Urine Incontinence
Background
Urinary incontinence (UI) is any involuntary leakage of urine. It is a common and distressing problem, and often treatable.
Causes
Stress incontinence
Stress urinary incontinence (SUI), is caused by weakening of the pelvic floor muscles. It is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase intra-abdominal pressure and thus increase pressure on the bladder.
Stress incontinence is treatable.
Urge incontinence
Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence is involuntary bladder spasm. This can occur from many causes including:
- Hidden bladder infections.
- Nerve problems such as stroke, MS, or Parkinson’s Disease.
- Spasm of the muscle attached to the top of the pubic bone.
- Prostate sensitivity.
For incontinence, a urologist will do the best evaluation, but consider doing the treatments discussed under the "Treatments" section first to see if they work (allow 2-3 months) so you don’t get pushed into unnecessary surgery or medications.
Functional incontinence
This is when you can’t physically make it to the bathroom in time due to limited mobility.
Bladder spasm from tight pelvic muscles
If there is tenderness where the muscle going down the front of the abdomen attaches to the top of the pubic bone (the lowest bone in the middle of the abdomen/pelvis), this tight muscle attachment can trigger bladder spasm. A hot compress or other treatments to relax that tender area over the top of the pubic bone can help bladder spasm.
Also, have your urologist look for other more common and well known causes, and they can offer treatments that can also help.
Treatments
Recommended Supplements
Optimize magnesium 200 mg/day, zinc 15 mg/day , vitamin A (2,000-5,000 units a day), and theamino acids alanine, glycine and glutamic acid (@ 500-2,000 mg a day).
Saw palmetto
Saw palmetto 160 mg twice a day.
Angelica
The herb angelica is very helpful for both male and female incontinence.
Quercitin
This special highly absorbed form (500 mg 2x a day) can be very helpful.
Exercise
Kegel exercises
While sitting on the commode urinating, repeatedly tighten and relax the muscles that allow and then stop urine flow. Then alternate tightening and relaxing those muscles 5-10 times 2-3x day for a few seconds each for a few weeks. If you are going to laugh or cough, you can tighten the muscle for a few seconds to lower the risk of leakage.
Take walks
Walking 2-3 hours a week was associated with a 25% decreased risk of BPH.
Medications
Proscar
Proscar 5 mg, 1/2 tablet, 3 days a week (Monday, Wednesday and Friday) is worth a try if urine hesitancy along with slow urine flow is also a problem. Though not necessarily more effective than the natural remedies, they may work more quickly and may be combined with the natural therapies.
Bioidentical testosterone
Both too low or too high a testosterone level can aggravate prostate enlargement.
For more info, see Testosterone Deficiency and Prostatitis.