Mini Medical School: Urinary Incontinence Not A Normal Part Of Aging

November 3, 2021

While common among older women, urinary incontinence (UI) is not an inevitable part of the aging process, said Dr. Sachin Shenoy, a minimally invasive surgical obstetrician and gynecologist at University Medical Center.

UI is defined as a complaint of involuntary leakage of urine. “But half of women never complain. They think it’s a normal part of aging, but leakage is not normal,” Shenoy said during an October Mini Medical School presentation. Mini Medical School is a collaboration of The University of Alabama’s OLLI program and UA’s College of Community Health Sciences, which operates UMC.

Studies show that nearly half of older women reported experiencing UI during the past year. Common signs and symptoms including leaking urine when coughing, sneezing, laughing or exercising; feeling sudden and uncontrollable urges to urinate; frequent urination during the day (eight or more time); and waking up many times at night to urinate.

Left untreated, UI can lead to sleep loss, depression, anxiety and loss of interest in sex, Shenoy said. He said a majority of women dealing with UI worry when they cough, sneeze or laugh, and a third avoid exercise and travel because of UI.

Shenoy said there are two main types of UI.

Stress UI is involuntary leakage upon exertion and can be caused by obesity or weight gain, smoking or pelvic organ prolapse, which is a weakness in the pelvic floor muscles and connective tissue resulting in herniation of the vagina, cervix or uterus. There are treatments for Stress UI, including pelvic floor exercises or “Kegels,” and minimally invasive surgical treatments such as pubovaginal slings and urethral bulking agents.

Another type is Urgency UI, which is involuntary leakage accompanied by or immediately preceded by an urge or strong desire to void, often very suddenly and without warning. Shenoy said Urgency UI is characterized by an overactive bladder, and while the cause is unknown its symptoms include a loss of urine before reaching the toilet, and frequent urination (more than 10 times per day and waking up more than two times per night).

Shenoy said treatments include pelvic floor exercises; avoiding carbonated beverages, caffeine and beverages with sugar substitutes, all of which can irritate the bladder; and retraining the bladder and brain to suppress the urgency to urinate frequently.

“It takes two to three hours for the bladder to fill, so if you’re going every hour, your brain is giving you a false signal,” he said. “If you go to the bathroom every time before you leave the house, you’re retraining your bladder.” The Mini Medical School program has been presented by CCHS faculty since 2016. It provides an opportunity for community learners to explore trends in medicine and health, and the lectures offer important information about issues and advances in medicine and research.