What is Incontinence: Symptoms, Causes, Types & More

What is Incontinence - A Brief Overview

In India, approximately 50 million people suffer from urinary incontinence. That’s 50 million people who remain shackled to their beds and bathrooms. 50 million sufferers of urine incontinence remain trapped in their homes. While adult diapers provide some respite and mobility, urine incontinence is hardly a topic for conversation in India.

And while one can normalise a conversation that is going wrong, how does one normalise a conversation that doesn’t even exist?

As a company that manufactures adult diapers, we at Friends Adult Diapers consistently attempt to begin a conversation around urine incontinence. A large part of that is through providing the correct information that is not marred by shame or stigma.

Urine incontinence refers to a condition where the body is unable to control the passage of urine resulting in sudden, accidental leaks. If you are dealing with sudden strong urges to pee, or the leakage of some urine when you laugh, sneeze, cough or exercise—you probably are facing urine incontinence. For most people, urine incontinence may be a product of old age, but the condition can show up in younger people in their mid-20s as well due to certain health conditions and lifestyle habits. 

Most people are not vocal about their incontinence issues and tend to think of it as just another health condition related to ageing. However, it can also have psychological effects on the person, like stress and/or depression.

The treatment of incontinence is decided based on the person, symtpomsits and their severity. But, it must be managed with adult diapers until it gets treated. Finding out the type of incontinence that one suffers from, can help to determine the root cause and treatment options. 

Are You Experiencing These Symptoms of Incontinence?

Sometimes, urine can be passed accidentally due to the consumption of diuretics such as alcohol, caffeine or certain aerated drinks. However, if you detect one of the following urinary incontinence symptoms more than twice you must immediately visit a doctor:

• Accidental leakage of urine during everyday activities such as coughing, laughing, lifting, bending or exercising.
• Feeling a sudden strong urge to urinate right away.
• Leaking urine suddenly without any warning or build-up of urge.
• Being unable to (physically) reach a toilet in time.
• Being unable to reach a toilet in time as the urge comes suddenly with little or no warning.
• Repeated bedwetting at night.

Diapers for old age may be tape style or pant style. Tape style elderly diapers can be taped on one side and adjusted at will. Pant style elderly diapers or ‘pull up pants’, on the other hand, can simply be slid on and are easier to handle without caregivers.

Today, diapers for old age are convenient, highly absorbent, engineered for comfort and can be worn for several hours without leaks or wetness. Brands such as Friends Adult Diapers have also worked towards making the elderly diaper as sleek as possible. This helps in wearing them discreetly under pants or dresses while going out to meet family or friends.

Who Might Suffer from Incontinence?

Incontinence of urine can happen to anyone, regardless of age or gender. However, it is more common in certain groups of people, including:

• Women: Women are more likely to experience incontinence than men, especially after childbirth, during menopause, and as they age. This is often due to weakened pelvic floor muscles, which support the bladder and urethra.
• Aged People: As people age, the muscles that control the bladder can weaken, leading to incontinence.
• People with Medical Conditions: Certain medical conditions, such as diabetes, neurological disorders, and urinary tract infections, can increase the risk of incontinence. So, people suffering from these diseases are more likely to experience urinary incontinence symptoms.
• People Who Have Undergone Surgery: Surgery in the pelvic area, such as prostate surgery in men or hysterectomy (surgical removal of the uterus) in women, can sometimes damage the nerves or muscles that control urination. This can lead to incontinence

What Are the Types of Urinary Incontinence?

There are two main types of urinary incontinence:

1. Temporary Urinary Incontinence

Temporary urinary incontinence is usually caused by a treatable condition. It is a short-term issue that can be resolved once the underlying cause is treated. The causes for this type of incontinence include urinary tract infections (UTIs), constipation, or even caffeine intake. 

2. Persistent Urinary Incontinence

Persistent urinary incontinence is a long-lasting bladder control issue. It can be caused by a variety of factors, such as weakened pelvic floor muscles, nerve damage, prostate problems in men, hormonal changes in women, or certain medical conditions like diabetes or Parkinson's disease. It often requires ongoing treatment to help manage symptoms and improve quality of life.

