Urgency and urge incontinence is perhaps the most difficult and distressing symptom to manage. It can destroy your confidence if severe.
You may find you are beginning to anticipate every journey by planning your routes around the accessibility of toilets; even shopping can be a nightmare.
The work place can be difficult, particularly if you are employed on a factory line, or indeed in some office situations, when you need to ask to be excused before each toilet visit. You might even be accused of time wasting.
Urge incontinence is described as a sudden intense desire to pass urine. Sometimes you may not be able to hold on and leak a little - or maybe empty your bladder completely.
You may also notice that you need to pass urine more frequently and to have to get up several times during the night.
Urge incontinence is caused by an overactive, irritable, unstable bladder-muscle contraction. The bladder is reluctant to hold as good a volume as it used to; it becomes unpredictable and gives a shorter warning.
Symptoms - A sudden and strong urge to urinate
- Need to urinate frequently, more than every two hours (including getting out of bed a number of times)
- Frequent leakages or wetting
- The passing of a large amount of urine shortly after the sensation indicating that the bladder is full
- A dry, sore vagina may be experienced, particularly after the menopause
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The truth about fluid intake
In order to prevent accidents you have probably tried to improve the situation by reducing fluid intake, believing the less you drink the more likely you are to be continent. Unfortunately this method seldom helps to improve the situation but is more likely to increase the severity of the problem.
It is, however, important to consider the type of fluid taken. We know that drinks that contain caffeine such as tea, coffee, or fizzy drinks have the potential to stimulate a greater production of urine and therefore make the problem worse. It is important to take at least 8 cups of fluid each day, water being the best.
If your fluid intake is low you may be more likely to experience urinary tract infection and have a bladder with a low functional capacity. The infected urine will irritate the bladder; the bladder muscle will contract to empty, resulting in frequent, painful passing of urine.
Urge incontinence can occur due to infections such as cystitis, which make the bladder more sensitive. Cystitis is accompanied by a burning sensation when going to the toilet.
Treatment
It is important that you seek the advice of your GP who may refer you for bladder studies to determine the reason for the urgency.
The most likely cause is an unstable bladder, neurological illness such as stroke or multiple sclerosis, or nothing associated with any medical diagnosis. The bladder muscle itself can become unstable.
You may be prescribed an anticholinergic drug to reduce the activity of the bladder muscle, allowing the bladder to store a greater volume of urine.
You may be offered bladder retraining, to increase the volume by learning to hold on between voids. This takes a lot of determination but can be successful.
It is easy to fall into bad habits by going to the toilet too frequently (frequency refers to the number of times you go to the toilet in 24 hours) to avoid accidents. Your bladder needs retraining to improve its functional capacity, allowing you more time between visits to the toilet.
We also recognise that anxiety, depression and other emotional states may result in frequency and urgency or by association such as hearing running water.
20/05/2009