Are Kidney Stones Causing Your Incontinence? Here’s What You Need to Know 

Have you ever found yourself dealing with the discomfort of kidney stones or the frustration of incontinence? If so, you’re not alone and might be surprised to learn that these two issues can be interconnected. It’s easy to think of kidney stones and incontinence as separate problems—after all, one is a painful condition affecting your kidneys, and the other is a troublesome issue pertaining to bladder control. However, the reality is that these two conditions can influence each other in ways that might affect your daily life more than you realise.

 

Kidney stones are hard mineral deposits that can develop in your kidneys and don’t just cause severe pain—they can also create blockages in your urinary tract. When this happens, it puts extra pressure on your bladder, which can lead to or worsen incontinence. It’s a connection that often goes unnoticed, leaving many people struggling with both conditions without understanding the link.

 

Addressing this connection is crucial, especially here in Singapore, where the hot climate can increase the risk of dehydration—a key factor in the formation of kidney stones. If you have been dealing with one or both of these issues, understanding how they are related could be the first step toward finding relief. Let’s explore how kidney stones and incontinence are connected and what you can do to manage them.

What Are Kidney Stones and Why Do They Form?

 

Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. These stones can vary in size, ranging from as small as a grain of sand to as large as a golf ball. Depending on their size and location, kidney stones can cause significant pain and discomfort, particularly when they move through the urinary tract. There are several types of kidney stones, each formed from different substances:

 

• Calcium stones: the most common type, these stones [1] are usually made of calcium oxalate, although they can also be composed of calcium phosphate. Oxalate is a substance found in foods like spinach, nuts, and chocolate, and it can also be produced by the liver.
• Struvite stones: often associated with urinary tract infections, these stones [2] can grow quickly and become quite large, sometimes with few symptoms.
• Uric acid stones: these stones [3] form in people who lose too much fluid due to chronic diarrhoea, malabsorption or those who eat a high-protein diet. Uric acid stones are also more common in individuals with gout.
• Cystine stones: these are rare and occur in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria) [4]. 

 

Causes and Risk Factors 

Kidney stones form when your urine contains more crystal-forming substances )such as calcium, oxalate, and uric acid) that the fluid in your urine can’t dilute. Various factors can increase the risk of developing kidney stones:

 

• Diet: a diet  [5] high in protein, sodium, and sugar can increase the risk of certain types of kidney stones. High sodium intake, in particular, can increase the amount of calcium in your urine, which is a significant risk factor for kidney stone formation.
• Hydration: not drinking enough [6] water each day can increase your risk of kidney stones. When you are dehydrated, your urine becomes more concentrated with substances that can form stones.
• Genetics: if someone in your family has had kidney stones [7] you are more likely to develop them too. Certain inherited conditions, such as cystinuria [8], can also increase your risk.
• Other medical conditions: conditions such as obesity [9], and certain types of gastrointestinal diseases [10] can also increase your risk of kidney stones.

 

Symptoms of Kidney Stones 

The symptoms of kidney stones can vary depending on the size and location of the stone. Common symptoms include:

 

• Severe pain in the side and back, below the ribs
• Pain that radiates to the lower abdomen and groin
• Pain that comes in waves and fluctuates in intensity
• Painful urination
• Pink, red, or brown urine (haematuria)
• Nausea and vomiting
• Frequent urination or the feeling of needing to urinate but only passing small amounts

 

In Singapore, the prevalence of kidney stones has been rising, likely due to changes in diet and lifestyle. The hot and humid climate can contribute to dehydration, which is a significant risk factor for the development of kidney stones. 

 

According to local studies, approximately 10% of the population [11] may experience kidney stones at some point in their lives, with middle-aged individuals being particularly at risk. This growing prevalence highlights the importance of understanding the risk factors and symptoms associated with kidney stones to promote early intervention and management.

What is Incontinence and How Does It Affect Your Life?

 

Incontinence refers to the involuntary leakage of urine, meaning that a person urinates when they don’t intend to. It’s a common problem that can range from a slight loss of urine when coughing or sneezing to a complete inability to control urination. Understanding the types of incontinence is crucial for effective management and treatment. There are several types of urinary incontinence, each with distinct characteristics:

 

• Stress incontinence: this occurs when physical movement or activity—such as coughing, sneezing, laughing, or exercising—puts pressure on your bladder, leading to urine leakage [12]. It’s the most common form of incontinence in women, particularly after childbirth or during menopause.
• Urge incontinence: also known as overactive bladder (OAB), this type is characterised by a sudden, intense urge to urinate, followed by involuntary loss of urine. It can be caused by a variety of factors, including bladder infections, neurological disorders, or conditions like diabetes.
• Overflow incontinence: this occurs when the bladder doesn’t empty completely [13], leading to frequent dribbling of urine. It can be caused by conditions that block the flow of urine, such as an enlarged prostate or a narrowed urethra, as well as by bladder muscle weakness.
• Functional incontinence: this type [14] occurs when a physical or mental impairment prevents someone from getting to the bathroom in time. For example, severe arthritis might make it difficult to unbutton pants quickly enough, leading to accidents.
• Mixed incontinence: this is a combination of stress and urge incontinence, and is particularly common in older women.

