Incontinence is on the rise among women. Clinical data shows that 25 to 45 per cent of women report urine leakage occasionally and about 10 per cent report urine leakage on a weekly or regular basis. Men on the other hand suffer from urge incontinence where they have an urgent desire to pass urine and due to which leakage occurs. Most of these cases are isolated and the incidence is based on age-to-age basis, surgical procedures or neurological problems. The incidence is half in men compared to women.
Unpredictable, without warning
Most women suffer from mixed urinary incontinence wherein the causes are stress and also the urge to pass urine. Stress urinary incontinence is the highest when urine leaks on coughing, straining or lifting weights. A tenth of women suffer from isolated urge incontinence. Leakage is more severe and common in women who are in their menopause stage or over 60. The most distressing aspect is that it is unpredictable and can happen without warning.
Dr Sanjay Sinha, senior consultant urologist and transplant surgeon at Apollo Hospitals said, “Delay in taking medical help is one of the common sources of needless suffering. In women, the problem is often neglected because women are unsure whom they should turn to for a solution. At the same time, many elderly men and women assume that urine leak is a natural and normal consequence of ageing, which it is not. Treatment is almost invariably possible. Awareness has certainly increased but it is extremely common for even educated women and men to suffer for significant lengths of time before seeking help.”
Natural therapies to control incontinence:
Reduction of fluid intake is a cardinal step: Most people in society suffer from a misconception that drinking lots of water is good for their bladder and kidney. In fact, for a vast majority of people, excessive fluid consumption is unnecessary. While this may not harm the individual, it can aggravate urinary incontinence and worsen frequency and urgency. While consuming too less of fluids can cause constipation or dryness of skin or mouth, it is far more common in society to find people drinking too much rather than too less. If the urine volume is 1.4-1.5 liter in 24 hours, all the body’s requirements are taken care of.
Timed urination: Electing to use the toilet every 2-3 hours irrespective of whether there is an urge to pass, can also help by keeping the average amount of urine in the bladder low and hence minimising leakage.
Dietary substances like tea, coffee, and alcohol must be had in moderation as it helps to keep the urine volume in check.
Pelvic floor training exercise is found to help in managing urinary incontinence. In specific groups of women suffering from post-partum urinary incontinence it is a very successful treatment.
Multiple childbirth and UT infections
One of the major causes of women suffering from incontinence is multiple childbirth and urinary tract infections. With multiple childbirths the muscles involved become weak and lead to incontinence. At the same time, women suffer from increased incidence of urinary tract infections as they are prone to it.
Dr Mallikarjuna Reddy, consultant laparoscopic urologist at Global Hospitals said, “Women are prone to recurrent urinary tract infections but often they do not get it treated properly. Preventing recurrence is also an important aspect and this is often overlooked or neglected by them. This is found to be one of the major reasons why many who are below 60 are also suffering from incontinence.”
Five major symptoms of incontinence:
1 Urgency feeling
2 Unable to hold urine for long
3 Passing urine while coughing or sneezing
4 Frequent or increase in the number of times one passes urine.
5 Accidental leakage which leads to severe embarrassment
Skin of the pelvic region is damaged
People who have problems controlling their urine are at risk of skin problems around the buttocks, hips, genitals, and the area between the pelvis and rectum due to excess moisture in these areas. This causes skin problems like redness, peeling, irritation and yeast infections leading to incontinence dermatitis.
Dr Sanand Bag, senior urologist and kidney transplant surgeon at Yashoda Hospitals explained, “Skin infections, sores, rashes, irritation develop when the skin in the pelvic region is constantly wet. It also increases the risk of repeated urinary tract infections. The most severe impact is seen on the psychology of the individual as it affects their social life, work and also personal relationships.”
In very chronic cases where the pelvic region is damaged, the disorders involve dropping down of the bladder, urethra, small intestine, rectum, uterus or vagina caused by weakness or injury to the ligaments, connective tissue and muscles of the pelvic region. Dr Bagh added that Pelvic floor disorders occur only in women. “They also become more common as they age. During their lifetime, about 1 of 11 women need surgery for a pelvic floor disorder.” he says.
