By Ana Theresa Williams,BSN,RN
Are you suffering from loss of bladder control? This is a very common condition and often an embarrassing problem among many women, especially during the menopausal period. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong that you don’t get to a toilet in time.
Urogynecologist and pelvic reconstructive surgeon Geoffrey M. Que,MD at Davao Doctors Hospital Medical Tower said there are different types of urinary incontinence: Urgency Urinary Incontinence – complaint of incontinence preceded by urgency; Overactive Bladder – complaint of urgency, frequency and nocturia with or without urinary incontinence; Stress Urinary Incontinence – involuntary leakage of urine associated with coughing, sneezing, effort and exertion; Overflow incontinence – incontinence due to urinary retention; and Mixed Urinary Incontinence – combination of stress urinary incontinence and overactive bladder.
Although the etiology or causes of urinary incontinence is multifactorial, Dr. Que said the most common cause can be due to aging and menopause, patients who underwent hysterectomy, patients who are overweight because of constant pressure in the urinary bladder, patients who are into strenuous activities are among the many causes of urinary incontinence, he added.
Urinary incontinence can also be due to behavioral problem or iyong nakasanayan lang ng patient, he said.
“Meron din patient with urinary retention, where they will present clinically with overflow incontinence,” the medical expert said.
The cause could also be idiopathic, wherein you do not know the cause itself, Dr. Que said.
He said a complaint of urgency, frequency, nocturia or excessive urination at night with or without urge incontinence, and also the need to consider the endocrine factors for the incontinence.
Also among certain drinks, foods and medications can act as diuretics or stimulating your bladder and increasing your volume of urine, such as alcohol, caffeine, decaffeinated tea and coffee, carbonated drinks, artificial sweeteners, corn syrup, foods that are high in spice, sugar or acid, especially citrus fruits, heart and blood pressure medications, sedatives and muscle relaxants, and large doses of vitamins B or C.
Management includes behavioral modifications, bladder training, and Kegels exercise or also known as pelvic floor exercise where you repeatedly contract and relax the muscles that form part of the pelvic floor. “Surgery for stress urinary incontinence can also be done for this type of patients,” Dr. Que said.
Also, we give anti-muscarinic that is a new drug for overactive bladder that acts on the muscarinic receptors on the bladder to block the bladder contractions and sensations. The other one is called anticholinergic therapy that acts on the cholinergic receptors in the bladder also.
The urogynecologist and pelvic reconstructive surgeon said regulate fluid intake from one to two glasses every three hours during waking hours only. Urinate every 3 to 4 hours with or without the urge during waking hours too. And there should be no more fluids two hours prior to sleep, he said.
For women with atrophic vagina or vaginal dryness, he said they can start with local hormone therapy. And of course, they can always do Kegels exercise and may start with medications.
“And if everything else fails,” the medical expert said, “they can always visit my clinic at DDH Medical Tower, Mondays to Saturdays except Tuesdays, from 1 to 5 p.m..”