Based on symtpoms, causes and other factors, these two types can be further classified into seven types of incontinence:

1. Stress Incontinence: 

The word stress in stress incontinence is not linked to mental stress. It is related to any kind of physical stress that is exerted on the bladder, due to lifting large or heavy objects, coughing, laughing, and sneezing, or being overweight.

2. Urge Incontinence:

Also known as an overactive bladder, this condition involves having a strong, sudden urge to urinate, and that too, frequently, which makes it difficult for the person to reach the toilet in time. Hence, it is essential to manage it with adult diaper pants, in order to avoid leakage.

3. Mixed Incontinence:

It is a combination of urge incontinence and stress incontinence, and is usually found in women.

4. Overflow Incontinence:

Most commonly affecting men, this type of incontinence is associated with the inability to feel the urge to urinate or empty the bladder completely, resulting in leaks later.

5. Reflex Incontinence:

This occurs especially in patients with paralysis where urine leaks without any warning or urge, often in large quantities.

6. Functional Incontinence:

Functional incontinence occurs when a person is not able to reach the toilet, due to the presence of diseases such as Alzheimer's or Arthritis. It mostly affects elderly people. You can easily find adult diapers for Alzheimer's patients online. 

7. Bowel Incontinence:

Also known as faecal incontinence, is an involuntary release of faeces or wind from the rectum.

If you have a friend or family member suffering from incontinence, then encourage them to openly talk about it and consult their doctor. In the meantime, they should shop for adult diapers online, so their incontinence can be managed. With Friends Adult Diapers, they can save themselves the accompanying discomfort and enjoy their lives without worrying too much.

What Causes Incontinence?

Different types of urinary incontinence are caused by different underlying issues which include obesity, menopause, diabetes, ageing, prostate issues, etc. The correct urine problem solution depends on the underlying cause. Let us take a detailed look at these causes:

• Pregnancy and Childbirth –

Pregnancy comes with a lot of hormonal changes. The growing baby can exert pressure on organs inside the stomach and the vaginal canal. This can result in damage to nerves, supportive tissue, bladder muscles and the pelvic floor. This is the most common type of urine leakage in women. Stress incontinence causes small spurts of urine to be leaked during activities that engage the pelvic region such as laughing or sneezing.

• Menopause –

The secretion of oestrogen, a hormone that helps keep the lining of the urethra and bladder healthy, reduces in quantity post-menopause. As a result, uncontrolled bladder contractions become more frequent leading to urine leaks.

• Hysterectomies –

In women, several muscles and ligaments in the pelvic region hold up the bladder and uterus. Any surgery that involves the removal of the reproductive system, including the uterus can cause loosening or weakening of these muscles, or damage them – leading to urine incontinence.

• Enlarged Prostate –

Incontinence in older men may be caused due to an enlarged prostate. Urge incontinence is also often associated with prostate cancer. Urge incontinence causes an inability to urinate even when there is a strong urge. More commonly, though, it is a side effect of the treatment for prostate cancer.

• Prostate Cancer -

Prostate cancer can be treated via two methods - surgery and radiation. Both of these are invasive methods that affect the function of your bladder. During the surgery, nerves and muscles around the bladder and urethra can get damaged. In radiation therapy, the radiation also affects some of the surrounding areas and causes inflammation and swelling. This can lead to incontinence.

• Obstruction –

Functional incontinence can be caused by an obstruction, such as a tumour somewhere in the urinary tract. Urinary stones in the kidney or the bladder can also cause urine incontinence

• Age –

Ageing can weaken bladder muscles or decrease their capacity to store urine. Involuntary bladder contractions also become more common with age.

• Medication and Sedatives –

Some types of medication can hamper the process of urinating, increase the quantity of urine released or damage the bladder muscles. Diuretics, also known as water tablets, enhance the production of urine. Did you know that alcohol and caffeine also act as diuretics? Angiotensin-converting enzyme (ACE) inhibitors, usually taken to treat blood pressure issues, can lead to stress incontinence by causing a severe cough. Morphine, sedatives, excess ketamine, and antidepressants can also lead to incontinence.

