Incontinence

Urinary incontinence, the involuntary loss of bladder control, is not just an issue for old women. Approximately 3.3 million Canadians experience urinary incontinence, according to The Canadian Incontinence Foundation. While it affects one in three women, because it's an embarrassing problem, many sufferers are reluctant to seek help.

Incontinence causes Urinary incontinence can develop at any age, but getting older can increase the risk because of changes in the body that affect bladder function. Childbirth weakens the pelvic muscles that hold the bladder in place, and the estrogen drop during menopause also weakens the pelvic and vaginal muscles. Carrying excessive weight, constipation and chronic cough are also causes. Incontinence can also be temporary, for example as a result of a urinary tract infection.

Incontinence symptoms Leaking urine and not being able to hold urine until reaching a bathroom are signs of urinary incontinence. With stress incontinence, the most common type of urinary incontinence in women, small amounts of urine may leak when a person coughs, laughs, sneezes or exercises.

Incontinence diagnosis/tests If you're experiencing urinary incontinence, you may feel shy about mentioning it to your doctor, but staying mum means you'll miss out on treatment. Your doctor may refer you to another health care professional, such as a Nurse Continence Advisor (NCA),  who is specially trained to help people with continence problems gain bladder control. A physiotherapist may also be able to provide advice and exercises for regaining bladder control. You may also get a referral to a urologist, a specialist in the urinary tract or a urogynaecologist who specializes in problems with women's bladders. The health care provider you visit will do an assessment, offer treatment options, such as diet and exercise, and may suggest further testing or surgery to get to the root of the problem, and surgery to deal with it.

Incontinence treatment Most cases of urinary incontinence can be improved or cured.

• Pelvic floor muscle training, such as Kegel exercises, weighted vaginal cones, biofeedback and electrical stimulation, are some therapies that can help strengthen weak pelvic floor muscles.

• Using the bathroom too frequently can cause bladder problems, since the muscle is not regularly challenged and can lose tone and strength. Bladder retraining involves setting up a schedule to lengthen the time between bathroom trips to increase bladder capacity.

• While people with urinary incontinence may try to drink less, that can exacerbate the problem. Better options include decreasing fluids close to bedtime, avoiding alcohol and caffeine and spicy foods that can irritate the bladder.

Pads and other products, such as disposable underwear, are available to absorb urine leaks.

Incontinence prevention Since many risk factors can't be changed, urinary incontinence may not be preventable, however, you can reduce the likelihood that you'll develop it or its severity:

•  Keep your weight at a healthy number or shed pounds if you're overweight or obese.

•  Eat a fibre- and fluid-filled diet and exercise regularly to prevent constipation, since straining during bowel movements can weaken the pelvic floor muscles.

• Do Kegel exercises regularly.

• Don't smoke.

• Avoid heavy lifting.

More info from Chatelaine
Beat the clock

Outside resources
The Canadian Continence Foundation