Incontinence - urge

Urge incontinence, also known as overactive bladder, is a form of urinary incontinence characterized by the involuntary loss of urine accompanied by or immediately preceded by a sudden and intense urge to urinate. This condition is a symptom of an underlying bladder disorder and can significantly impact the quality of life of those affected.

Causes

Urge incontinence is primarily caused by involuntary contractions of the detrusor muscle, which is responsible for bladder emptying. These contractions can be triggered by various factors, including neurological disorders, urinary tract infections, bladder tumors, and bladder stones. In some cases, the exact cause remains unknown, a condition referred to as idiopathic urge incontinence.

Symptoms

The hallmark symptom of urge incontinence is a sudden, intense urge to urinate, followed by an involuntary loss of urine. This can happen at any time, regardless of the amount of urine in the bladder. Other symptoms may include frequent urination, nocturia (needing to urinate multiple times at night), and urgency with little urine output.

Diagnosis

Diagnosis of urge incontinence involves a thorough medical history, physical examination, and possibly additional tests. These tests can include a urinalysis to check for infections or blood in the urine, a bladder diary to record urination patterns, and urodynamic tests to measure bladder function and urine flow. In some cases, imaging tests such as ultrasound or cystoscopy may be recommended to rule out other conditions.

Treatment

Treatment for urge incontinence typically starts with conservative measures such as bladder training, pelvic floor muscle exercises, and lifestyle modifications (e.g., fluid and diet management). If these measures are insufficient, medications known as antimuscarinics or beta-3 adrenergic agonists may be prescribed to relax the bladder and reduce urgency. In more severe cases, treatments such as neuromodulation therapy or botulinum toxin injections into the bladder muscle may be considered. Surgery is rarely recommended and is usually reserved for cases that do not respond to other treatments.

Prevention

While not all cases of urge incontinence can be prevented, certain lifestyle changes can reduce the risk or alleviate the symptoms. These include maintaining a healthy weight, practicing pelvic floor exercises, avoiding bladder irritants (such as caffeine and alcohol), and managing chronic conditions that could contribute to bladder problems.

See also

• Urinary incontinence
• Stress incontinence
• Functional incontinence
• Overflow incontinence