Have you ever found yourself in a situation where you just can’t seem to “hold” it? Are you constantly rushing to a restroom only to never make it in time? Do you experience a spurt of urine escape the moment you cough or sneeze?

Urinary incontinence or loss of bladder control resulting in leakage of urine is a common and often embarrassing problem. Its severity can range from an occasional leak when you cough or sneeze to having the urge to urinate that’s so sudden and strong that you don’t get to a toilet in time. 

You can leak a small amount of urine OR a lot of urine at one time if you suffer from urinary incontinence. 

If urinary incontinence is negatively impacting the quality of your life, and your daily activities or is affecting your confidence thereby limiting your social interactions, don’t hesitate to see a doctor. For most people, simple lifestyle and dietary changes or medical care can treat symptoms of urinary incontinence.

What Causes Urinary Incontinence?

Urine is produced by the kidneys and is stored in the muscular ballon-like structure called the urinary bladder. The lower end of this bladder has a tube called the urethra which carries the urine out of our body. A guard muscle regulates the flow of urine from the bladder into the urethra. Certain nerves carry messages from the bladder to the brain and back. Muscles in the pelvis provide support to the bladder. When the bladder is full, it sends signals to the brain which in turn orders the muscles of the bladder to contract and the guard (sphincter) muscles to relax so that the urine flows out of the body. Whenever there is a problem anywhere in this pathway, either with the nerves or muscles or the sphincter, you experience urinary incontinence. 

Risk Factors You Must Be Aware Of For Urinary Incontinence 

Though urinary incontinence occurs more often as people get older, it isn’t an inevitable consequence of ageing. Factors that put you more at risk of getting urinary incontinence than others are –

• Your gender: Urinary incontinence affects twice as many women as it does men, particularly pregnant women, females who’ve had one or multiple vaginal deliveries and women in menopause due to hormonal changes.
• Age: As you get older, the muscles in your bladder and urethra lose some of their strength and elasticity. Changes with age reduce how much your bladder can hold and increase the chances of involuntary urine release.
• Obesity: Excess fat puts pressure on the urinary bladder.
• Diabetes: Raised blood sugar levels, obesity, increased risk of UTIs, and damage to the nerves surrounding the bladder can give a “diabetic bladder” capable of incontinence.
• Neurological disorders: People with neurological conditions, viz. stroke, Parkinson’s disease, multiple sclerosis, injury to the brain or spinal cord etc. tend to lose nerve control in the pathway.
• Surgeries: If you’ve undergone a uterus removal (hysterectomy) or a prostate removal (prostatectomy) as a treatment for an enlarged prostate or prostate cancer.
• Health conditions such as chronic or severe constipation, long-term persistent coughing, or  high-impact activities, such as running, leaping or heavy weightlifting, over a long period of time can weaken the pelvic floor muscle in both men and women.
• Smoking: Causes the sphincter muscle to relax resulting in incontinence.

If you already suffer from incontinence, there could be several factors that can aggravate the problem further and should be kept under check. These are:

1. Intake of certain medications that can relax the sphincter or the guard muscle of the bladder, such as heart and blood pressure medications, sedatives, muscle relaxants, etc. 
2. Having an overactive bladder (OAB)
3. Urinary tract infections (UTIs)
4. Certain drinks (alcohol, caffeine, carbonated drinks and sparkling water), foods that are high in spice, sugar or acid (citrus fruits, artificial sweeteners, chocolates, chillies), and vitamin C may act as diuretics — stimulating your bladder and increasing the volume of urine. 

Why Is Urinary Incontinence More Common In Women?

Events like pregnancy, childbirth, and menopause can damage the bladder, urethra, or pelvic floor muscles that support these organs.

During pregnancy, the uterus expands and sits on the bladder, which puts more pressure on it. As a result, women encounter episodes of incontinence or inability to hold urine and frequent trips to the washroom a day.

Injury, damage or strain caused to the pelvic floor muscles or the sphincter during childbirth can weaken the pelvic tissues and muscles that support the urinary bladder and urethra. Consequently, they can no longer keep the urethra closed or halt the flow of urine during bursts of physical activities that raise abdominal pressure such as coughing, sneezing, laughing, exercising or lifting something heavy. This kind of incontinence under stress might develop just after delivery or even years later.

Also, hormonal changes during menopause make older women vulnerable. More than 4 in 10 women (ages 65 and older) suffer from some form of urinary incontinence – stress, urge or a mixed leak.

