Urinary incontinence is an issue faced by people of all ages, not just the elderly. In fact, more than one-third of women over 30 years of age suffer from some type of urinary incontinence.
Men are at risk too, though the issue is more common in women, because of anatomical differences in the pelvic region. Still, it is estimated at least 5 million men are affected by urinary incontinence in the U.S.
No matter who is afflicted, urine incontinence can have a measurable impact on quality of life, as sufferers will often forego social and physical activities because of their urine leakage.
Urinary incontinence can be treated and the condition improved, through medication, surgical options or physical therapy. Ethel Larsen, a physical therapist with Northern Michigan Sports Medicine Center, said therapy involves a two-pronged approach.
“First, we see how we can have people modify their bladder habits through simple things they can do, like reducing the amount of caffeine they are drinking or bottled water, and avoiding ‘just in case’ emptying of the bladder that can lead to other problems like making the bladder more irritable and cause more leaking,” said Larsen. “The second part is conditioning the supporting muscles in the pelvis, which is critical for restoring continence.”
Seeking treatment once the problem becomes noticeable is key to improving it.
“There are a fair number of women who are working out who are wearing a form of protection because of leaking,” she said. “If you’re 30 or 35 and you find you’re jogging or leaking, that’s an ideal time to address the issue.”
Larsen also presents and educational seminar explaining bladder function and habits through the Community Health Education Center of Northern Michigan Regional Hospital. Visit www.northernhealth.org for more information.
 

More incontinence information

Dr. Carin Nielsen, a family medicine doctor at Little Traverse Primary Care, provides further answers and information on urinary incontinence:
 

PNR: How is incontinence defined?

Nielsen: Urinary incontinence involves the involuntary leakage of urine. There are several types of urinary incontinence. The two most common are stress urinary incontinence and urge incontinence.
SUI causes leakage of urine with physical stress such as coughing or sneezing. UI causes an urge to urinate and patients often find that once that urge hits, they cannot make it to the bathroom in time.
There is also mixed incontinence, which can involve aspects of both.
SUI is most commonly caused by loss of pelvic muscle tone and support, and is much more common after childbirth. The cause of UI is not as clear. It can be caused by the interruption of the central nervous system pathways or by bladder irritation caused by stones, infection, chronic inflammation or cancer. Often times we can’t pinpoint the cause of urge incontinence.
 

PNR: When a patient comes to you expressing concerns about incontinence, what is a typical course of action?

Nielsen: I usually start with a series of questions to determine what type of incontinence we are dealing with, followed by an exam. If the type of incontinence or cause is not clear, I will refer them to a gynecologist or urologist for urodynamic testing.
Like most chronic conditions, I always start with discussing lifestyle changes first. Stress incontinence often responds well to pelvic floor muscle exercises. I sometimes refer to physical therapy, which also works very well. Physical therapists can use special weighted devices and other aids to train patients to do the exercises correctly.
Weight loss can also help to lessen symptoms.
 

PNR: What are the treatment/medication options available?

If someone doesn’t respond (to the approaches suggested above), then I will refer them on for a surgical evaluation. There are several new less-invasive procedures that can be very helpful for SUI.
For urge incontinence, we start by limiting bladder irritants such as caffeine and alcohol, and starting “timed voids” — having a patient empty their bladder on a regular schedule. If someone doesn’t respond to these changes, there are several medications on the market that can relieve symptoms.
We have to be careful, though, because these medications may have troublesome effects which are more pronounced in the elderly (dry mouth, constipation, dizziness).
Medications don’t work very well for stress incontinence, and surgery generally doesn’t work very well for urge incontinence.
 

PNR: What is a common age range that people may begin to experience incontinence?

Nielsen: Urinary incontinence is more common in women after childbirth, and even more common in post-menopausal women. The lack of estrogen to the pelvic floor muscles can worsen symptoms.
 

PNR: What else should people know about incontinence?

Nielsen: Your doctor can only offer help if they know about the problem. I ask patients routinely during their annual physical about urine leakage and am surprised how often patients will respond with symptoms that they don’t bring up unless I ask.
I think many patients don’t realize how many treatment options we have to offer.