Aging is often associated with a decline in some of our cognitive and biological functions. So when we talk about bladder weakness, we inevitably think of it as a condition that occurs with age. While urinary incontinence does affect many older people, there are many causes and it can affect much younger adults! So what is urinary incontinence, and what causes it? We detail everything in this article.
What is urinary incontinence?
Urinary incontinence is the involuntary loss of urine, in varying amounts. It is also known as bladder weakness. There are several types of urinary incontinence.
Stress urinary incontinence, the most common, manifests itself by urine leakage following an activity or a particular effort (sport, jumping, carrying heavy loads…), but also when coughing or laughing. The activities that cause leakage most often lead to an increase in abdominal pressure, resulting in the loss of urine when the person did not feel the need to urinate.
Overactive bladder incontinence is caused by an urgent need to urinate, at rest and without effort. The person is unable to control the leakage and hold it before going to the bathroom.
In most cases, urinary incontinence encompasses these 2 different types. Many older people are affected by this problem, but not only!
Causes of urinary incontinence
In the collective mind, urinary incontinence is associated with old age, and it is true that advancing age increases the risk of bladder weakness. However, there are many causes of urinary incontinence at any age.
In women, urinary stress incontinence can appear following pregnancies, especially after complicated deliveries (use of forceps, episiotomy…), but also as a consequence of genital prolapse (descent of organs, impacting the bladder). In men, it can occur after prostate surgery. Bladder weakness can also be a consequence of surgery (abdomen, pelvis) for both men and women.
There are many causes of urinary incontinence due to bladder overactivity: urinary infections, bladder cancer, prostate cancer, abnormality or narrowing of the urethra or neurodegenerative diseases (Alzheimer’s) and neurological diseases (Parkinson’s, multiple sclerosis…).
All these causes of urinary incontinence are biological, occurring at a particular time of life or due to a pathology. On the other hand, there are risk factors related to lifestyle. For example, being overweight, having a chronic cough, recurrent constipation problems or taking certain medications can all contribute to the development of bladder weakness. Certain excesses, such as the consumption of substances that are harmful to the body (tobacco, alcohol, drugs…), but also too much high-intensity sport, are also risk factors.
As we age, our hormones also change. Menopause, due to a significant drop in estrogen, is a frequent cause of urinary incontinence. The same is true for men, not because of their hormones in particular, but rather because of their prostate. While this may seem like a normal consequence of aging, it is not inevitable!
Solutions for urinary incontinence
The treatment used to combat urinary incontinence will obviously depend on the cause of the problem. Therefore, if the cause is a pathology or a particular behavior, the health care professional will first direct you to an appropriate treatment.
In all cases, perineo-sphincter re-education (carried out with a physiotherapist or a midwife) is the preferred therapeutic solution. It also allows you to take stock of a lifestyle that is sometimes unsuitable (bad postures, poorly practiced or inadequate sports) for this phenomenon.
In addition, your doctor may also prescribe a drug treatment. This acts on the tone of the bladder, reducing the urge to urinate. Therefore, medication cannot be used exclusively for stress incontinence. Finally, surgery may be considered. Often offered after other treatment options have failed, this procedure requires the expertise of a gynecologist or urologist.