Urinary Incontinence

What is urinary incontinence?

Symptoms of urinary incontinence

Causes of urinary incontinence

Prevention and treatment of urinary incontinence

References

What is urinary incontinence?

Urinary incontinence is any involuntary leakage of urine. It is a common problem which can have a profound impact on one's quality of life. Difficulty with bladder control can cause stress and limited social activity. It may mean having to plan any trip or outing around access to toilets.

Urinary incontinence is usually treatable. Often it has a large psychological component (5, 6, 7), with the sufferer losing confidence. There is almost always poor muscular control. Getting back to normal involves practising using the muscles and strengthening them with exercises.

The psychology of incontinence is also important. It is possible to feel an urgent need to pee, but then to get distracted and busy, and to discover an hour later that you did not pee and there was no incontinence. Once this happens several times there is a profound understanding that the need to pee was an habitual anticipation rather than a genuine need. When you are out and feel the need to pee, notice how the need becomes stronger as you arrive home or get nearer to a toilet. After waiting half an hour or whatever, the last few seconds are the most difficult to hold back.

Incontinence can occur at any age, but is more common in the elderly. One in three women over the age of 60 have some incontinence problems, but only half as many men. It is one of the most common reasons old people go into care facilities.

Symptoms of urinary incontinence

• Frequent need to urinate.
• Urgency (compelling need to urinate that cannot be deferred).
• Weak urinary stream.
• Painful urination (dysuria).
• Hesitancy (needing to wait for the stream to begin).
• Intermittency (when the stream starts and stops intermittently).
• Straining to void.
• Dribbling.

Consequences over longer time period

• Social and sexual embarrassment, limitation of both work and social life with the need to plan one's life around the availability of toilets.
• Sleep disturbance - the need to wake to urinate frequently through the night (nocturia).
• Incomplete voiding may cause the proliferation of bacteria in the bladder residue and a urinary tract infection (UTI).
• Urinary bladder stones can form from the crystallisation of salts in the residual urine if the bladder is not regularly emptied completely.

Causes of urinary incontinence

• Vitamin B1 deficiency. The bladder is controlled by surrounding muscle, which in turn is controlled by the nerves and up to the brain. This nerve control system is particularly sensitive to a thiamine deficiency. The causes of thiamine (B1) deficiency include a high carbohydrate diet, especially sugar and refined carbohydrates, being diabetic, pre-diabetic (metabolic syndrome), insulin resistance. (7) B1 deficiency is the cause of 50% to 70% of cases of loss of bladder control. (1, 2, 3, 4)
• Prostate enlargement (BPH) in men after the age of 40.
• Diabetes, metabolic syndrome. There is a strong connection between insulin resistance and urinary incontinence. (8)
• Brain disorders like multiple sclerosis, Parkinson's disease, strokes and spinal cord injury can interfere with nerve function and control of the bladder. (5, 6)
• Prolapsed bladder in women.
• Infection in bladder or urinary tract.
• Vitamin D deficiency.
• Obesity is associated with incontinence but does not necessarily cause it.
• Other infrequent causes like drinking too much water causing excessive production of urine; or fibroids.

Prevention and treatment of urinary incontinence

• Diet. Eliminate all added sugar, refined carbohydrates, sweet foods, sweet fruit, dried fruit and fruit juice. See the Grow Youthful diet.
• Get sufficient thiamine (vitamin B1). Food sources include grass-fed meat, fish, fresh yeast and unfortified nutritional yeast. Black tea is high in tannin, a compound that binds a variety of micronutrients, particularly vitamin B1, calcium, iron and zinc.
• Vitamin D sufficiency.
• Kegel Exercises. Named after Dr Arnold Kegel, these exercises contract and relax the muscles that form part of the pelvic floor. They improve muscle tone by strengthening the pubococcygeus and other muscles. Kegel exercises may be used by pregnant women, for treating vaginal prolapse, or preventing uterine prolapse. For men, in addition to urinary incontinence they are used for treating prostate pain and swelling resulting from benign prostatic hyperplasia (BPH) and prostatitis. Kegel exercises also increase sexual performance.
  
  Two exercises to practice are:
  
  • When urinating, stop and hold the flow of urine for several seconds, with the time gradually lengthening as the muscles become stronger.
  • Lift and hold the pelvic floor. At first, hold for a few seconds, but increase the time as your muscles strengthen.
• For men with a swollen prostate, see BPH remedies.

If you use any remedies from Grow Youthful, please come back next week (or whenever you have an outcome) and let us know about your experience. Please leave a comment as many people are interested.

See details of remedies recommended by Grow Youthful visitors, and their experience with them.

References

1. Sakatoku Jisaburo, Takahashi Youichi. Statistical observations on the promoting effect of thiamine tetrahydroflurfril disulphite (TTFD) on spontaneous discharge of ureteral calculus. December 1967. Kyoto University Research Information Repository.

2. Song XS, Huang ZJ, Song XJ. Thiamine suppresses thermal hyperalgesia, inhibits hyperexcitability, and lessens alterations of sodium currents in injured, dorsal root ganglion neurons in rats. Anesthesiology. 2009 Feb;110(2):387-400. doi: 10.1097/ALN.0b013e3181942f1e. PMID: 19194165.

3. Matsuo T, Miyata Y, Nakamura T, Satoh K, Sakai H. Prosultiamine for treatment of lower urinary tract dysfunction accompanied by human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis. (2018), Int. J. Urol., 25: 54-60.

4. Mazevet D, Vassilev K, Perrigot M. Neuropathies par carence en thiamine sans intoxication alcoolique: deux cas de troubles vesicosphincteriens [Neuropathy with non-alcoholic thiamine deficiency: two cases of bladder disorders]. Ann Readapt Med Phys. 2005 Feb;48(1):43-7. French. doi: 10.1016/j.annrmp.2004.06.054. PMID: 15664684.

5. de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr Physiol. 2015 Jan;5(1):327-96. doi: 10.1002/cphy.c130056. PMID: 25589273; PMCID: PMC4480926.

6. Kuchel GA, Moscufo N, Guttmann CR, Zeevi N, Wakefield D, Schmidt J, Dubeau CE, Wolfson L. Localization of brain white matter hyperintensities and urinary incontinence in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2009 Aug;64(8):902-9. doi: 10.1093/gerona/glp037. Epub 2009 Apr 21. PMID: 19386575; PMCID: PMC2709544.

7. Daneshgari F, Liu G, Birder L, Hanna-Mitchell AT, Chacko S. Diabetic bladder dysfunction: current translational knowledge. J Urol. 2009 Dec;182(6 Suppl):S18-26. doi: 10.1016/j.juro.2009.08.070. PMID: 19846137; PMCID: PMC4684267.

8. Uzun H, Yilmaz A, Kemik A, Zorba OU, Kalkan M. Association of insulin resistance with overactive bladder in female patients. Int Neurourol J. 2012 Dec;16(4):181-6. doi: 10.5213/inj.2012.16.4.181. Epub 2012 Dec 31. PMID: 23346484; PMCID: PMC3547179.