Welcome to the OutUK series looking at gay men and their health brought to you in association with the NHS website.
Each week we'll tackle a different topic in our A to Z of Gay Health. We'll have features and advice on everything from relationships, sexual health, mental and physical conditions and how to stay fit. You can follow any of links provided below for more information direct from the nhs.uk website, or view any of our Previous A to Z Features.

This Week - U : Urinary Incontinence

Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people.

There are several types of urinary incontinence, including:

  • stress incontinence - when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
  • urge incontinence - when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
  • overflow incontinence (chronic urinary retention) - when you're unable to fully empty your bladder, which causes frequent leaking
  • total incontinence - when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking

It's also possible to have a mixture of both stress and urge urinary incontinence.

Read about the symptoms of urinary incontinence.

When to seek medical advice

See your GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you shouldn't feel embarrassed talking to them about your symptoms.

This can also be the first step towards finding a way to effectively manage the problem.

Urinary incontinence can usually be diagnosed after a consultation with your GP, who will ask about your symptoms and may carry out a pelvic examination (in women) or rectal examination (in men).

Your GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.

Read about diagnosing urinary incontinence.

Causes of urinary incontinence

Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.

Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.

Overflow incontinence is often caused by an obstruction or blockage to your bladder, which prevents it emptying fully.

Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a bladder fistula.

Certain things can increase the chances of urinary incontinence developing, including:

  • obesity
  • a family history of incontinence
  • increasing age - although incontinence is not an inevitable part of ageing

Read about the causes of urinary incontinence.

Treating urinary incontinence

Initially, your GP may suggest some simple measures to see if they help improve your symptoms.

These may include:

  • lifestyle changes - such as losing weight and cutting down on caffeine and alcohol
  • pelvic floor exercises - exercising your pelvic floor muscles by squeezing them, taught by a specialist 
  • bladder training - where you learn ways to wait longer between needing to urinate and passing urine, guided by a specialist

You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.

Medication may be recommended if you're still unable to manage your symptoms. 

Read about non-surgical treatments for urinary incontinence.

Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.

Surgical treatments for stress incontinence, such as sling procedures, are used to reduce pressure on the bladder or strengthen the muscles that control urination.

Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Read about surgery and procedures for urinary incontinence.

Preventing urinary incontinence

It's not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it developing.

These include:

  • controlling your weight
  • avoiding or cutting down on alcohol
  • keeping fit - in particular, ensuring that your pelvic floor muscles are strong

Healthy weight

Being obese can increase your risk of developing urinary incontinence. You may therefore be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating.

Use the healthy weight calculator to see if you are a healthy weight for your height.

Get more information and advice about losing weight.

Drinking habits

Depending on your particular bladder problem, your GP can advise you about the amount of fluids you should drink. 

If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder.

The recommended weekly limits for alcohol consumption are 14 units.

A unit of alcohol is roughly half a pint of normal-strength lager or a single measure (25ml) of spirits.

Read more about drinking and alcohol.

If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day.

Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled - including family members

Our guide to care and support explains your options and where you can get support.


We'll have more information and advice next week on another topic in our A to Z of Gay Health. We have covered many subjects in this series and you can catch up with all of our Previous A to Z Features.

If you want to find out more about this week's subject you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.

Photos: LightFieldStudios and one of VladOrlov, Stockcube, darak77 or ajr_images.

 

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