Treatment for Urge Incontinence

Sometimes known as an overactive bladder, urge incontinence has the potential to completely disrupt a person's life. The frequent need to urinate, sometimes at inopportune moments, can lead to a loss of confidence, sleep and even intimacy with a partner. An overactive bladder becomes categorized as urge incontinence when this issue causes a person to involuntarily leak urine.

Overactive Bladder & Urge Incontinence Symptoms

Some people find that they may need to urinate more frequently due to factors such as drinking too much water or consuming a diuretic like coffee. These issues may temporarily lead to more frequent urination, but a person who has true symptoms of urge incontinence will feel the following signs on a consistent basis:

  • A Sudden Urge to Urinate. A person with urge incontinence will often find themselves feeling the sudden and overwhelming need to urinate at random times during the day. The urge is sudden and will occur regardless of how much and how recently the person has had a drink. 
  • Frequent Urination. In a person with normal bladder function, urination occurs no more than eight times in a 24 hour period. A person who has an urge incontinence will need to visit the restroom more times than that and in some cases, may only release a small amount of urine at a time. 
  • Disrupted Sleep. It is normal to occasionally awaken during the night to urinate, but in people with urge incontinence, the issue is more consistent. Sufferers often wake up during the night one to two times to urinate on an almost nightly basis. 

Urge Incontinence Causes

To understand what can cause an urge incontinence, it's important to know how the the urinary system works:

  1. The kidneys produce urine which then drains into the bladder.
  2. When the bladder fills, nerve signals are transmitted to the brain, eventually causing the urge to urinate.
  3. When the person is ready to urinate, the brain sends signals to the muscles around the pelvic floor and urethra to allow the urine to be released.

When there is a malfunction in any steps of this process, issues such as urge incontinence can arise. The following issues are among the most common causes of urge incontinence:

  • Diabetes
  • Neurological dysfunction
  • Medication side effects
  • Bladder abnormalities or growths
  • Age-related cognitive function decline

Testing for Urge Incontinence

Your doctor can perform a variety of tests to determine which will help them get a better idea of what may be causing symptoms. The most common tests that are performed include:

  • Urine Volume Test. After urinating, the doctor will measure the amount of urine that is left inside of the bladder. This will help determine if leftover urine is causing symptoms that are nearly identical to an overactive bladder.
  • Urine Flow Measurement. The doctor will measure the volume of urine and the speed at which the urine is leaving the urethra. This test will help them identify any possible issues caused by blockages or abnormalities. 
  • Bladder Pressure Test. The doctor will slowly fill the bladder with warm water. A pressure sensor will be used to measure changes in the patient's bladder pressure. This will help identify any involuntary muscle contractions or a bladder that is not able to store urine at low pressure.

Urge Incontinence Treatment Options

The first two steps in the treatment process include behavior modifications such as pelvic exercises or changes in diet, and medications that can help reduce the urge to go. But, when those options fail to relieve symptoms, other treatments may be necessary.

Nerve Stimulation

This option uses a small device that is implanted under the skin in order to control the electric pulses to the sacral nerves. The sacral nerves help transmit messages from the bladder to the brain. Before a permanent device is placed under the skin, a temporary device is clipped to the patient's belt and used for a few weeks to determine if this is a viable treatment option.

Bladder Injections

Bladder injections are sometimes chosen to partially paralyze the muscles around the bladder. Typically these treatments are effective for approximately five months before another injection is needed. 

Surgery

Surgery is often a last resort for those with bladder issues. The goal of bladder surgery is to improve the bladder's ability to more effectively retain urine and reduce the amount of unnecessary pressure felt before urinating.