Urinary Incontinence

Urinary incontinence is the inability to control urination. It affects more than 13 million people of all ages in the United States. It is more common in the elderly and women.

Incontinence is classified as either stress incontinence (caused by coughing, laughing, sneezing), urge incontinence (losing urine when suddenly feeling the urge to urinate), overflow incontinence (continually leaking urine), functional incontinence (in people with a brain injury), or transient incontinence (temporary incontinence). Treatment is highly effective in more than 80 percent of cases. Exercise and behavioral therapies are most successful.

Signs and Symptoms

• Not being able to hold your urine until you get to a bathroom
• Frequent and unusual urges to urinate

What Causes It?

• Stretched pelvic muscles from pregnancy and childbirth
• Low estrogen levels in women
• Enlarged prostate in men
• Side effects of certain medications
• Urinary tract infections (UTIs)
• Frequent constipation
• Damage to or diseases of the brain or spinal cord (for example, dementia, spinal cord injury, multiple sclerosis, stroke)
• Weakened muscles that control urination (urethral sphincter and pelvic-floor muscles)

What to Expect at Your Provider's Office

Your health care provider will give you a physical examination and may ask you some questions about your past prostate problems, pregnancy, hysterectomy, your pattern of urinating, when your urine leakage occurs, and whether you strain or experience discomfort when you urinate. You may be asked to cough vigorously to see if it causes urine loss, a sign of stress incontinence.

Your provider may suggest urine tests to detect infection, urinary stones, diabetes, and other underlying causes. A pelvic ultrasound may be performed to examine your bladder, kidneys, and urethra.

Treatment Options

• Exercises: Kegel exercises strengthen muscles that control urination. While increased muscle tone requires long-term exercise, squeezing the muscles just before coughing or sneezing provides initial relief.
• Biofeedback: Electronic devices inserted into the vagina or rectum aid in muscle identification for exercise therapy.
• Relaxation techniques may help you go longer without urinating.
• Habit training helps establish regularity of urination.

Several types of drugs are available to help muscle control. Surgery is also helpful, particularly in women with stress incontinence and for men with an enlarged prostate. Various other options exist as well, such as catheters, urethral plugs, condom catheters, and absorbent pads or underwear.

Complementary and Alternative Therapies

Alternative therapies mainly involve Kegel exercises, biofeedback, and preventing any conditions that worsen incontinence. Yoga may help as well.

Nutrition

• Eliminate caffeine, alcohol, sweetener substitutes, simple sugars.
• Cranberries and blueberries contain substances that keep bacteria from adhering to the bladder. This may help prevent infections that can make incontinence worse, and helps deodorize urine.
• Vitamin C (1,000 mg three times a day) keeps bacteria from growing in urine.
• Beta-carotene (25,000 to 50,000 IU per day) helps your immune system function properly and keeps mucous membranes healthy.
• Zinc (30 mg per day) supports immune function.
• Calcium (1,000 mg per day) and magnesium (500 mg per day) taken together may improve control of the muscles used in urination.

Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Urinary astringents tone and heal the urinary tract and can be taken long-term at 1 cup per day or 30 drops tincture per day.

• Horsetail (Equisetum arvense) helps connective tissue integrity.
• Plantain (Plantago major) is an astringent and demulcent.

Marshmallow root (Althaea officinalis) is a urinary demulcent, best used alone in a cold infusion. Soak 1 heaping tbsp. of marshmallow root in 1 qt. of cold water overnight. Strain and drink during the day in addition to other teas. Homeopathy
Some of the most common remedies used for urinary incontinence are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours until your symptoms get better.

• Causticum for stress incontinence, especially with retention from holding the urine and frequent urges to urinate
• Natrum muriaticum for stress incontinence, vaginal dryness and pain during sex, especially with a history of grief
• Pareira for retention of urine from an enlarged prostate
• Sepia for stress incontinence with sudden urge to urinate, especially with prolapsed uterus and vaginitis
• Zincum for stress incontinence, urinary retention from prostate problems, unable to urinate standing

Acupuncture
May help, depending on cause of the incontinence

Following Up

Exercise and behavioral therapy are highly successful when closely adhered to. You may need close monitoring by your health care provider and support from someone close to you to stay committed to these lifestyle changes.

Special Considerations

If you are pregnant, consult with your provider before taking any medication. For men, regular prostate examinations can detect problems early.

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