 

Causes and Risk Factors 

Incontinence can be caused by a variety of factors, some temporary and others chronic:

 

• Pelvic floor muscle weakness: weakened pelvic floor muscles, often due to pregnancy, childbirth, or ageing, can make it difficult to control urination.
• Bladder muscle overactivity: conditions that cause the bladder muscles to contract involuntarily, such as urinary tract infections or neurological disorders, can lead to urge incontinence.
• Hormonal changes: menopause can cause a drop in estrogen, which affects the lining of the bladder and urethra, potentially leading to incontinence.
• Prostate issues: in men, an enlarged prostate can obstruct the urethra, leading to overflow incontinence.
• Medications: diuretics, sedatives, and certain antidepressants can contribute to incontinence by affecting bladder control.
• Lifestyle factors: excessive alcohol or caffeine intake, obesity, and smoking are also known to exacerbate incontinence.

 

Incontinence can have a huge impact on a person’s quality of life. It can cause embarrassment, anxiety, and a loss of confidence; as a result, many individuals avoid social situations or physical activities. The constant worry about leakage can make it difficult to relax, sleep, or focus on daily tasks, which may lead to emotional distress or depression. For some, incontinence can also cause skin problems, such as rashes or infections, due to constant exposure to moisture.

 

In Singapore, incontinence is a widespread issue, particularly among older adults. It’s estimated that around 10-15% of the adult population [15] experiences some form of urinary incontinence. However, due to the stigma surrounding the condition, many people do not seek medical help, leading to underreporting and a lack of adequate support. 

 

The prevalence is particularly high among women, especially those who have had multiple pregnancies, as well as among men with prostate conditions. The increasing awareness of incontinence as a manageable condition is crucial for improving the quality of life for those affected. 

How Kidney Stones Can Lead to Incontinence

 

Kidney stones and incontinence might seem like unrelated conditions, but there’s a significant connection between the two that can lead to complications for those affected. Kidney stones, which are hard deposits formed from minerals and salts in the kidneys, can have a direct impact on the urinary system, potentially leading to or worsening incontinence.

 

When kidney stones form, they can move through the urinary tract, which includes the kidneys, ureters, bladder, and urethra. Depending on their size and location, these stones can cause a variety of issues within the urinary system. One of the most common ways kidney stones can lead to incontinence is through the obstruction of the urinary tract. When a kidney stone blocks the ureter (the tube that carries urine from the kidney to the bladder), it creates a backup of urine. This obstruction increases pressure in the kidneys and bladder, which can lead to a strong and sudden urge to urinate—a classic symptom of urge incontinence.

 

In some cases, the stone can cause such severe pressure that it leads to overflow incontinence. This happens when the bladder is unable to empty fully due to the obstruction, causing urine to leak out involuntarily. Additionally, the presence of kidney stones can irritate the bladder wall, leading to bladder spasms and involuntary contractions, which can further contribute to urge incontinence.

 

Clinical observations suggest that when kidney stones block the ureter, the resulting obstruction can cause the bladder to contract more forcefully in an attempt to expel urine, which may lead to a sudden, intense need to urinate [16]. In other cases, large stones may physically block the urethra, leading to overflow incontinence, where the bladder becomes overly full and urine leaks out involuntarily.

 

Healthcare providers often observe that treating the underlying kidney stones—whether through surgical removal, lithotripsy (using shock waves to break up stones), or other methods—can alleviate the symptoms of incontinence in affected patients. This emphasises the importance of addressing kidney stones not only to relieve pain but also to manage urinary incontinence effectively.

 

How Kidney Stones and Incontinence Are Diagnosed

 

Diagnosing kidney stones and incontinence typically begins with a thorough medical history and physical examination. For kidney stones, doctors may use imaging tests such as CT scans, ultrasounds, or X-rays to locate the stones and determine their size and position. Blood tests can reveal high levels of substances like calcium or uric acid that contribute to stone formation, while a urinalysis can detect blood in the urine or substances that form stones.

