Urinary incontinence - loss of bladder control - is a common and often embarrassing problem. It ranges from the occasional leakage of urine while coughing or sneezing to the need so sudden and strong to urinate that you can no longer reach the toilet in time.

In addition to the loss of bladder control, unpleasant sensations of pressure in the bladder, diffuse pelvic pain, discomfort when urinating and the feeling of incomplete emptying of the bladder may also occur. More frequently attributed to the third age, urinary incontinence affects daily activities, but by adopting a balanced lifestyle in terms of nutrition, hydration, specific physical exercise, as well as proper medical care helps treat the symptoms.

It is manifested by urine leakage when a pressure is exerted on the bladder by coughing, sneezing, shaving, exercising, or lifting heavy objects.

It can be caused by a minor condition, such as an infection, or by a more severe condition, such as a neurological disorder or diabetes.

It manifests by a sudden, intense impulse to urinate, followed by an involuntary loss of urine.

It is manifested by frequent or constant elimination of urine due to a bladder that does not empty completely.

A physical (such as arthritis) or mental condition can slow down the walk to the toilet and thus urine leaks appear.

Refers to a combination between stress incontinence and emergency incontinence.

The treatment depends on the type of incontinence, its severity, and the triggering cause, sometimes a combination of treatments being required.

Firstly, we try to educate the bladder through a series of techniques.

A first technique consists in postponing the urination by 10 minutes from the moment the need to urinate is triggered. The goal is to extend the time between going to the toilet until urination is obtained every 2.5 - 3.5 hours.

Another technique is double urination, which means urination followed by a few minutes of waiting and then trying to urinate again. This technique is useful to educate the complete emptying of the bladder, thus avoiding overflow incontinence.

A final technique is to schedule trips to the toilet to urinate every 2-4 hours.

In order to regain control over the bladder, it is important to manage fluids and diet. Thus, it may be necessary to reduce or even avoid alcohol, caffeine, and acidic foods.

Losing weight or increasing physical activity can also help solve the problem.

Firstly, the pelvic floor muscles are localized, feminine and masculine, muscles that help control urination (in order to locate them we imagine that we are trying to stop the flow of urine) and then exercises will be practiced for strengthening them, and best known are the Kegel exercises.

More precisely, the pelvic floor muscles contract for 5 seconds followed by their relaxation for 5 seconds (if it is too difficult, start with the contraction of these muscles for 2 seconds and relax for 3 seconds). Practice gradually until a contraction is maintained for 10 seconds followed by relaxation for 10 seconds. Daily at least 3 sets of 10 repetitions will be practiced.

A specialist doctor will choose the right medicines for each patient.

There are several classes of drugs commonly used to treat urinary incontinence, which act either to soothe an overactive bladder as it happens in emergency incontinence or by relaxing the muscles of the bladder thus increasing the amount of urine that the bladder can retain or help empty the bladder completely. In men who have emergency incontinence or overflow incontinence, medications are indicated to relax the bladder muscles as well as the muscle fibers in the prostate, thus easing the emptying of the bladder. In women applying a low dose of estrogen topically in the form of a vaginal cream, ring or patch can help tone and rejuvenate the tissues in the urethra and vaginal areas. Botox injections into the bladder muscle can be used in the case of overactive bladder (emergency incontinence). But Botox is generally prescribed only if other treatments have not been successful.

Certain specific electrodes can be temporarily inserted into the rectum or vagina to stimulate and strengthen the pelvic floor muscles.

This delicate electrical stimulation can be effective for stress incontinence and emergency incontinence. To stimulate the nerves involved in the control of the bladder (sacral nerves) 2 types of devices that use painless electrical impulses are indicated. One of the devices is implanted under the skin in the buttock and the other type is a removable plug that is inserted into the vagina. Stimulation of the sacral nerves can control the overactive bladder, being indicated if other therapies have not worked.

The devices designed to help women with urinary incontinence are:

1. Urethral insertion - a small disposable device, similar to the tampon, will be inserted into the urethra before a specific activity that can trigger urine loss (such as sports). The urethral insertion acts as a "plug" to prevent leakage and is removed before urination.
2. Pessary ring - a flexible silicone ring that is inserted into the vagina and can be worn all day. The device is also used in women with vaginal prolapse. The Pessary helps support the urethra to prevent the outflow of urine.

Injections with load material - a synthetic material is injected into the tissue around the urethra helping to keep the urethra closed and reduce urine leakage. This procedure is recommended for the treatment of stress incontinence and is generally less effective than more invasive treatments, such as surgery. It may also be necessary to repeat it several times.

If the treatments described above do not work, several surgical procedures may be recommended to treat the medical problems that cause urinary incontinence. The specialist doctor will decide the best surgical approach for each patient.

➢ It is recommended to visit a specialist doctor from the first symptoms.

➢ Untreated, urinary incontinence can lead to an increased risk of urinary infections, local irritations, and mental discomfort. Also, there is the risk of depression, caused by the impossibility of having a normal life, given that the imperative need to go to the toilet can occur at any time.