Incontinence
Urinary incontinence is the involuntary release of urine. It can be an uncomfortable and potentially embarrassing condition. It is one of many urinary symptoms that indicate an underlying problem. Acute urinary incontinence generally occurs with sudden onset and is often reversible, while chronic incontinence tends to be associated with aging or secondary to other conditions.[1]
Contents
Naturopathic Assessment
An appropriate workup to investigate the common causes incontinence is required to initiate proper treatment.
Causal Factors
The etiology of incontinence is complex and depends on the conditions with which it is associated.
Lifestyle
- Highly acidic fruits and drinks may increase incontinence.[1]
- Caffeine is associated with increased risk of urinary incontinence.[1]
Social
- Emotional State
Posture
- Pelvic Floor Dysfunction is often due to postural imbalance of muscles and tendons in the pelvic floor. A common symptom of pelvic floor dysfunction is incontinence.
Environmental
Medical Interventions
- Prescription Medications
- Medical Treatments
- Incontinence is a common outcome in medical procedures involving the prostate, bladder or other pelvic organs or muscles.
Diagnosis
- Urinalysis is routinely performed.[5]
- Imaging
- Ultrasound and catheterization can be used to assess postvoid residual volume to rule out obstruction.[5]
Associated Conditions
The following conditions are associated with urinary incontinence:[1] [6]
- Pelvic floor dysfunction
- Obesity
- Diabetes
- Vitamin B12 deficiency
- Uterine Fibroids
- Benign Prostatic Hyperplasia
- Menopause
- Atrophic Vaginitis
- Spinal Cord Injury
- Cognitive Impairment
- Mobility Impairment
Characteristics
Urinary incontinence occurs when the bladder muscles are too weak or over active. Symptoms can range from mild infrequent loss of urine to severe uncontrollable wetting. Severe cases are generally associated with an deeper underlying pathology, such as stroke or injury in the pelvis or can be due to aging.
There are three seperate types of incontinence:[5]
- Stress Urinary Incontinence refers to involuntary urination on physical exertion, sneezing, or coughing.
- Urgency Urinary Incontinence refers to involuntary urination preceded by urgency. Often the desire to pass urine arises suddenly and is difficult to control.
- Mixed Incontinence, as the name suggests, mixed incontinence refers to a condition sharing characteristics with both stress and urgency incontinence.
Naturopathic Treatments
It is important to identify the root cause in order to effectively treat. Along with treatment of the underlying etiology, the following therapeutics are specific to urinary incontinence:
- Pelvic floor exercises such as kegels have been shown to be helpful in many situations.[1]
- Voiding the bladder at scheduled intervals can reduce the risk of accidents.[1]
- Appropriate management of both quantity and timing of fluid intake can reduce the occurrence of urinary incontinence.[1]
- Proper abdominal breathing can decrease the frequency and severity of incontinence.
References
Reviewed by Iva Lloyd, BScH, RPE, ND [1]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Carter C, Stallworth J, Holleman R (2011) Rakel: Textbook of Family Medicine 8th ed Chap 40 Urinary Tract Disorders Saunders
- ↑ Elenskaia K, Haidvogel K, Heidinger C, Doerfler D, Umek W, Hanzal E (Oct 2011) The greatest taboo: urinary incontinence as a source of shame and embarrassment. Wien Klin Wochenschr.;123(19-20):607-10. PMID: 21935649.
- ↑ Moore EE, Jackson SL, Boyko EJ, Scholes D, Fihn SD (Feb 2008) Urinary incontinence and urinary tract infection: temporal relationships in postmenopausal women. Obstet Gynecol.;111(2 Pt 1):317-23. PMID: 18238968.
- ↑ Jackson SL, Scholes D, Boyko EJ, Abraham L, Fihn SD (Oct 2006) Predictors of urinary incontinence in a prospective cohort of postmenopausal women. Obstet Gynecol.;108(4):855-62. PMID: 17012446.
- ↑ 5.0 5.1 5.2 Fong E, Nitti VW (2010) Urinary Incontinence Prim Care;37(3):599-612
- ↑ Jackson SL, Scholes D, Boyko EJ, Abraham L, Fihn SD (Jul 2005) Urinary incontinence and diabetes in postmenopausal women. Diabetes Care.;28(7):1730-8. PMID: 15983327.