 

Incontinence is diagnosed through a combination of medical history, physical exams, and tests such as urinalysis, bladder diaries, and post-void residual measurements. These help determine the type and cause of incontinence, whether it’s stress, urge, overflow, or mixed incontinence. Urodynamic tests and cystoscopy may also be used to assess bladder function and check for any structural issues.

 

Treatment for kidney stones depends on their size, type, and location. Small stones often pass on their own with increased fluid intake and pain management. Medications like alpha-blockers can help relax the muscles in the ureter, making it easier for stones to pass. For larger stones, more invasive treatments like extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, or even percutaneous nephrolithotomy may be required to break up or remove the stones.

 

Incontinence treatment varies based on the type and severity of the condition. Pelvic floor exercises, like Kegels, are effective for strengthening the muscles that control urination, especially in cases of stress incontinence. Medications such as anticholinergics can help calm an overactive bladder in urge incontinence, while surgical options like bladder slings or the use of bulking agents might be recommended for more severe cases. For men with significant stress incontinence, an artificial urinary sphincter may be considered.

 

When both kidney stones and incontinence are present, treatment plans often involve addressing the kidney stones first, which can alleviate some of the incontinence symptoms. Lifestyle modifications, such as increasing fluid intake and dietary changes, are important for both conditions, helping to prevent the recurrence of stones and reducing the risk of bladder irritation. Regular follow-up care is essential to ensure that both conditions are managed effectively, improving overall quality of life.

 

How Can You Prevent Kidney Stones and Incontinence 

 

Preventing kidney stones and incontinence involves making some practical lifestyle adjustments and being mindful of your overall health. For kidney stones, staying well-hydrated is crucial. Drinking enough water each day helps dilute the substances in urine that lead to stone formation. Aim for at least 8-10 glasses of water daily, and more if you live in a hot climate or engage in strenuous activities. 

 

Dietary changes also play a significant role; reducing sodium intake, moderating consumption of oxalate-rich foods like spinach and nuts, and balancing animal protein with plant-based options can all help lower the risk of stones. Regular check-ups with your doctor are essential, especially if you have a history of kidney stones, as they can monitor your condition and recommend preventive measures.

 

For incontinence, lifestyle changes are equally important. Strengthening the pelvic floor muscles through exercises such as Kegels can greatly improve bladder control, particularly in cases of stress incontinence. Maintaining a healthy weight, limiting caffeine and alcohol intake, and quitting smoking can also help manage and prevent incontinence. Additionally, staying active and engaging in regular physical exercise can reduce the risk of obesity, which is a significant contributor to both conditions.

 

Early intervention is critical in managing both kidney stones and incontinence. The sooner you address the symptoms or take preventive steps, the more effective the treatment will be, reducing the likelihood of complications and improving your quality of life. 

 

When to See a Urologist

 

Knowing when to consult a urologist is crucial for managing kidney stones and incontinence effectively. These specialists are trained to diagnose and treat conditions related to the urinary tract and male reproductive organs, offering expertise that can significantly improve your health outcomes.

 

If you experience any of the following symptoms, it’s important to seek medical attention from a urologist:

 

• Severe pain: intense pain in your back, side, lower abdomen, or groin could indicate the presence of a kidney stone, especially if the pain comes in waves and fluctuates in intensity.
• Blood in urine (haematuria): visible blood in your urine is a common sign of kidney stones and requires prompt evaluation. It can also indicate other serious conditions, such as urinary tract infections or bladder cancer.
• Persistent urinary symptoms: frequent, urgent, or painful urination that doesn’t resolve with over-the-counter treatments may be linked to either kidney stones or incontinence and should be assessed by a specialist.
• Inability to urinate or empty bladder completely: difficulty in urination or feeling like your bladder isn’t fully emptying could be a sign of an obstructed urinary tract, possibly due to a kidney stone.
• Uncontrolled leakage of urine: if you experience frequent or severe episodes of incontinence, it’s important to consult a urologist to determine the underlying cause and explore treatment options.

 

A urologist plays a central role in managing both kidney stones and incontinence. For kidney stones, the urologist can provide treatments ranging from non-invasive options like medication and shock wave lithotripsy to more advanced surgical procedures for removing larger stones. They can also offer advice on preventing future stones through dietary changes, hydration, and medication.

 

For incontinence, the urologist can help determine the type and cause of the condition and recommend appropriate treatments. These might include pelvic floor exercises, medications to calm an overactive bladder, or surgical interventions to support the bladder or urethra.

 

By working closely with a urologist, you can develop a comprehensive treatment plan that addresses both conditions, improving your overall urinary health and quality of life. Regular follow-ups with your urologist ensure that your treatment remains effective and can be adjusted as needed based on your progress.

