Introduction
People feel the urge to urinate multiple times a day. Some sounds, sights, or movements in some people can trigger it. The leakage of urine that is difficult or impossible to control is called urinary incontinence. It can negatively impact the quality of life and can be a source of embarrassment. It can also hamper social life, as they would find it difficult to mingle with people due to the fear of accidental urine leakage.
What Is Urinary Incontinence?
A condition where a person finds it difficult to control the urge to pass urine is called urinary incontinence. Sometimes, it might be an accidental leak, or the bladder might be emptied completely. The condition can be temporary or permanent, depending on the cause and severity. The Urology Care Foundation states that it is a very common condition in the current world. Females are more prone to be affected by this condition than men. However, it can affect anyone, depending upon the cause.
What Is Stand-up Urgency?
When a change in position or posture causes an urgency to urinate, it is called stand-up urgency. Many people experience an urgency to urinate while they stand up from a sitting or reclined position. It can be associated with the inadequacy of the urethral closure and sphincter mechanism or the overactivity of the detrusor (the involuntary muscle of the walls of the bladder) muscle caused by the shift in position.
How Does Voiding Occur Normally?
The brain and the bladder control the functioning of the urinary system. The urine is held in the bladder until it is removed from the body. About 300 to 400 ml of urine can be held in the bladder. The bladder is held in position by the muscles of the lower part of the pelvis. The smooth muscle in the bladder is usually relaxed. This helps the bladder to hold the urine, and the neck of the bladder remains closed. The sphincter muscles around the urethra (the tube that removes the urine from the body) are closed. In this state, there is no leakage of urine.
The nervous system regulates the voiding of urine. The bladder has two main roles as part of the urinary system: storing urine and removing the urine from the body. The external urethral sphincter contracts voluntarily, while the internal sphincter contracts due to the action of the sympathetic nervous system. The sympathetic nervous system's action enables the detrusor muscle to distend without reflex contractions (contractions that happen in response to a stimulus). The urethral reflexes are important for the process of voiding. When the bladder is full, it sends signals to the bladder muscles. The bladder muscles contract and send the urine through the urethra. The bladder contracts, which causes the opening of the sphincter muscles. A number of reflexes from the spinal cord play an important role in removing the urine from the body.
What Are the Symptoms of Stand-up Urgency?
The main symptom of stand-up urgency is the urge to pass urine as one stands up or attempts to stand up. A little urine may leak when people stand up. This is called urge incontinence.
How Is Stand-up Urgency Diagnosed?
The condition is mainly diagnosed based on the patient's history. Symptoms like the inability to control the urge to urinate while trying to stand up can be noted. Journaling the urinary urgency can help one understand the factors that trigger it. It also shows when and how often the patient shows stand-up urgency. It might also be noted if the patient suffers incontinence and stand-up urgency. The diagnostic tests to be done can include:
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Urinalysis: It can help understand if the urgency is due to an underlying condition. The underlying condition can be treated appropriately to solve the problem.
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Urine Culture: Urine culture test helps to understand if the condition is due to an underlying urinary tract infection. It also helps the medical professional to decide the medication required for the treatment. Treating the underlying condition solves the stand-up urgency.
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Assessment of the Pelvic Floor: Stand-up urgency can be due to weak pelvic floor muscles. Exercises that help to strengthen the pelvic floor can solve the issue of stand-up urgency due to weak pelvic floor muscles.
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Bladder Ultrasound and CT Scan: An ultrasound or CT (computerized tomography) of the bladder helps to identify if the condition is due to any bladder abnormalities. Treating them appropriately can solve stand-up urgency.
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Cystometrogram: A test used to identify any problems with the voiding or filling of the bladder is called cystometrogram. Treating them appropriately can help to prevent leakage of urine.
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Uroflowmetry: It is a test to measure the volume of urine that is removed from the body. It can give an idea of what abnormality causes the condition.
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Urinary Stress Testing: This test helps to check if the patient has accidental urine leakage during coughing, sneezing, or laughing.
How Is Stand-up Urgency Treated?
Many strategies may help manage stand-up urgency. It can include:
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Pelvic Floor Exercises: Exercises to strengthen pelvic floor muscles can help manage stand-up urgency due to the weakening of these muscles. Kegel’s exercise is an exercise to strengthen the pelvic floor. In addition, it can support the proper functioning of the bladder and bowel. These are simple clench-and-release exercises of the pelvic floor.
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Breathing Exercises: Breathing exercises help to relieve stress and calm the mind, thereby reducing stress incontinence. It can be practiced anytime or anywhere.
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Distracting the thoughts can help stop urine leakage temporarily. Distracting the brain can stop it from sending signals to the bladder. However, this may not be a permanent solution.
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Quitting habits like smoking or alcohol can help control urinary incontinence to an extent.
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Medical attention might be required to solve the condition completely. Medical professionals may suggest medication or some methods to prevent stand-up urgency. Surgical intervention might be required in severe cases.
Conclusion
Stand-up urgency is a situation that can hamper the quality of life, and confidence of a patient. It can be appropriately diagnosed and treated to prevent embarrassing situations. Simple exercises to strengthen the pelvic floor like Kegel’s exercises, breathing exercises, quitting habits like alcohol and smoking, etc., can solve the issue temporarily. Medical attention can help to solve the problem permanently.
