Understanding Urinary Incontinence in Men and Women

Urinary incontinence describes any accidental leaking of urine. The condition is especially common amongst elderly people but can happen to anyone. Oftentimes, it can cause embarrassment and disrupt one’s daily life.

Fortunately, intervention is available to stem the flow and improve the quality of life. Let’s discover the different types of urinary incontinence and treatment options that can be considered.

The Types of Urinary Incontinence 

In Traditional Chinese Medicine (TCM), the condition is said to arise from a combination of two or more organ system imbalances. These include disorders of the Bladder, Heart, Liver, Spleen, Kidneys and Lungs. 

Urge incontinence 

This incontinence type involves an overwhelming urge to urinate immediately. This urgency occurs when the bladder muscle – the detrusor – contracts, and signals a need to urinate, even if your bladder is not full. Generally, the condition is a by-product of an accident, diabetes, or neurological disease. These events may damage the brain, spine, or nerves extending from the spine to the bladder. 

In addition, bladder, prostate or urinary tract infections can trigger a temporary urgency. Meanwhile, a partial blockage of the urinary tract – due to a tumour, bladder stone, or an enlarged prostate in men – can induce frequency, urgency and urge incontinence. 

Separately, TCM states that the Kidneys “govern water”. Simply put, it’s in control of urination, urine filtration and water metabolism. Hence, a deficiency of Kidney qi can lead to an overactive bladder. If Lung and Spleen qi are deficient, you can also experience symptoms like abdominal discomfort, chronic fatigue, loose stools and shortness of breath.

“Every organ has yin and yang functions. The Bladder’s ability to hold urine is a yin function. When there’s a Kidney yin deficiency, the Bladder will not be able to hold urine. This results in frequent and sudden urination, or urge incontinence.

“In TCM, common symptoms of incontinence that relate to a Kidney yin deficiency are dizziness, poor memory, hot flushes, night sweats, frequent night urination, or a dry mouth and throat. Kidney yang deficiency symptoms are chills, impotence, pale urine, decreased libido and lower back pain”, explains Eu Yan Sang physician Vong U Chan.

The Liver, on the other hand, “governs the muscles and sinews”. Optimal Liver function is a reflection of healthy muscles. As the muscles have the urine-holding ability, a Liver dysfunction can impair muscle strength and give rise to an overactive bladder.

Overflow incontinence 

This type of incontinence is aggravated when there’s a blockage of the urine flowing out of the bladder. Prostate enlargement is a physical condition that partially closes off the urethra. Bladder spasms – a condition that’s synonym with diabetes – increases a person’s risk of overflow incontinence. It can also come about in men and women with an underactive bladder muscle. 

Reflex incontinence 

A severe neurological disorder is the primary reason behind this type of incontinence. Typically, the condition presents in people with multiple sclerosis, a spinal cord injury, or damage from surgery or radiation treatment. 

Stress incontinence 

Contrary to popular belief, this incontinence type isn’t linked to emotion but physical exertion that increases pressure on the abdomen and bladder. For instance, leaking urine when you cough, jump, or laugh can indicate stress incontinence. In severe cases, the pressure of a full bladder can overpower the ability to hold urine. Consequently, you will urinate, even if you don’t have the urge or your bladder muscles are not contracting. 

In women, the muscles in the urethra and pelvic floor can weaken with age. As such, it’ll take less pressure for the urethra to open and allow leakage. Many women won’t go through such incidences until after menopause.

Natural childbirth, too, can stretch and potentially damage the pelvic floor, muscles and nerves, encouraging incontinency. For men, sustaining urinary sphincter damage after prostate surgery or a pelvic failure can also stimulate stress incontinence.

Functional incontinence 

Sometimes, your urinary tract may function properly but an illness or disability can make you prone to leakage. This type of incontinence is known as functional incontinence. Likewise, the use of certain medications can increase your susceptibility to incontinence.

For instance, the use of a diuretic – a medicine that promotes the expulsion of water and salt from the body – produces abnormal amounts of urine, thus requiring a change in treatment. 

Ways to Treat Urinary Incontinence Effectively 

A clinical physician uses several methods to diagnose urinary incontinence, such as: 

• An observation of your medical history 
• A physical examination 
• Imaging tests 
• Bladder function tests 
• Urine and blood tests 

Then, the physician may prescribe a treatment option or a combination of treatments to address your specific type of incontinence.

Lifestyle changes 

Making simple changes to your routine can go a long way in reducing accidental leaks. Firstly, it’s necessary that you drink the right amounts of liquid at the right time. People who urine frequently at night, specifically, should minimise their water intake before bedtime. Also, it’s advisable to avoid smoking, alcohol, caffeine, stay physically active and maintain a healthy weight.

Dietary restrictions are also crucial to solving incontinence. “Avoid cold and raw foods, as overconsumption can diminish the yang energy in our Spleen and Kidneys. Cold foods are not just foods that come directly from the fridge, In general, most fruits and vegetables have cooling properties, such as watermelon, bitter gourd and cucumber.

Though, cooking these vegetables with garlic or ginger, which have warming properties, can neutralise them. Take fruits in moderation. Refrain from blending them as juices as this often leads to overconsumption”, advises physician Vong.

Physical therapy 

A strong bladder is fundamental for preventing urine leakage. Kegel exercises are one of the best ways to strengthen the pelvic floor muscles, which helps manage urine flow. You may also practice urinating according to a schedule given by a physician.

Acupuncture enhances the use of herbal medications and Kegel exercises. A 6-week controlled study showed that electroacupuncture administered to the BL23 (Shenshu, 腎俞), BL32 (Ciliao, 次髎), BL33 (Zhongliao, 中髎), and BL35 (Huiyang, 會陽) points improved incontinency by 54%.

Alternatively, moxibustion can warm and invigorate the flow of qi in the body. This is helpful in increasing the yang energy of people with Kidney yang deficiency syndrome.

Herbal medications 

A case study of a woman in her late 50s also demonstrated that it’s possible to remedy urinary incontinence with herbal formulations and ingredients. According to physician Vong, the woman was diagnosed with Kidney and Spleen yang deficiency syndrome.

She was prescribed Jin Gui Shen Qi  medicinal decoction (金匮肾气汤) and Shuoquan pills (缩泉丸), and other herbs like Fructus Rubi (fu pen zi, 覆盆子) and Ootheca Mantidis (Sang Piao Xiao, 桑螵蛸). After three months of treatment, she achieved better control over her daytime urination and reduced her night urination to a maximum of once per night.

Ultimately, recognising the reasons behind urinary incontinence can help with identifying early intervention steps. Do speak to a clinical physician and TCM practitioner if you wish to support treatment with alternative therapies and herbal remedies.