 

Conclusion: Taking Charge of Your Urinary Health

 

Kidney stones and incontinence are two conditions that, while distinct, can often be interconnected. Kidney stones can lead to or exacerbate incontinence through obstruction of the urinary tract, increased bladder pressure, and irritation. Recognizing the signs and symptoms of these conditions early on is crucial for effective management and prevention of further complications.

 

If you are experiencing symptoms such as severe pain, blood in your urine, persistent urinary issues, or uncontrolled leakage, it is important to seek help from a urologist. Early diagnosis and treatment can make a significant difference in managing these conditions and improving your quality of life.

 

Maintaining good urinary health involves proactive steps such as staying well-hydrated, making appropriate dietary choices, and engaging in pelvic floor exercises. Regular check-ups with your healthcare provider are also key to catching any issues early and ensuring your urinary system remains healthy.

 

Remember, you don’t have to live with the discomfort and inconvenience of kidney stones or incontinence. By taking charge of your urinary health and seeking professional guidance, you can manage these conditions effectively and maintain a better quality of life.

 

References 

1. Calcium Oxalate Stone – Causes, Prevention, Treatment | National Kidney Foundation. https://www.kidney.org/kidney-topics/calcium-oxalate-stones. Accessed 27 Aug. 2024. 
2. Struvite Stone – Symptoms, Causes, Treatment | National Kidney Foundation. https://www.kidney.org/struvite-stones.  Accessed 27 Aug. 2024.
3. “Uric Acid Stones: Causes, Symptoms & Treatment.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/16378-uric-acid-stones.  Accessed 27 Aug. 2024.
4. Leslie, Stephen W., et al. “Cystinuria.” StatPearls, StatPearls Publishing, 2024. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK470527/. 
5. Siener, Roswitha. “Nutrition and Kidney Stone Disease.” Nutrients, vol. 13, no. 6, June 2021, p. 1917. PubMed Central, https://doi.org/10.3390/nu13061917. 
6. Lots of Water, Small Dietary Changes Can Help Prevent Kidney Stones, UTSW Expert Says. 12 June 2023, https://www.utsouthwestern.edu/newsroom/articles/year-2023/june-prevent-kidney-stones.html. 
7. Edvardsson, Vidar O., et al. “Hereditary Causes of Kidney Stones and Chronic Kidney Disease.” Pediatric Nephrology (Berlin, Germany), vol. 28, no. 10, Oct. 2013, pp. 1923–42. PubMed Central, https://doi.org/10.1007/s00467-012-2329-z. 
8. Sadiq, Sanober, and Onur Cil. “Cystinuria: An Overview of Diagnosis and Medical Management.” Turkish Archives of Pediatrics, vol. 57, no. 4, July 2022, pp. 377–84. PubMed Central, https://doi.org/10.5152/TurkArchPediatr.2022.22105. 
9. Poore, William, et al. “Obesity and Its Impact on Kidney Stone Formation.” Reviews in Urology, vol. 22, no. 1, 2020, pp. 17–23. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265184/. 
10.  “Do Gastrointestinal Issues Cause Kidney Stones?” Cleveland Clinic, https://health.clevelandclinic.org/do-gastrointestinal-issues-cause-kidney-stones. Accessed 27 Aug. 2024.
11. “Minimally Invasive Kidney Stone Treatments: From a 20-Minute Shockwave Procedure to Scope Surgery.” The Straits Times, 5 July 2023. The Straits Times, https://www.straitstimes.com/singapore/health/minimally-invasive-kidney-stone-treatments-urohealth-medical-clinic#:~:text=It%20affects%20approximately%2010%20per,their%20diet%2C%20notes%20Dr%20Koh. 
12. “Stress Incontinence – Symptoms and Causes.” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727.  Accessed 27 ug. 2024. 
13. “Overflow Incontinence.” Healthline, 12 Aug. 2020, https://www.healthline.com/health/overactive-bladder/overflow-incontinence. 
14. “Functional Incontinence.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/24858-functional-incontinence.  Accessed 27 Aug. 2024.
15. Nursing Management of Patients with Urinary Incontinence, MOH NURSING CLINICAL PRACTICE GUIDELINES 1/2003. https://www.moh.gov.sg/docs/librariesprovider4/guidelines/nursing_management_of_patients_with_urinary_incontinence.pdf 
16. “How Can Kidney Stones Cause Urinary Incontinence?” Because Market, 8 June 2023, https://becausemarket.com/blogs/news/can-kidney-stones-cause-incontinence.