Summary about Disease
Urge incontinence is a type of urinary incontinence characterized by a sudden, strong urge to urinate that you can't control, leading to involuntary urine leakage. It's often referred to as overactive bladder (OAB), although OAB also includes urgency and frequency without necessarily having incontinence. The bladder muscles contract involuntarily, even when the bladder isn't full, causing the urge.
Symptoms
A sudden, strong urge to urinate that is difficult to control
Involuntary leakage of urine (incontinence) after the urge
Frequent urination (eight or more times in 24 hours)
Nocturia (waking up two or more times during the night to urinate)
Causes
The exact cause isn't always known, but it's often related to:
Nerve damage: Conditions like multiple sclerosis, stroke, or Parkinson's disease can damage nerves, disrupting bladder signals.
Muscle damage: Damage to bladder muscles.
Diabetes: Can lead to nerve damage.
Infections: Urinary tract infections (UTIs) can irritate the bladder.
Medications: Certain medications can contribute.
Age: Changes in bladder function can occur with age.
Bladder stones or tumors: These can irritate the bladder.
Idiopathic: In many cases, the cause is unknown (idiopathic).
Caffeine and Alcohol: Can irritate the bladder.
Medicine Used
Anticholinergics: These medications (e.g., oxybutynin, tolterodine, darifenacin, solifenacin, trospium) block the action of acetylcholine, a chemical that signals bladder muscle contractions.
Beta-3 agonists: Mirabegron relaxes the bladder muscle, increasing bladder capacity and reducing the frequency of urination.
OnabotulinumtoxinA (Botox): Injected into the bladder muscle to relax it.
Tricyclic Antidepressants: Some antidepressants, like imipramine, can help relax the bladder.
Topical Estrogen: Can strengthen the urethra.
Is Communicable
No, urge incontinence is not a communicable disease. It cannot be spread from person to person.
Precautions
Bladder Training: Scheduled voiding to increase the time between urination.
Pelvic Floor Exercises (Kegels): Strengthen the muscles that support the bladder.
Dietary Changes: Reducing or eliminating caffeine, alcohol, and acidic foods.
Fluid Management: Drinking adequate fluids, but avoiding excessive intake, especially before bedtime.
Weight Management: Obesity can put extra pressure on the bladder.
Double voiding: After urinating, wait a few moments and then try to urinate again.
Absorbent pads or underwear: To manage leakage.
How long does an outbreak last?
Urge incontinence is not an "outbreak," it is a chronic condition. Without treatment, symptoms can persist indefinitely. With treatment, symptoms can be managed or reduced, but the underlying condition may still be present.
How is it diagnosed?
Medical history and physical exam: Review of symptoms, medical history, and a physical examination.
Bladder diary: Recording fluid intake, urination frequency, and leakage episodes.
Urinalysis: To check for infection or other abnormalities.
Postvoid residual measurement: To determine how much urine remains in the bladder after urination.
Urodynamic testing: To assess bladder function, bladder capacity, and flow rate. This may include cystometry (measuring bladder pressure), uroflowmetry (measuring urine flow rate), and electromyography (EMG) to assess muscle activity.
Timeline of Symptoms
The onset of symptoms can vary. Some people experience a gradual increase in urgency and frequency, while others may have a more sudden onset. The timeline depends on the underlying cause:
Gradual onset: Often seen with age-related changes or slowly developing conditions.
Sudden onset: May occur with UTIs or neurological events.
Variable: The severity of symptoms can fluctuate depending on factors like stress, diet, and medication use. Symptoms will continue unless interventions are made.
Important Considerations
Quality of Life: Urge incontinence can significantly impact a person's quality of life, affecting social activities, work, and self-esteem.
Comorbidities: It's important to consider underlying medical conditions that may contribute to or be affected by urge incontinence.
Medication Side Effects: Be aware of potential side effects of medications used to treat urge incontinence.
Individualized Treatment: Treatment should be tailored to the individual based on the severity of symptoms, underlying causes, and overall health.
Seek Professional Help: It's important to consult a healthcare provider for proper diagnosis and management. Do not self-treat.