Urinary incontinence in horse riders: symptoms and causes

If you ever had to pee several times before entering the arena in a show, if you had to dismount your horse in the middle of a lesson to go to the bathroom or if you felt a leakage “down there” while tightening the girth of your swollen horse full of air (which in any way wants to collaborate), you might find this blog post interesting. 

Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened. Urinary incontinence is more common among women than men and even more common among horse riders due to the vulnerability of the intimate area (it is continuously exposed to friction, impact and sweat). An estimated 30% of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men. 


The intensity ranges from occasionally losing urine when you cough, sneeze, tight the girth of your horse or make a specific physical effort like sitting trot, to having such a sudden and strong urge to urinate that you are not able to get to the bathroom on time. Although it occurs more frequently as people age, urinary incontinence IS NOT an inevitable consequence of aging and it can be caused by many other reasons that we will explain later.

If urinary incontinence affects your daily activities, don't hesitate to consult your doctor. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.

Types of urinary incontinence:

Stress incontinence: Urine leaks out when you put pressure on your bladder when you cough, sneeze, laugh, tight the girth of your horse, or lift some heavy buckets or bales of hay.

Urge incontinence: You have a sudden, intense urge to urinate, followed by an involuntary loss of urine. You may have to urinate frequently, even throughout the night. Urge incontinence can be caused by a minor condition, such as an infection, or a more serious illness, such as a neurological disorder or diabetes.

Overflow incontinence: You have frequent or constant urine dribbling because your bladder does not empty completely. 

Functional incontinence: A physical or mental deterioration prevents you from reaching the bathroom on time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.

Mixed incontinence: You have more than one type of urinary incontinence.

 

Causes

Urinary incontinence is not a disease, but a symptom. It can be caused by certain daily habits, underlying illnesses or physical problems. A thorough evaluation by your doctor can help determine what is causing your incontinence.

Temporary urinary incontinence

Certain foods, drinks and medicines can act as diuretics (they stimulate the bladder and increase the volume of urine). Some of them are: Alcohol. caffeine,  artificial sweeteners, foods high in spices, sugar, or acid, especially citrus.

Medications for blood pressure and heart, sedatives and muscle relaxants as well as large doses of vitamin C

Urinary incontinence can also be caused by an easily treatable conditions, for example:

Urinary infection:  Infections can irritate the bladder, cause a strong urge to urinate, and sometimes incontinence.

Learn more... 12 Things you should know so Urinary Tract Infections don't ruin your equestrian plans

Constipation: The rectum is located near the bladder and shares many nerves. Hard, compacted stool in the rectum causes these nerves to become overly active and increases urinary frequency.

A debilitated pelvic floor: The pelvic floor is a set of muscles and ligaments that close the abdominal cavity in its lower part. Its function is to hold the pelvic organs (bladder and urethra among others)

Learn more in... The pelvic floor: How to protect it while practicing horseback riding

Persistent urinary incontinence

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

Pregnancy: Hormonal changes and a fetus' weight gain can lead to stress incontinence.

Birth: Vaginal delivery can weaken the muscles needed to control the bladder and also damage your nerves and supporting tissue, leading to a lowering of the pelvic floor (prolapse). The prolapse can push the bladder, uterus, rectum, or small intestine down from their usual position, causing them to poke into the vagina. These lumps can be associated with incontinence.

Changes due to age: Aging of the bladder muscle can decrease the ability to store urine. Also, involuntary bladder contractions become more frequent over the years.

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 muscles and ligaments that they share. Any surgery that involves a woman's reproductive system, for example removal of the uterus, can damage the supporting muscles of the pelvic floor and lead to incontinence.

Enlarged prostate:  In older men especially, incontinence often comes from an enlarged prostate gland, a condition known as "benign prostatic hyperplasia."

It is also one of the 7 common equestrian intimate health issues

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 prostate cancer treatments.

Obstruction: A tumor anywhere in the urinary tract can obstruct the normal flow of urine and lead to overflow incontinence. Urinary stones (hard, stone-like lumps that form in the bladder) can sometimes cause urine leakage.

Neurological disorders: Multiple sclerosis, Parkinson's disease, a stroke, a brain tumor, or a spinal cord injury can interfere with nerve signals involved in bladder control and cause urinary incontinence.

 

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