Urinary Frequency, Urgency and Incontinence
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Bladder control problems affect millions of Americans of all ages — women twice as often as men — yet in most cases urinary incontinence can be treated and controlled, if not cured.
What urinary incontinence is
Bladder control, or urinary incontinence (UI), is an issue for millions of Americans. While it is common as we age, incontinence can occur in people of all ages, and women are twice as likely as men to experience UI.
UI is characterized by the inability to control the flow of urine. During an episode of incontinence, a small amount of urine (just a few drops) is passed, or a strong and extremely sudden urge to urinate is sensed, followed by losing a large amount of urine. It is not uncommon for women to experience both symptoms.
The severity of UI varies greatly among people. For some, it is mildly bothersome; for others, it can be virtually debilitating. Some people with UI are so fearful of the embarrassment their symptoms might bring that they avoid social interaction. Some UI sufferers are embarrassed to seek treatment — but it is important to get help: in most cases incontinence can be treated and controlled, if not cured.
How incontinence happens
UI occurs because of problems with the muscles and nerves that hold or release urine. The body stores urine in the bladder, which is a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.
During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass. Incontinence occurs if your bladder muscles suddenly contract, or the sphincter muscles are not strong enough to hold back urine.
Weight and other risk factors
Being overweight can increase your chances of experiencing UI due to the accumulation of extra weight in the midsection. When you carry excess weight in your abdominal area, the extra pounds put added pressure on your bladder, and the extra pressure makes your bladder more likely to leak.
The type of UI that stems from increased pressure on the bladder causing you to leak urine is referred to as stress incontinence. Actions that typically prompt episodes of stress incontinence include laughing, sneezing, coughing, or kneeling. Obesity can noticeably worsen UI if you had symptoms prior to gaining weight — the good news is, losing weight can often reduce its severity.
Being overweight is only one risk factor for UI. It can also be caused by a number of medical issues, such as the high glucose levels seen in diabetes, and by taking certain medications, such as hydrochlorothiazide for treatment of high blood pressure.
About the author
Allen Smolenski, M.D.
Emergency Medicine physician and founder of Coastal Medical Clinic in Surfside Beach (2009). After losing nearly 60 pounds himself — and placing third in his class at the 2008 NPC Natural Northern USA Bodybuilding Contest — he completed a fellowship in Anti-Aging and Regenerative Medicine through the A4M, and now helps patients across the Grand Strand optimize their hormones, metabolism, and long-term health.
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