• Neurological Disorders –

Disorders associated with the nervous system, like multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, diabetes or a brain tumour, can affect one’s ability to have control over their bladder, thereby resulting in mild or severe incontinence. There are adult diapers for Alzheimer’s patients online that prevent messy situations.

• Urinary Tract Infections –

When the urinary tract gets bacterial or fungal infections, the person’s bladder is more likely to get affected, thereby causing sudden urges to urinate, resulting in incontinence. UTIs are common, especially among women. There are highly absorbent, comfy adult diapers for women online.

• Constipation –

Straining while you are passing a stool exhausts the pelvic floor muscles, thereby also weakening bladder muscles, which might result in stress urinary incontinence.

• Extra Weight –

Obese people are also likely to suffer from incontinence, as additional weight acts as a catalyst by causing more pressure on the bladder.

• Nicotine –

Nicotine can exhaust the detrusor muscle, thereby increasing the possibility of urge incontinence.

 

Other than the ones listed above, there are a few additional causes, like carbonated drinks, extremely spicy foods, excess sugar, and excess Vitamin C. So, it is evident that there are many things one needs to take into consideration, in order to prevent incontinence.

However, even if one starts suffering from incontinence during the process of unavoidable surgical treatments or therapy or medication, they can still manage it with adult diapers and do not ultimately need to opt for further incontinence treatment. 

What Are the Complications Related to Incontinence?

Although urinary incontinence treatment is possible, you may face other complications that come along with it if it is not managed well. These are as follows:

• Skin Problems:

Prolonged exposure to urine or faeces can cause skin irritation, breakdown, and infections. This can lead to conditions such as dermatitis, pressure sores, or urinary tract infections.

• Decreased Quality of Life:

Living with urinary incontinence can impact daily activities, social interactions, and self-esteem. Fear of embarrassment or odour may lead to social withdrawal, isolation, and decreased participation in activities.

• Sleep Disturbances: 

You might feel the need to wake up frequently during the night to urinate. This can disrupt sleep patterns and lead to fatigue, daytime sleepiness, and decreased quality of life.

• Urinary Tract Infections (UTIs):

Incontinence can increase the risk of urinary tract infections due to residual urine in the bladder. It can easily become a breeding ground for bacteria and cause serious infections.

• Depression and Anxiety:

Living with urinary incontinence can cause psychological distress due to embarrassment. This can lead to depression, anxiety, stress, and a decreased sense of well-being.

• Sexual Dysfunction:

Urinary incontinence can lead to decreased sexual desire, arousal, and satisfaction for both partners.

When to Seek Medical Assistance for Incontinence?

However, in case the incontinence is going out of hand—episodes are increasing, the amount of urine lost is increasing, or the sensation of the need to pass urine has completely disappeared one should immediately consult their doctor. In the led up to your meeting with your doctor start recording some of these basic facts: 

• When did your symptoms start, and how severe are they?
• Are your symptoms continuous or occasional?
• How often do you need to urinate?
• When do you leak urine?
• Do you leak when you cough, laugh or sneeze?
• Do you have trouble emptying your bladder?
• Have you noticed blood in your urine?

Do you have any pain or burning sensation when you urinate?

These will help your doctor diagnose the underlying cause causing your urine incontinence. The doctor may further ask you: 

• Do you smoke?
• How often do you drink alcohol and caffeinated beverages?
• How often do you eat spicy, sugary, or acidic foods?
• Do you take any medications?
• What other medical conditions do you have?

Diagnosis of Incontinence

The doctor or the healthcare provider will conduct a physical exam, or a pelvic exam for women and a prostate exam for men. The tests for diagnosis may include -

The doctor or the healthcare provider will conduct a physical exam, or a pelvic exam for women and a prostate exam for men. The tests for diagnosis may include -

• Physical Exam -

The doctor will do an abdominal examination to check for an unhealthy bladder. A pelvic examination is done in women to determine urinary incontinence causes. This includes assessing the health of the pelvic organs, including the uterus, cervix, and vagina. For men, a digital rectal exam is conducted to check for an enlarged prostate gland.

