A burning sensation, sprints to the bathroom or just a little dribble? Symptoms from the lower urinary tract (LUTS) are extremely common in women, but nevertheless both unpleasant and embarrassing. We will help you to sort the terms.
1. Incontinence
Urinary incontinence most often means urine leakage. It is up to 3 times more common in women than in men. It is also more than 10 times more common that women have a stress incontinence.
Different types of incontinence
- Stress
It’s common to suffer from stress incontinence after pregnancy and child birth. The pregnancy makes the pelvic floor weaker, and it becomes harder to squeeze the muscles and sphincters at the bottom of the bladder. You may find that you accidentally leak a little wee when you cough, sneeze or exercise.
- Urge
Urge incontinence starts with a sudden urge to empty the bladder. The bladder contracts when it shouldn’t, causing some urine to leak. This type of incontinence is caused by a dysfunction in the actual bladder, and it is common due to neurological diseases like MS.
- Mix
It is possible to suffer from both stress and urge incontinence at the same time, then called mix incontinence. In severe cases, both stress and urge incontinence can be treated through surgery.
Causes of incontinence
There are various reasons for incontinence in women, two of them are Overactive bladder and Pelvic Organ Prolapse (POP).
Overactive bladder (OAB)
Overactive bladder involves problems with the storage function and it leads to a sudden urge to urinate, which may be difficult to stop and cause leakage. The urgency can occur both with and without incontinence, usually causing frequent visits to the bathroom, also during night.
Overactive bladder is reported to be more common among women than among men.
Pelvic Organ Prolapse (POP)
The pelvic floor is a group of muscles that form a “hammock” across your pelvic opening. Normally, these muscles keep the pelvic organs – bladder, uterus, vagina, small bowel and rectum – in place.
Pelvic organ prolapse (POP) can occur when the pelvic floor muscles and other supporting tissues becomes weak, and one or more organs shift out of their normal positions and into the vaginal canal.
Vaginal childbirth and menopause are the two leading causes of pelvic organ prolapse. POP may trigger problems such as urinary difficulties, urgency and incontinence.
2. Retention
Urinary retention is the opposite of incontinence – you have trouble emptying your bladder. Having residual urine can cause infections. Retention is common in elderly men (due to enlarged prostate) and also seen in women, especially if you have a neurological disease, prolapse or post op surgical complications.
To flush out bacteria from the urethra and maintain the chemical balance of your body, you regularly need to empty the bladder. If the normal mechanisms are out of play, you will need aids for draining the bladder, for example intermittent catheters. One condition causing retention is Atonic Bladder.
Atonic bladder
When the bladder muscles are too weak to “squeeze out” the urine, you have an Atonic bladder. This can be the case when you have a neurologic disease or injury.
It is common that people with Atonic bladder suffer from chronic retention. They may also experience overflow incontinence, a painful and dangerous situation where the bladder is filled and stretched to its maximum and yet the patient is unable to void.
Many patients with Atonic bladder also suffer from painful recurrent Urinary Tract Infections (UTIs) since bacteria tend to grow in the “old” urine, in the bladder.
3. Urinary Tract Infection
A Urinary Tract Infection (UTI) occurs when bacteria has a chance to grow and multiply in the urethra and bladder, causing symptoms. You might feel a strong urge to urinate, a burning sensation when urinating, a frequent need to urinate, pain, discomfort or fever.
Half of the women in the world will get at least one urinary tract infection in their lives, and it is more common in young women and women that have passed the menopause.
If you are a catheter user, you need to be extra careful to avoid infections since you are entering the catheter to the urethra. Hygiene is essential, and it is really important that you empty the bladder completely to avoid that urine stays in the bladder and promotes bacteria growth. Ask your nurse or doctor for a catheter that is scientifically proven to decrease the risk of infections.
To boost your knowledge we have created the app “Stop UTI” where you find all information you need. If you do the STOP-UTI check, you will get personal recommendations on how you can prevent UTIs.
References
Irwin et al., BJU International,2009
Dielubanza, EJ & Schaeffer,The Medical clinics of North America,2011.
Foxman et al., The American journal of medicine, 2002
Drake et al. Neurourology and urodynamics, 2016
Center for Urogynecology and Pelvic Floor Disorders, Obstetrics, Gynecology and Women’s Health Institute, Cleveland Clinic, USA
