Bladder and Mind: How Incontinence and Mental Health Affect Each Other - Dr Vineet Malhotra
Urinary incontinence is the loss of bladder control. It happens when a movement or activity puts pressure on the bladder, causing urine to leak. Movements caused by coughing, laughing, sneezing, running or heavy lifting. SUI happens because of a stretched, weakened or damaged pelvic floor which supports the bladder and urethra.
A week pelvic floor can be caused by pregnancy and childbirth, chronic coughing, nerve injuries to the lower back or pelvic surgery. While SUI impacts older women most often, it’s not caused by aging or by being female. It happens in younger women as well as some men.
SUI may occur from a host of causes, affecting about 3-6% of the population across the globe. Obesity, injuries to the pelvic floor, neurological disease, and underlying urologic conditions are some of the etiological factors.
Relationship Between Incontinence and Mental Health
There is mounting evidence that the relationship between these two factors is bidirectional, and that chronic psychological stress itself can result in the development of symptoms such as urinary frequency, urgency, incontinence, and pelvic pain.
Anxiety has been identified as both a consequence and a risk factor for urinary incontinence. The fear of experiencing an accident can heighten anxiety levels, while pre-existing anxiety can worsen incontinence symptoms. This creates a feedback loop where each condition perpetuates the other. Studies indicate a significant prevalence of anxiety symptoms among individuals with overactive bladder (OAB), further highlighting the interconnectedness of these conditions.
How to Prevent the Cycle?
While the interplay between incontinence and mental health can be daunting, proactive management strategies can help break the cycle. Addressing underlying mental health concerns is crucial. Individuals experiencing significant anxiety or depression should consult with a healthcare professional for appropriate evaluation and treatment.
Beyond professional intervention, several practical steps can help manage both incontinence and stress. Utilizing absorbent products can provide a sense of security and control, reducing anxiety related to potential accidents. Lifestyle modifications, such as pelvic floor exercises (Kegels), pilates, and dietary changes, can also improve incontinence symptoms and overall well-being.
Ultimately, recognizing the interconnectedness of incontinence and mental health is the first step towards effective management. By addressing both the physical and psychological aspects of these conditions, individuals can regain control, improve their quality of life, and break free from the cycle of anxiety and incontinence.
How to Treat SUI?
The treatment of male SUI has evolved significantly with multiple current options for treatment available. Male slings are more commonly performed in cases of low-to-moderate SUI. The sling is made of soft mesh implanted inside the body to reposition the urethra and provide support to surrounding muscles. This can help to keep the urethra closed, especially when coughing, sneezing and lifting.
Another procedure to treats SUI is artificial urinary sphincter (AUS), which is placed inside the body. The saline-filled cuff keeps the urethra closed and a pump in the scrotum allows urination on demand. The AUS is designed for all levels of SUI following prostate procedures and is considered the gold standard treatment.
Don’t let stress urinary incontinence (SUI) stop you from living your best life. Talk with a urologist who specializes in SUI and offers the full range of treatment options. The treatment always depends upon the medical condition of the patient and would result in best outcomes.
Dr Vineet Malhotra (MBBS, MS (General Surgery), DNB (Urology and Andrology)) is a Uro-Andrologist at VNA Hospital, New Delhi, India. He has over 17 years of Urological surgical experience in Minimally Invasive Urological and Andrological procedures. After pursuing his MBBS from JNMC, Wardha, in the year 1995, Dr. Vineet Malhotra completed his Masters in General Surgery at Government Medical College, Nagpur, in the year 1998. He acquired his DNB in Urology and Andrology from the prestigious Muljibhai Patel Urological Hospital at Nadiad, Gujrat. He is now a practicing Sexologist and Microsurgeon, specializing in the field of Surgery for Male Sexual Dysfunction, Infertility and Endourology.