• Urinalysis -

Consider checking your urine for infections, blood or any other kinds of abnormality. If any problems are identified, you might be referred to another doctor for further tests and even be asked to use adult diapers that come in various sizes like XL & XXL as per the size that fits you perfectly.

• Stress Test -

You might just be put under stress like asked to cough or laugh or jump or simply anything that can help the doctor watch for any loss of urine. After a thorough analysis of one’s case intensity, the doctor might suggest further tests or ask you to use adult diapers that are used by people suffering from Urinary Incontinence, from women undergoing pregnancy to other similar cases including people in their old age.

• Ultrasound -

This will help in measuring how much urine is left in your bladder just after visiting the washroom. Often, people are asked to use adult diapers that are available for those in their old age and others suffering from Urinary Incontinence or suggest further tests if required.

While the above exams are the maximum testing people usually need, considering your case, your doctor may refer you to a urologist, urogynecologist or a geriatrician for special tests such as –

• Urodynamic testing-

A catheter is inserted in the urethra to fill the bladder with water and the pressure in the bladder is recorded to help measure its strength as it fills and you urinate. In order to manage the problem, one can try using adult diapers that are perfect for people in their old age or others suffering from bladder control loss.

• Cystoscopy-

The doctor inserts a thin tube with a lens through the urethra into the bladder to get a good look for any abnormalities in the urinary tract. Post this, if the doctor finds any abnormalities they’ll let you know about treatments for the same and might ask you to use adult diapers that come in all sizes such as XL & XXL.

• Pelvic ultrasound-

One's urinary tract or genitals are checked for abnormalities with the ultrasound. The doctor will then let you know the further action to be taken to manage urine leakage or you could even use adult diapers that are available in various sizes like XL & XXL.

What Are the Key Ways of Managing Incontinence at Home?

Once the diagnosis is complete, the doctor may recommend some procedure, or medications to manage the condition. In addition to those, here are some of the best at home methods to manage all types of urine leakage: 

• Bladder Training: 

This training involves the concept of holding the urine in for around 10 minutes every time you get the urge to urinate, just to ensure that you urinate once every 2-4 hours.

• Double voiding:

This involves the practice of trying to empty the bladder completely by urinating and then waiting for a few minutes, to try once again.

• Kegel Exercises:

Kegel exercises help to strengthen the Pelvic floor muscles that control one’s bladder movements. It is highly effective in cases of urge and stress incontinence. When you try to stop the flow of urine, your bladder muscles tend to contract. Kegel exercises are, basically, the act of pulling in and squeezing those muscles for 10 seconds and then resting for 10 seconds. Doing 3-4 sets of 10 repetitions every day is highly advised. The best thing about kegel exercises is that one can do it anywhere, be it a bedroom, an office space, or a car.

• Fluid and Diet Management:

As self-explanatory as it is, this involves managing diet and fluid intake by avoiding the foods or drinks that catalyze incontinence, like excess Vitamin C, spicy foods, acidic foods, and alcohol.

Lifestyle Changes to Manage Incontinence

Irrespective of your urine incontinence causes, the following lifestyle changes will help you manage the condition:

• Practice Kegel exercises every day.
• Maintain a healthy weight.
• Eat a balanced diet and avoid foods that will irritate your bladder.
• Stay hydrated throughout the day, but don't overdo it. Drink less water before bed to avoid nighttime leaks.
• Don't hold urine for too long.
• Schedule regular bathroom breaks to empty your bladder.
• Limit alcohol and caffeine intake.
• Quit smoking.
• Manage chronic cough immediately because it puts pressure on the bladder.

