain medication, sweeteners, alcohol and citrus fruits.
What Can Cause Urge Incontinence?
Urge incontinence occurs due to abnormal bladder contractions. In individuals with urge incontinence, the bladder muscles contract with enough force to override the sphincter muscles of the urethra. The main reason for the bladder experiencing abnormal contractions is damaged nerves from various diseases such as Diabetes, Stroke, Multiple Sclerosis or Parkinson’s Disease. These diseases can affect the nerves that control bladder emptying. Impairments from these conditions can cause a lack of control over the sphincter muscle.
Men with prostate gland problems are at an increased risk of developing urge incontinence. An enlarged prostate can obstruct the urethra, causing urination retention and frequent urges to urinate. Urge incontinence is common in men who have had surgery or radiation for prostate cancer. The removal of the prostate through surgery or destroying it through radiation disrupts the way the bladder holds urine and can result in urine leakage. Radiation can decrease the capacity of the bladder and cause spasms that force urine out. Radical proctectomy can also sometimes cause severe damage to the sphincter muscle.
Women, on the other hand, are particularly at risk of urge incontinence if they have had a C-section or other pelvic surgery. It is also common for women who are going through the menopause to experience urge incontinence. This is due to the lack of estrogen in the body. The Luteinizing Hormone and Follicle-Stimulating Hormone can no longer perform their usual functions to regulate your estrogen, progesterone and testosterone. 59-year-old Mary tells her story of developing urge incontinence during the menopause. She explains, “dealing with the menopause was bad enough but when I found I was suddenly wetting myself it was a nightmare”. She explains “because I was scared of accidents happening, I stopped visiting friends for weekends or dinners out, which left me disconnected. Baggy clothes made me feel as though I was going on a camping trip when in reality I was just going to have lunch with friends”. After booking an appointment, her Doctor explained how menopause is a common cause of urge incontinence and that there are special pads designed for leakages”.
Surprisingly, a hysterectomy has been found to be a high-risk factor for incontinence. A study in 2003 aimed to examine the contribution of hysterectomy to the occurrence of urge or stress incontinence. The study followed 2322 woman aged between 35 and 70 years of age from a suburban area in the Netherlands. 70% of women responded, and the prevalence of urge incontinence was much higher in women who’d had a hysterectomy. Meta-analysis has also shown that hysterectomy increases the odds of urge incontinence by 30%.
Other risk factors for urge incontinence include the following:
- Old Age
- Having a Prostatectomy
- Urinary tract infections
- People who have undergone a C-section or other pelvic surgery
- Brain damage or diseases that affect the brain such as Alzheimer’s disease