Urinary Incontinence as a Disabling Condition

Urinary incontinence is a surprisingly common problem that affects millions of Americans, and is described by the Mayo Clinic [1] as follows:

Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.

Though it occurs more often as people get older, urinary incontinence isn’t an inevitable consequence of aging. If urinary incontinence affects your daily activities, don’t hesitate to see your doctor. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.

Symptoms

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

Types of urinary incontinence include:

  • Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
  • Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.
  • Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
  • Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
  • Mixed incontinence. You experience more than one type of urinary incontinence.

Causes

Urinary incontinence isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.

Temporary urinary incontinence

Certain drinks, foods and medications may act as diuretics — stimulating your bladder and increasing your volume of urine.

Urinary incontinence may also be caused by an easily treatable medical condition, such as:

  • Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence.
  • Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.

Persistent urinary incontinence

Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including:

  • Pregnancy. Hormonal changes and the increased weight of the fetus can lead to stress incontinence.
  • Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions can be associated with incontinence.
  • Changes with age. Aging of the bladder muscle can decrease the bladder’s capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
  • Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
  • Hysterectomy. In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
  • Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
  • Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
  • Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage.
  • Neurological disorders. Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

On average, women are approximately twice as likely as men to develop some form of urinary incontinence, and both sexes become increasingly likely to develop urinary incontinence as age increases. Those who experience incontinence that is frequent or severe enough to impact quality of life should consult a doctor, who will likely request that they complete a bladder diary to record the amounts and types of liquids they drink and provide detailed notes on the frequency, amount, and urgency of urination over the span of a few days. More severe cases may call for more complex and involved testing, which can be used to determine whether corrective surgery may be necessary.

Most cases of urinary incontinence are treatable, although some patients will require more invasive treatments if initial conservative treatment options don’t provide sufficient relief. Severe cases can even require invasive surgery to address the physical causes of urinary incontinence.

Urinary incontinence can be an extremely embarrassing and disabling condition for those who suffer from it. Patients who work in environments without quick and easy access to a restroom – such as outdoor worksites, large warehouses, and classrooms – are often unable to work because they are physically unable to reach a toilet before having an accident. Likewise, individuals who suffer from stress incontinence are often unable to work in physically-demanding jobs since they are prone to losing bladder control under physical exertion.

Unfortunately, many insurance companies are reluctant to issue benefits for urinary incontinence alone, arguing that their insureds are still physically capable of working, and ignoring the obvious negative impacts that incontinence can have on an individual’s employability.

If you suffer from urinary incontinence and are considering applying for short term or long term disability benefits, it is important to obtain a diagnosis and seek regular treatment from a urologist and/or gynecologist. Ideally, they will be able to prescribe an effective treatment, but if your issues persist, records of thorough treatment from a relevant specialist will be critical to your disability benefits claim.

If you are suffering from urinary incontinence and are considering applying for or have been denied short term or long term disability benefits from your insurance company, please contact O’Ryan Law Firm so we can discuss a strategy to obtain the benefits you deserve.

[1] https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808