Friends’ Users Share Their Stories

Mukesh Saini is a 63-year-old architect from Indore. “My bladder issues started a few years ago when I contracted a urinary tract infection,” he says. “A few months later, I learned about transient incontinence from my doctor. I was later introduced to intermittent self-catheterisation as a test when the problem persisted and grew. At first, I was frightened to use it but a little patience and time helped me relax and come up with a much friendlier way to manage the incontinence, which is using adult diapers in the XXL or XL size which fits me well and is comfortable to wear as well.”

Sana Thakur, a 43-year-old woman, was working as a teacher in Nagpur until she was diagnosed with urinary incontinence at 39. Just like any other day, she returned home from her workplace around 4pm on a rainy September day back in 2015, about 4 hours after she noticed a urine leak. At first, she thought of it as just a minor issue, so did not pay much attention to it. But, when the episodes started to get more frequent, it left her a little worried. She got in touch with her doctor to know the cause, and found out that she has stress urinary incontinence, due to obesity. 

“Anytime I lift a heavy object, laugh or sneeze, it results in urine leakage,” she said. “The doctor said that my incontinence issue is not completely curable, and I must accept it as it is. That I would need to manage it by incorporating the right lifestyle changes and using adult incontinence diapers.”

However, this was much easier said than done.

Sana took over two months to get used to it and accept it as a reality. 

During that period of time, she did not talk to some of her family members and friends openly about it, and found using the diapers uncomfortable, which was accompanied by a sense of embarrassment. She used to find herself getting extremely conscious about the visibility of her diapers and the incontinence episodes in public places. However, as time passed, she began to understand that her incontinence issue will never cease to exist, which changed her way of looking at the problem. 

Today, she works as a freelance tutor, and is totally comfortable with using adult diapers, with no shame. Besides diapers, scheduled toilet visits, bladder training and Kegel exercises helped her significantly in managing her incontinence condition. She ended our chat with us saying: “It takes time; but if you look at it with a positive mindset, accepting and managing incontinence becomes easier.”

Sam Williams, a 57-year-old resident of Baroda, wakes up every day at 7am to make a scheduled toilet visit and do his Kegel exercises, as he suffers from urinary incontinence. Sam has been a diabetes patient for the last 13 years, because of which he started getting frequent incontinence episodes at the age of 52. This ultimately became a troublesome thing for him, until he started managing his urinary incontinence after a consultation with his doctor. 

“The doctor recommended that I use Friends adult incontinence diapers, do bladder training and Kegel exercises, and plan my toilet visits better, to reduce the frequency of incontinence episodes,” he says. “However, I had to learn how to use diapers properly the hard way, as I got a urinary tract infection due to long hours of using the same diaper. The fluid soaked in the diapers for extended periods of time caused a urinary tract infection on the urethra, which made incontinence even more annoying for me. I fought the infection by using natural supplements, probiotics, and drinking plenty of water at regular intervals. Once the infection was completely eradicated, I started changing diapers regularly and realized how disastrous being irresponsible can be.”

Sam has not gotten rid of his incontinence but has surely managed it pretty well. Not only that, even his family members and friends have helped him normalize it over the years, by understanding his problem and helping him fight it in every way possible. 

*Names changed to protect privacy.

FAQs

1. Am I at a higher risk of incontinence at an older age?

Yes, people of older age are at a higher risk of incontinence as their pelvic floor muscles are weakened, and the nerves around the bladder don't have the same sensitivity as they do at a younger age.

2. Is incontinence more common in women?

Yes, incontinence is more common in women as compared to men. The reason is that their pelvic floor muscles weaken after childbirth. The hormonal imbalance during menopause can also be a contributing factor.

3. Can I use a sanitary pad or adult diapers to manage my incontinence?

Yes, you can use sanitary pads or adult diapers to manage your incontinence. They can help improve your lifestyle as you can move around and do your regular activities without the risk of spoiling your clothes.

4. What do I need to know about incontinence and skin care?

Incontinence can irritate the skin and cause redness, sores, or even skin infections. You must clean the area thoroughly after every incontinence episode. Don't use harsh soaps or cleansers. Instead, opt for gentle and fragrance-free products.