It happens when we get home, when we arrive at work or when we arrive at the mall. We can’t help but have an overwhelming need to go to the bathroom. When we say overwhelming, it is both immediate and critical. Part of this all-consuming need is a fear that we won’t make it to the bathroom on time. Gone are the days of at least being able to put the coffee on, or even just turning the kettle on first. If this is you, don’t fret. Millions of people experience key-in-lock syndrome or, urge urinary incontinence.
What Is Key-In-Lock (Urinary Urge) Syndrome?
Definition
The strong urge to urinate can be attributed to the bladder being unable to hold liquid due to involuntary contractions. Part of urge incontinence is psychological. The need to urinate arises when we associate places that we know have a bathroom with the need to urinate. It is often possible to go the entire day without needing to pee, but when we go to those places, the bathroom springs to mind.
At the mall, we often don’t need to use the bathroom until we see the signpost. We cringe at the word incontinence as it conjures up pictures of us being old and frail. The reality though is that it is just a medical term used to label an ongoing condition. While many people experience urinary tract conditions as they age, it can also be because of unhealthy lifestyle choices. The good news is that there are steps to be taken to manage it. (As an aside, if you aren’t quite making it to the loo, even if by just one drop, have yourself evaluated.)
Candidates
Urge incontinence is prevalent in certain age groups, at different times in their lives. Men and women can both experience incontinence, although it is more common in women. This form of incontinence is connected to pregnancy, childbirth – natural and cesarean, and then menopause. The pelvic support muscles tend to weaken in women who have been through these episodes. There is a strong likelihood of leakage problems occurring.
Clinical studies suggest between 25 percent and 30 percent of Americans, men, and women, struggle with some form of urine leakage or urine incontinence. In addition to being caused by weakened pelvic muscles, there are other causes such as bladder inflammation, infection, bladder stones, bladder cancer, and, in men, prostate problems. As of yet, there is no definitive evidence though and the research on age-related urinary incontinence is ongoing.
Treatment
Today, there is no definitive treatment for urinary urge syndrome, as it involves more than just the bladder. Ordinarily, our brains receive signals from the bladder to let us know it is full. The brain then responds with a message to either hold or contract the bladder muscle in order to release urine. Those who suffer from urinary urges seem to have a disconnect between the bladder and the brain, culminating in the bladder releasing before being ready to do it – usually as we get to the door. Although not certain, it does seem as if age is a factor in the malfunction in some sufferers.
Drink the right amount of liquid at the right time
Ask your health care professional whether you should drink less liquid during the day. However, don’t limit liquids to the point of becoming dehydrated. Your health care professional can tell you how much and when to drink, based on your health, activities, and local climate.
To limit nighttime trips to the bathroom, you may want to stop drinking liquids a few hours before bedtime, but only if your health care professional suggests it. Limiting foods and drinks with caffeine, such as chocolate, tea, coffee, and carbonated beverages, may help reduce leaks. You should also limit alcoholic drinks, which can increase how much urine your body makes.
The amount of urine a person should make is different for everyone, based on how much liquid you drink, how much you sweat, how much liquid you lose by breathing, and the medicines you take.
Be physically active
Although you may not feel like being physically active when you have UI, regular physical activity is important for weight management and good overall health. Activities such as walking, swimming, biking, and dancing can improve your health. If you’re concerned about not having a bathroom nearby during physical activity, find a place with nearby restrooms, such as a shopping mall, community park, or local gym.
Keep a healthy weight
Your chances of developing UI and other diseases, such as diabetes, are higher if you’re overweight or have obesity. Losing weight can help you have fewer leaks, and avoiding weight gain may prevent UI. Studies suggest that as your body mass index (BMI) increases, you’re more likely to leak. If you’re overweight or have obesity, talk with your health care professional about how to lose weight.
Bladder training
Bladder training, which involves timed voiding, is an effective method for managing urinary urgency.
Timed voiding is where a person keeps a bladder diary and works with a doctor to determine a regular schedule for using the toilet.
People can gradually increase the time between toilet visits to train the bladder to hold urine for longer and reduce the frequency of urinary urgency.
Physical therapy
It is a common trusted Source for a doctor to prescribe physical therapy. This therapy will involve strengthening the pelvic floor muscles to support the urethra, the tube that carries urine out of the body. Strengthening these muscles can lead to a reduction in the number of times that urinary urgency occurs.
MEDICATIONS
There are two primary categories of medications used to treat urge incontinence. Your health care provider will help you determine which is right for you and your condition.
Medications include:
- Anticholinergics: These medications help relax your bladder and can be helpful for urge incontinence and overactive bladder. There are a few side effects to be aware of, including dry mouth and eyes, constipation, and difficulty completely emptying your bladder.
- Beta 3 agonist: This category of medications relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It also may increase the amount you are able to urinate at one time instead of small amounts more frequently. This is a newer category of medications, and your insurance provider may require that you try other conservative or medication options first.
INTERVENTIONAL THERAPIES
There are several treatments that involve stimulating your nerves to help you improve. Your nerves help communicate the message that your bladder needs to be emptied to your brain. By treating the nerves, your healthcare provider can improve your bladder control.
- Sacral nerve stimulation: Sacral nerve stimulation is a therapy that electrically stimulates the nerves that control the bladder. A small device (a neurotransmitter) is implanted under the skin in the upper buttock area in an outpatient setting. The device sends mild electrical impulses through a lead (a wire) close to the sacral nerve (a nerve located in the lower back). The impulses, in turn, help provide bladder control. Sacral nerve stimulation can reduce the number of voids and/or the number of wetting episodes, and has very good overall efficacy.
- Percutaneous tibial nerve stimulation: This type of nerve stimulation is an outpatient procedure in which small nerve impulses are delivered to a nerve branch near the ankle that stimulates bladder control. Patients usually have to have 12 weekly sessions and then maintenance therapy once a month after that.
- Botox injections into the bladder muscle: This treatment involves an injection of Botox A (onabotulinum toxin A) into the bladder wall using a small telescope (cystoscope). This therapy is very effective, even for patients who have not had good results with other therapies. A very small percentage of people may have temporary urinary retention (difficulty voiding) after Botox. This treatment wears off over time and generally needs to be repeated every six months.
Complications
Urinary urgency can disrupt daily functioning. Without proper management, frequent bouts of urinary urgency can make daily tasks more challenging and even affect work performance. Some people may become more physically inactive as a result of urinary urgency.
If urinary problems affect a person’s mental well-being, they can speak to a doctor about ways to manage their symptoms.
Outlook
Urinary urgency can affect a person’s daily life. A doctor can diagnose the underlying cause and recommend treatment to manage the symptoms. People can also make some lifestyle changes and try bladder training to minimize urinary urgency.
Additional Reading:
ADULT PEDIATRIC UROLOGY & UROGYNECOLOGY
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