Understanding Urge Urinary Incontinence in Women
Urge urinary incontinence (UUI) is a common yet treatable condition that affects many women. This article will help you understand what UUI is, its causes, symptoms, and the various treatment options available.
What is Urge Urinary Incontinence?
Urge urinary incontinence is the involuntary loss of urine associated with a sudden, strong desire to urinate. Key characteristics include:
- A sudden, intense urge to urinate
- Urine leakage before reaching the bathroom
It is commonly associated with:
- Frequent urination (more than 8 times in 24 hours)
- Nocturia (waking up to urinate at night)
Key Point
With UUI, you may feel like you have little to no control over your bladder, leading to unexpected and sometimes large amounts of urine leakage.
How Common is Urge Urinary Incontinence?
UUI is more prevalent than many realize:
- Affects approximately 17% of women over 40
- Incidence increases with age
- Often coexists with stress urinary incontinence (known as mixed incontinence)
Remember, while UUI is common, it is not a normal part of aging. It’s a medical condition that can be managed effectively with proper treatment.
Causes and Risk Factors
Urge urinary incontinence occurs when the bladder muscle (detrusor) contracts involuntarily. Several factors can contribute to this:
- Neurological disorders: Such as multiple sclerosis, Parkinson’s disease, or stroke
- Bladder abnormalities: Like tumors or stones
- Urinary tract infections: Can cause temporary UUI symptoms
- Hormonal changes: Especially during menopause
- Certain medications: Some drugs can affect bladder function
- Excessive caffeine or alcohol intake: Can irritate the bladder
- Obesity: Excess weight can put pressure on the bladder
- Aging: Natural changes in the bladder can increase risk
Symptoms of Urge Urinary Incontinence
The primary symptoms of UUI include:
- Sudden, strong urge to urinate that’s difficult to control
- Involuntary loss of urine immediately following or accompanied by an urgent need to urinate
- Leaking large amounts of urine
Did you know?
When urge incontinence coexists with urinary frequency (urinating more than 8 times in 24 hours), the condition may be referred to as overactive bladder (OAB) with incontinence or “OAB wet”. This distinguishes it from OAB without incontinence, also known as “OAB dry”.
Diagnosis
If you’re experiencing symptoms of UUI, it’s crucial to consult a healthcare provider. Diagnosis typically involves:
- Medical history: Your doctor will ask about your symptoms, medical background, and lifestyle
- Physical examination: To check for any physical abnormalities or pelvic organ prolapse
- Urinalysis: To rule out urinary tract infections or other issues
- Bladder diary: You may be asked to keep a log of your fluid intake, urination frequency, and incontinence episodes
- Urodynamic testing: In some cases, to measure bladder pressure and urine flow
- Cystoscopy: A scope may be used to examine the inside of your bladder and urethra
Treatment Options
There are many effective treatments for urge urinary incontinence, ranging from lifestyle changes to medications and more advanced therapies:
Conservative Treatments
- Bladder training: Techniques to increase the time between feeling the urge to urinate and passing urine
- Pelvic floor exercises (Kegels): Can help improve bladder control
- Double voiding: Urinating, waiting a few moments, then trying again to empty the bladder more completely
- Scheduled toilet trips (aka Timed voiding): Going to the bathroom at set times, rather than waiting for the urge
Lifestyle Changes
- Fluid management: Avoiding bladder irritants like caffeine and alcohol
- Weight loss: If overweight, losing excess pounds can reduce pressure on the bladder
- Dietary modifications: Avoiding foods that may irritate the bladder
Medications
- Antimuscarinics: Help relax the bladder muscle (e.g., oxybutynin, tolterodine)
- Beta-3 agonists: Improve the bladder’s ability to store urine (e.g., mirabegron, vibegron)
- Topical estrogen: For postmenopausal women, may help improve urethral and vaginal tissue health and decrease bladder irritation
Advanced Therapies
- BOTOX injections: Injections of botulinum toxin into the bladder muscle, causing it to relax and reducing involuntary contractions, thus improving symptoms of overactive bladder and urge urinary incontinence.
- Percutaneous and implantable tibial nerve stimulation (PTNS): A minimally invasive treatment that uses electrical pulses to stimulate nerves in the ankle, which can improve bladder control by modulating the neural pathways that control bladder function.
- Sacral neuromodulation: a therapy that uses a small implanted device to send mild electrical pulses to the sacral nerves, which help control bladder and bowel function, to improve symptoms of overactive bladder and urinary retention.
Remember
Treatment plans are individualized. Your healthcare provider will work with you to find the best approach for your specific situation.
Living with Urge Urinary Incontinence
While seeking treatment, there are strategies to manage UUI in your daily life:
- Locate bathrooms before you need them when out in public
- Wear easily removable clothing for quick bathroom access
- Use absorbent products for peace of mind
- Practice relaxation techniques when you feel the urge to urinate
- Stay hydrated, but limit fluids before bedtime
Take Action!
If you’re experiencing symptoms of urge urinary incontinence:
- Don’t be embarrassed – it’s a common, treatable medical condition
- Keep a bladder diary to share with your healthcare provider
- Schedule an appointment with a urogynecologist or pelvic health specialist
- Be open about your symptoms and how they affect your quality of life
You’re Not Alone
Many women have found relief from urge urinary incontinence. Take the first step towards regaining control and confidence in your daily life by seeking help today.
Remember, urge urinary incontinence may be common, but it’s not something you have to accept as a normal part of life. With the right care and treatment, you can significantly improve your symptoms and quality of life.