What Are The Different Types Of Urinary Incontinence?

Common types of urinary incontinence can be –

● Stress incontinence: This is the most common type of urinary incontinence found in women who have damaged/injured their pelvic floor muscles or the sphincter during pregnancy and childbirth. Urine leaks the moment one puts pressure on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Men usually encounter this kind of incontinence after surgical removal of the prostate gland to treat prostate cancer (prostatectomy). The urethral sphincter, which is located just under the prostate gland and encircles the urethra, may be weakened as a result of this operation.

● Urge incontinence: This urine leakage happens with a sudden, intense urge to urinate before you can find a restroom. You may need to urinate often, including throughout the night. It may result from minor conditions, such as infection, or more severe conditions such as a neurological disorder or diabetes. Urge incontinence is more common in older men and women.

● Overflow incontinence: This type of incontinence is found more commonly in men with prostate issues where there is always some amount of residual urine in the bladder. One can experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.

● Functional incontinence. It happens when there is no issue with the bladder. A physical or mental impairment keeps one from making it to the toilet in time. For example, if someone has severe arthritis, or is suffering from Alzheimer’s or mental retardation, one may not be able to reach the toilet in time or unbutton quickly enough.

● Mixed incontinence: You experience more than one type of urinary incontinence — most often this refers to a combination of stress and urge incontinence.

How Is Urinary Incontinence Diagnosed?

Your doctor may suggest any of the following tests to reach an accurate diagnosis:

● Urine test – to look for urinary tract infections, sugar etc.
● Ultrasound – to check for any blockage or incompetence.
● Bladder stress test – to check for bladder function.
● Cystoscopy – to look for any abnormal pathology in your bladder and urethra.
● Urodynamics studies (UDS) such as a cystometrogram, uroflowmetry, and voiding pressure study to test how well your bladder, sphincters, and urethra hold and release urine and why there could be leaks or blockages.

What Can You Do At home To Manage Urinary Incontinence?

A few things you can do at home to help treat urinary incontinence:

● Kegel Exercises: Integrate them into your daily routine to improve the tone of your weakened pelvic floor and bladder muscles. Avoid contracting your buttocks, thighs, or abdominal muscles and breathe normally while performing the exercises.

Always check with your doctor about your urinary symptoms before trying Kegels. If your urinary issue is due to pelvic floor muscle tightening, Kegel exercises are not meant for you and may cause more problems.

● Bladder Training: Both men and women can help control overactive bladder or urge incontinence by going to the restroom at set times. You can begin by tracking how often you go each day in a diary. Slowly begin to add 15 minutes in between your restroom visits. This gradual increase in time between visits trains the bladder to hold more urine before it signals the need to go again.

● Avoid Bladder Irritants, such as caffeine, carbonated drinks, alcohol, nicotine, spicy foods, and citrus or acidic foods.

● Maintain a healthy weight.

● Better your eating habits. Eat more fibre, which can prevent constipation, a cause of urinary incontinence.

● Quit smoking to have a good night’s sleep. 

How Can Homoeopathy Help?

Homoeopathy can help treat urinary incontinence where there are no major pathological changes. 

Homoeopathic Materia Medica is full with a plethora of remedies to successfully address the issue of incontinence (stress, overflow, urge, or mixed), be it due to a damaged or weakened pelvic floor, bladder issues, UTIs, hormones, post surgeries and use of catheters, etc. Here are a few most commonly used homoeopathic medicines for incontinence: 

1. Alumina is given when there is paresis of the bladder muscles especially in old people with a frequent urge but one needs to sit for a long time to pass urine.
2. Causticum works well in cases of progressive loss of muscle strength and stress incontinence. Retention of urine due to paralysis of bladder muscles. Involuntary urine in the first half of sleep.
3. Sepia for incontinence caused due to weakness of pelvic floor muscles accompanied by prolapse/descent of bladder, uterus and rectum.
4. Pulsatilla works very well for stress incontinence and urge incontinence at night.
5. Kreosotum is most indicated for urge incontinence, especially at night. Bedwetting in the first part of the night. 
6. Sabal Serulata helps treat leaking consequent upon the weakness of the sphincter muscles due to enlarged prostate.

Treatment with Homoeopathy is highly individualistic and varies from person to person as it works on the totality of physical, mental and emotional traits of an individual apart from the presenting illness.