World Continence Week
Written by
Kayleigh Maxwell
If I’m leaking urine, could I have a urinary tract infection?
The most common symptoms of urinary tract infection (UTI) are needing to pee more often than usual and feeling a strong, often overwhelming, urge to pee. Another common symptom of UTI is waking up in the night with the urge to pee, and all of these symptoms may result in the leakage of urine (1). So incontinence is often associated with UTI.
There are 4 types of incontinence (2)
Stress incontinence: When urine leaks at times when your bladder is under pressure, for example, when you cough or laugh.
Urge incontinence: When urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards.
Overflow incontinence: When you are unable to fully empty your bladder.
Total incontinence: When your bladder cannot store urine at all, meaning you pass urine constantly.
Incontinence associated with UTI is often ‘urge incontinence’. When you have a UTI, the infection causes inflammation and irritates the bladder, which then causes common UTI symptoms such as the urge to pee and experiencing pain when you (3),(4)
However, continence issues are not necessarily a sign of UTI.
Overactive Bladder or UTI?
Overactive Bladder (OAB) is a diagnosis sometimes given to patients who experience a frequent and strong urge to pee and continence issues (5), but who test negative for UTI. OAB can be split into ‘wet’ OAB, where bladder overactivity causes incontinence, and ‘dry’ OAB where it does not.
In one US study, researchers found that when defining OAB as often experiencing an urgent need to pee and/or urge incontinence, OAB had a prevalence of 33% in women and 16% in men out of a sample of 31,588 people. (6)
So OAB is a widespread issue and another potential cause of continence issues.
But how do you know if you have an overactive bladder or a UTI? OAB is a condition which persists over a long period of time, whereas UTI usually happens in acute episodes. There are also other common symptoms of UTI that are not also a sign of OAB, including pain when you pee and visible blood in the urine. (7)
If you do suspect a UTI, it is important that you do a urine test and seek help from a medical professional if your symptoms become more severe. The TestCard UTI test kit is available at TestCard.com.
Risk factors for bladder health problems
Do you suffer from incontinence that you suspect may be due to either an overactive bladder or UTI? Bladder health issues can be closely interlinked with each other due to underlying abnormalities.
Obstruction to the urinary tract, dysfunctional voiding of urine from the bladder, bladder muscle weakness, and differences in the bacterial species present in the bladder are all examples of microbiological, structural and functional factors that can make having issues with the urinary tract more likely. (8)(9)
There are also a number of other risk factors for bladder health issues including ageing, pregnancy, catheterisation, and certain chronic health conditions such as neurological disorders as well as some cancers. (2)
If you are aware that you suffer from any of the above and are experiencing problems with continence, it is important to firstly test for UTI, and seek the advice of your doctor / medical provider.
Living well with urologic conditions: Managing urinary symptoms
Whether you have an overactive bladder, recurrent UTIs, or other/undiagnosed urologic health issue, here are some useful tips/resources:
Most importantly, stay hydrated! You may wonder whether drinking less would ease your symptoms, but in fact dehydration can worsen symptoms of an overactive bladder and can also lead to UTI. It is important that your bladder empties itself regularly, so drink lots of water (6-8 glasses a day is recommended (15)) and avoid drinks that contain caffeine as it makes you dehydrated.
Pain is one symptom associated with UTI which can be extremely debilitating, especially for people who experience recurrent UTIs, so finding pain management tools that work for you is really crucial. Here are a few techniques:
8 Non-invasive Pain Relief Techniques that Really Work
If you have recurrent or chronic urinary symptoms, such as incontinence, for any reason, pelvic floor exercises are often recommended to increase bladder control:
Pelvic Floor Exercises for Women
If you are living with an intermittent or indwelling catheter, there are also guidelines on catheter management, which help you to reduce the risk of infection and maintain good urinary tract health:
But if you do have symptoms which are concerning you and you are unsure what is causing them, it is important to check whether you have a UTI. You can check the most common signs/symptoms of a UTI, and you can also use a TestCard UTI test kit (available at TestCard.com).
If your symptoms become more severe, or you begin to experience a fever, seek help from a medical professional straight away.
Find out more:
References:
1 https://www.nhs.uk/conditions/urinary-tract-infections-utis/
3 Moore, E. E., Jackson, S. L., Boyko, E. J., Scholes, D., & Fihn, S. D. (2008). Urinary incontinence and urinary tract infection: temporal relationships in postmenopausal women. Obstetrics & Gynecology, 111(2), 317-323.
4 Grover, S., Srivastava, A., Lee, R., Tewari, A. K., & Te, A. E. (2011). Role of inflammation in bladder function and interstitial cystitis. Therapeutic advances in urology, 3(1), 19-33.
5 RUH Overactive Bladder Syndrom (OAB)
6 Reynolds, W. S., Fowke, J., & Dmochowski, R. (2016). The burden of overactive bladder on US public health. Current bladder dysfunction reports, 11(1), 8-13.
7 Nik-Ahd, F., Ackerman, A. L., & Anger, J. (2018). Recurrent urinary tract infections in females and the overlap with overactive bladder. Current urology reports, 19(11), 1-5.
8 Karami, H., Valipour, R., Lotfi, B., Mokhtarpour, H., & Razi, A. (2011). Urodynamic findings in young men with chronic lower urinary tract symptoms. Neurourology and urodynamics, 30(8), 1580-1585.
9 Pearce, M. M., Hilt, E. E., Rosenfeld, A. B., Zilliox, M. J., Thomas-White, K., Fok, C., ... & Wolfe, A. J. (2014). The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. MBio, 5(4), e01283-14.
10 McAchran, S. E. (2014). The Mind-Bladder Connection: Current Understanding of the Relationship of Psychological Stress and Overactive Bladder Symptoms. Current Bladder Dysfunction Reports, 9(2), 145-150.
11 Kinsey, D., Pretorius, S., Glover, L., & Alexander, T. (2016). The psychological impact of overactive bladder: a systematic review. Journal of health psychology, 21(1), 69-81.
12 Maxwell, K., Roberts, L., Kramer, M., & Finlay, K. (2021). Using the Working Model of Adjustment to Chronic Illness to explain the burden of recurrent urinary tract infection: A survey-based study. International Journal of Pharmacy Practice, 29(Supplement_1), i5-i6.
13 Perry, S., McGrother, C. W., Turner, K., & Leicestershire MRC Incontinence Study Group. (2006). An investigation of the relationship between anxiety and depression and urge incontinence in women: development of a psychological model. British journal of health psychology, 11(3), 463-482.
14 McKernan, L. C., Bonnet, K. R., Finn, M. T., Williams, D. A., Bruehl, S., Reynolds, W. S., ... & Crofford, L. J. (2020). Qualitative analysis of treatment needs in interstitial cystitis/bladder pain syndrome: Implications for intervention. Canadian Journal of Pain, 4(1), 181-198.
15 https://www.nhs.uk/live-well/eat-well/water-drinks-nutrition/