Occurs in females where the woman receives a strong and sudden urge to go to the toilet, this urge can be so sudden and intense that it is not always possible to make it to the bathroom. When under this extreme pressure of a contracting bladder it is quite common to have involuntary leakage as the bladder squeezes when it shouldn’t, this can even happen when you only have a small amount of urine in your bladder.
When the bladder muscles squeeze or contract at the wrong time, you leak urine and these contractions can occur at any time no matter how much urine is in the bladder. The common causes of urge incontinence are:
• Poor bladder habits e.g going to the toilet just in case rather when needing to go to the toilet can irritate the bladder muscle
• Brain or nerve damage from illnesses like multiple sclerosis, stroke, prolapse and uterine fibroids
• Bladder inflammation
• Interstitial cystitis
• Neurological conditions that affect the brain and spinal cord such as parkinsons disease or multiple sclerosis
• Nerve injury that can occur from a spinal cord injury, diabetes or stroke
• Bladder cancer
• Urinary tract infections or tumors in the bladder affecting the lower urinary tract (urethra and bladder)
• Bladder stones
• Excessive consumption of alcohol or caffeine
A variety of medications, behavioral treatments and electrical stimulation are used to treat urge incontinence and sometimes combinations of these treatments are used. Treatments available to use are:
• Practicing biofeedback training to help learn how your body behaves and recognise when your bladder is overactive. Please see below for a more detailed explanation.
• Kegel exercises are used to strengthen the bladder and bowels to reduce or prevent problems such as leaking urine.
• Visiting the bathroom on a regular basis and especially before doing physical activity.
• Avoid drinking fluids two hours before going to bed.
• Caffeine should be avoided.
• Don’t lift heavy objects.
• Drinking a lot of fluids before activities should be avoided.
• Alcohol should be avoided.
• Using the bathroom too often can worsen the effects of incontinence as the bladder becomes used to holding small amounts of urine. This can cause the bladder to become more sensitive or overactive when it is stretched only a little.
• Weight management is important and should be considered if you are over weight or obese. Loosing weight may take the pressure off your bladder and improve these symptoms.
• Your natural spring water intake needs to remain the same. Drinking less fluid can make incontinence worse as the urine becomes more concentrated.
• Avoid spicy, acidic or high sugar foods that can irritate your bladder.
• Quit smoking so you cough less.
• Eat foods high in fibre to prevent constipation.
• Avoid drinking large amounts of fluids while eating.
• Citrus fruits and juices may also irritate the bladder.
• Bladder training techniques to hold more urine. Create a schedule and increasing the amount of time between toilet trips.
• Control urge techniques. Please see below for a detailed explanation.
• Botox injections may be recommended if medications are not successful.
Control Urge Techniques:
Women should learn several urge techniques to help reach the toilet dry.Learn to perform a pelvic floor contraction by trying to squeeze the buttocks, drawing in your lower abdomen, use breathing techniques, apply pressure to the clitoris or perineum by using a rolled towel or pressure from your hand or toe curling anything that will assist you in contracting the muscles and allowing you to hold on longer. Some people may prefer to try the method of distraction by thinking or doing something, like hanging the washing out, reading a book or magazine or cleaning to take your focus away from the urge to urinate.
Biofeedback is a training technique used to learn more about how your body behaves. This enables you to know when your body is not functioning properly and recognise when your bladder is overactive. There are two specific techniques:
Using a diary to record the times that you urinate or leak urine is the way to follow this practice. This should be recorded daily to give you an idea of your leakage patterns that occur. To avoid leaking in the future, you schedule those times into your diary to go to the bathroom at those specific times.
Wait to go to the bathroom by stretching out the intervals in between using the bathroom. First you should plan to go to the toilet once an hour and after following this practice for a period of time you should then change your schedule and start to go to the toilet every ninety minutes. Eventually you will be able to lengthen the interval to every two hours and gradually build up to three or four hours between bathroom visits.