Incontinence

 

Overview

 

Urinary Incontinence refers to a loss of bladder control. It is a condition that could affect anyone but females are twice as likely to suffer from incontinence than males. This is attributed to a number of factors such as pregnancy, childbirth and hormonal changes during menopause.

Signs of incontinence can include loss of bladder control, feeling a weakness of the bladder, involuntary urinary leakage, or urinary leakage during physical exertion.

In some cases, incontinence occurs when the pelvic floor muscles are weak and are unable to support bladder and sphincter control. Some factors that contribute to incontinence include childbirth, aging, hormonal changes, surgery, chronic cough, chronic constipation or prostate-related issues in men.


Causes of Incontinence

Incontinence could be temporary and caused by everyday habits, or persistent due to underlying medical conditions or physical problems and weak pelvic floor.

Temporary urinary incontinence


Diuretics such as certain drinks, foods and medications may stimulate your bladder and increase your volume of urine.

They include:

  • Alcohol
  • Caffeine
  • Carbonated drinks and sparkling water
  • Artificial sweeteners
  • Chocolate
  • Foods that are high in acidity such as citrus fruits and spicy foods
  • Heart and blood pressure medications, sedatives and muscle relaxants
  • Large doses of vitamin C


Urinary incontinence may also be caused by medical conditions, such as:

  • Urinary tract infection (UTI). Infections can cause irritation to the bladder and lead to strong urges to urinate.
  • Constipation. The rectum is located near the bladder and both are connected to the same nerves and are also supported by the pelvic floor. Constipation may cause these nerves to be overactive and increase urinary frequency.


Persistent urinary incontinence


Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes that weakens the pelvic floor. In these cases, consultation and assessment is recommended. These include:

  • Pregnancy. Hormonal changes and the increased pressure and weight of the foetus can lead to stress incontinence (SUI).
  • Childbirth. Vaginal delivery could weaken muscles needed for bladder control and may also damage bladder nerves and supportive tissue
  • Pelvic Organ Prolapse. With a dropped (prolapsed) pelvic floor, the bladder, uterus or rectum could get pushed down from the usual position and protrude into the vagina. This is often associated with incontinence.
  • Changes with age. Weakening of the bladder muscle and pelvic floor often happens with age.
  • Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy.
  • Hysterectomy. The bladder and uterus are supported by the pelvic floor. Any surgery that involves a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
  • Enlarged prostate. Particularly prevalent in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
  • Prostate cancer. Stress incontinence or urge incontinence can be associated with untreated prostate cancer. Incontinence is a side effect of treatments for prostate cancer.

Risk Factors

Factors that increase your risk of developing urinary incontinence include:

  • Gender. Women are more likely to have stress incontinence due to pregnancy, childbirth and menopause. However, men with prostate related conditions are at greater risk of urge and overflow incontinence.
  • Age. Age and weakened muscles reduce how much your bladder can hold and increase the chances of involuntary urine release.
  • Being overweight. Additional weight increases pressure on the bladder and pelvic floor, weakening the muscles and often causes stress urinary incontinence (SUI).
  • Other diseases. Neurological disease or diabetes may increase your risk of incontinence.

Complications

Complications of chronic urinary incontinence include:

  • Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
  • Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.
  • Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.

Preventions

Urinary incontinence may not be preventable. However, to help decrease your risk:

  • Maintain a healthy weight
  • Practice pelvic floor exercises
  • Avoid bladder irritants, such as caffeine, alcohol and acidic foods
  • Eat more fiber, which can prevent constipation, a cause of urinary incontinence
  • Don’t smoke, or seek help to quit smoking

Types of Incontinence

Types of incontinence include:

  • Functional incontinence is when physical or mental impairment keeps you from making it to the toilet in time despite the awareness of the need to relieve yourself. This can range from small leakages to a complete emptying of the bladder. Functional incontinence is more common in the elderly due to the conditions associated with aging such as stroke, dementia, Alzheimer’s or impaired mobility.
  • Stress incontinence is a leakage with physical exertion such as laughing, sneezing, coughing or sexual activity. This is most commonly experienced by postpartum mothers due to the additional weight of the baby placing stress on the pelvic floor muscles during gestation. Additionally, vaginal deliveries have been associated with weakened pelvic floor muscles and incontinence. The force of pushing the baby through the birth canal may cause trauma to the connective tissue and nerves in the pelvic floor.
  • Overflow incontinence is when you experience frequent or constant dribbling of urine due to an inability to empty the bladder completely. It might also be a case of involuntary leaking from an overly full bladder, due to the lack of urge to urine. Overflow incontinence is common in people who have a blockage in their bladder, such as prostate cancer in men, or when the pelvic floor muscles are too weak to fully expel the contents of the bladder. In such cases, strengthening the pelvic floor muscles would help to mitigate the condition. However, overflow incontinence can also be caused by spinal cord injuries or nervous system disorders. 
  • Urge incontinence is when you feel a strong urge to urinate even when your bladder is not full. This may be related to an overactive bladder which is classified as the need to urinate with a frequency that is greater than 8 to 9 times within a span of 24 hours. Oftentimes, urge incontinence points to a medical issue or physical problem.

Fecal incontinence is the inability to control bowel movement, causing stool to leak unexpectedly from the rectum. This can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.

While common, incontinence is definitely not a normal part of the aging process. Incontinence is also not something you have to live with after giving birth to your baby. The fear of incontinence whether urinary or fecal, often stops people from doing things they enjoy and drastically affects their quality of life.

Seeking early treatment for incontinence is often more effective with faster results. If left untreated, incontinence may worsen with time and even result in a pelvic organ prolapse in very severe cases.

Treatments

 

Treatment at Orchard Clinic employs the use of physical therapy and medical technology to strengthen the pelvic floor muscles for fast and effective treatment of incontinence.

HIFEM Technology

High intensity electromagnetic energy to treat Incontinence and Diastasis Recti.

Vaginal Rejuvenation

EXILIS Ultra Femme 360 to tighten the inner vaginal canal walls and firm up the labia.

Floorwork

One-to-one exercises for muscle stretching and strengthening customised to the individual.

 

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Orchard Clinic is a specialised centre for Postnatal and Postpartum conditions, helping clients achieve healthy and pain-free lifestyles.

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Orchard
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Tong Building #09-01A
Singapore 238862

Tel: 65 6235 4560

Kembangan
18 Jalan Masjid
Kembangan Plaza, #B1-07
Singapore 418944

Tel: 65 6741 8911

E: method@orchardclinic.com
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