Aerobics, dance, kegel exercises and medications are some of the common and effective non-surgical methods to treat incontinence

With an infant, an episode of bedwetting is considered normal since the child is not toilet trained. However, for a toilet-trained child, it becomes a source of embarrassment. As the age increases, the embarrassment due to incontinence too increases. Incontinence or the involuntary loss of urine is considered common, especially as people age, but that is anything but true — incontinence, at any age, is not normal. In men, it may happen due to age and neurodegenerative disease such as Parkinson’s, dementia, multiple sclerosis, or stroke. However, in women, incontinence is a major problem that no one wants to recognise due to socio-cultural implications. They are in denial and in most of the cases suffer silently. Women with advancing age have overactive bladder especially in diabetic patients but it is managed by some medications.

There are three types of incontinence which are seen the most. These are:

Stress incontinence: This kind is the most common one and happens in women who have normal delivery during childbirth. This is because due to the stress put on their pelvic muscles during delivery, they become weak. Nearly half of the women above the age of 50 who have also bore a child face stress incontinence. Those who have an elected caesarean delivery usually have less chances of developing this condition. There are grades of this kind of incontinence grade 3 being the highest where a leak happens even if someone is getting up from a lying down position.

Urgency incontinence: The term refers to a sudden and strong need to urinate and is also referred to as an unstable or overactive bladder, or detrusor instability. The cause of urge incontinence is not understood well but, in all likelihood, the chances increase as we age. Symptoms may get worse at times of stress and by caffeine in tea, coffee and fizzy drinks or alcohol. Constipation (not being able to empty the bowel or having difficulty doing so), an enlarged prostate gland or simply a long history of poor bladder habits may also cause this kind of incontinence.

Mixed incontinence: Since mixed incontinence is typically a combination of stress and urge incontinence, it shares symptoms of both the types. One can experience urine leakage as they sneeze, cough, laugh, do jarring exercise, or lift something heavy or after a sudden urge to urinate, while sleeping, after drinking a small amount of water, or touching water or hearing it run.

Some of the diagnostic tests for incontinence include:

Bladder stress test: The doctor checks to see if you lose urine when coughing. This could indicate stress incontinence.

Catheterization: After emptying your bladder, the doctor inserts a catheter to see if more urine comes out, meaning you are unable to empty your bladder completely.

Ultrasound. An imaging test performed to visualise inner organs such as the bladder, kidneys, and ureters.

After ascertaining the gravity of the case, it is decided whether a surgical or non-surgical intervention is needed. Aerobics, dance, Kegel exercises, and medications are some of the common and effective non-surgical methods to treat incontinence. There are surgeries too but not many finally need them.

The writer is Dr VINEET NARANG, Head, General Urology  at Indian Spinal Injury Centre, new delhi