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What is Urinary Incontinence?

Urinary System

Urinary incontinence (UI) is not a fun topic to discuss with your doctor or anyone else for that matter. Fortunately, if you have UI, you are not alone, and there are solutions. It affects 10-13 million people in the United States and 200 million throughout the world. Both men and women are affected by UI, but it is more common in women and the elderly.  

Unexpected urinary loss from the bladder is called Urinary Incontinence (UI). It can be a tiny amount of urine or an uncontrollable amount. Some of you may remember having trouble urinating on command when you were younger. One trick that worked was to turn on the bathroom faucet to trigger the desire to void. The problem with this technique is that it can trigger UI later in life known as urge incontinence. More on that later. UI can arise from infection, trauma, muscle dysfunction, surgery, neurologic diseases, and other conditions.

Male vs Female Urinary Incontinence

Except for the prostate in men, the reasons for incontinence and symptoms are similar in both genders.

What Causes Urinary Incontinence?

Pregnancy and childbirth are the leading cause of UI. Other contributing factors can include:

  • Loss of pelvic muscle tone and nerve damage usually due to a traumatic birth—even cesarean sections do not protect from UI. The weight of the growing baby for nine months is also a factor in bladder dysfunction.
  • Hysterectomy due to its proximity to the bladder
  • Nerve and muscle damage from birthing or surgical trauma, especially spine or colon surgery
  • Obesity due to pressure on the bladder
  • Pelvic organ prolapse such as dropped bladder or uterus.
  • Lack of exercise
  • Old age
  • Menopause due to lack of estrogen that maintains the collagen and blood supply to the bladder
  • Chronic coughing due to smoking and lung disease
  • Genetics
  • Repeated heavy lifting or even on usual strain such as moving furniture, and high impact sports
  • Prostatic enlargement
  • Prostrate surgery or radiation
  • Urethral sphincter nerve or muscle damage (muscle that controls the release of urine at the opening of the urethra)
  • Medical disorders such as diabetes, multiple sclerosis, Parkinson’s disease, and Alzheimer‘s which harm the nerves to the bladder
  • Chronic constipation
  • Medications
  • Alcohol and caffeine

What are the symptoms of urinary incontinence?

Some people with neurologic disorders, such as neurogenic bladder, cannot sense the loss of urine or the dampness that ensues. The primary symptoms of UI are wet underwear, ammonia-like odor, frequency of urination, pain with urination, chafing, rashes, pressure over the bladder, straining, the feeling of incomplete emptying, and weak or slow urine stream.

What are the urinary incontinence ICD-10 codes?

Urinary Incontinence ICD-10 Codes     

What are the different types of urinary incontinence?

Stress Urinary Incontinence (SUI)

Not due to situational stress but rather associated with increased abdominal pressure from laughing, sneezing, coughing, climbing stairs, or other physical pressure abdominal cavity and the bladder [2, 3] Exercises like aerobics, golf, and tennis worsen the SUI symptoms. The amount of urine loss can be small or large. The sufferers usually use thin to medium urinary incontinence pads. (1-3 per day is common).

Urge Incontinence

Involuntary leakage accompanied by or immediately preceded by the feeling of imminent urination or urgency. It is uncontrolled urine loss that cannot be prevented and usually a large quantity of urine is lost.  Frequency symptoms and urge at night is also present. Excess intake of water, tea, coffee, and alcohol can aggravate the symptoms.

Overflow Urinary Incontinence:

When the bladder is over-filled, and the increased bladder pressure exceeds the ability of the urethra to keep the urine from coming out. People experience a sense of incomplete emptying, slow-flowing urine, and urinary dribbling. Symptoms of overflow incontinence may be confused with mixed incontinence. Patients may lose a small amount of urine when waking, sneezing, or coughing. Symptoms of frequency and urgency are present as the muscle of the bladder attempts to push out urine.

Neurogenic Incontinence:

Due to disease or damage to the nerves of the spine, bladder causing it to overfill or leak continuously. Sometimes the nerves fire erratically and lead to spastic contractions that cause a large amount of urine to leak. In other cases, the nerves do not work at all and the bladder muscle weakens and continuously fills with urine which may drip or partially empty.

Functional Urinary Incontinence:

The inability to hold urine due to reasons other than neuro-urologic and lower urinary tract dysfunction (delirium, psychiatric disorders, urinary infection, impaired mobility).

  • May have multiple causes
  • Structural and functional disorders involving the bladder, urethra, and/or ureters
  • Disorder of the spinal cord or central nervous system (CNS)
  • Medical conditions such as multiple sclerosis or diabetes
  • Drug-induced or side effects of medication

Mixed Urinary Incontinence:

Patients with mixed incontinence have symptoms of both stress incontinence and urge incontinence. There is mild to moderate loss of urine with activity or without warning. Urinary frequency, urgency, and nocturia can be present.

What is the treatment for urinary incontinence?

There are many options to treat incontinence depending on the type, underlying cause, and severity of the condition.

Pelvic Floor Exercises

Stress incontinence:

  •       Pelvic floor exercises, electrical stimulation
  •       Physical Therapy
  •       Anti-incontinence devices like pessaries
  •       Laser or radiofrequency vaginal rejuvenation
  •       Surgery

Urge incontinence:

  •       Changes in diet
  •       Behavioral modification
  •       Pelvic-floor exercises such as kegels
  •       Medications- vaginal estrogen or antispasmotic drugs
  •       New forms of surgical intervention

Mixed incontinence:

  •       Pelvic floor physical therapy
  •       Laser or radiofrequency vaginal rejuvenation
  •       Anticholinergic drugs
  •       Vaginal Support devices such as pessaries
  •       Surgery

Overflow incontinence:

  •       Catheterization regimen or diversion

Functional incontinence:

  •       Treatment of the underlying cause

Medications used in stress and urge urinary incontinence:

  •       Alpha-adrenergic agonists-pseudoephedrine (Sudafed)
  •       Anticholinergic agents-dicyclomine (Bentyl); tolteradine (Detrol)
  •       Antispasmodic drugs-oxybutynin (Ditropan)
  •       Tricyclic antidepressants
  •       Estrogen
  •       Alpha-adrenergic blockers
  •       Myrbetriq
  •       Botox

Surgical care for stress incontinence includes the following:

  •       Bladder neck suspension with a permanent suture supporting the bladder and urethra
  •       Periurethral bulking therapy- use gels to provide support
  •       Midurethral slings-natural or artificial material that act like a hammock to prevent leakage
  •       Artificial urinary sphincter

How Catheters Help with Urinary Incontinence

With that being said, many individuals find the use of CompactCath‘s intermittent catheters to be a great product to help in managing UI.  CompactCath offers the most compact intermittent catheter on the market that are easy to use, sanitary, and discreet.  Designed the fit seamlessly into your every day life, try out our award winning catheters with a free sample box by clicking the link down below!

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