Urinary Incontinence

What is urinary incontinence?

Urinary incontinence is the loss of bladder control. This means that you can’t always control when you urinate. Urinary incontinence can range from leaking a small amount of urine (such as when coughing or laughing) to having very strong urges to urinate that are difficult to control. This can be embarrassing but talk to your doctor about it. It can be treated.

Millions of adults in the United States have urinary incontinence. It’s most common in people older than 50 years of age, especially women. Aging can reduce how much urine your bladder can hold. It can make your stream of urine weaker and can cause you to feel the urge to urinate more often. This doesn’t mean you’ll have urinary incontinence just because you’re aging. With treatment, it can be controlled or cured. Urinary incontinence But can also occur in younger people, especially women who have just given birth.

Be sure to talk to your doctor if you have this problem. If you hide your incontinence, you risk getting rashes, sores, skin infections and urinary tract infections. Also, you may find yourself avoiding friends and family because of fear and embarrassment.

Symptoms of urinary incontinence

There are 5 types of urinary incontinence:

Stress incontinence

Stress incontinence is when urine leaks because of sudden pressure on your lower stomach muscles. This may happen when you cough, laugh, lift something, or exercise. Stress incontinence usually occurs when the pelvic muscles are weakened, for example, by childbirth or surgery. Stress incontinence is common in women.

Urge incontinence

This occurs when the need to urinate comes on very suddenly, often before you can get to a toilet. Your body may only give you a warning of a few seconds to minutes before you urinate. Urge incontinence is most common in the elderly and may be a sign of a urinary tract infection or an overactive bladder.

Overflow incontinence

This type of incontinence is the uncontrollable leakage of small amounts of urine. It’s caused by an overfilled bladder. You may feel like you can’t empty your bladder all the way and you may strain when urinating. This often occurs in men and can be caused by something blocking the urinary flow, such as an enlarged prostate gland or tumor. Diabetes or certain medicines may also cause the problem.

Functional incontinence

This type occurs when you have normal urine control but have trouble getting to the bathroom in time. You may not be able to get to the bathroom because of arthritis or other diseases that make it hard to move around.

Mixed incontinence

This type involves having more than one of the types of incontinence listed above.

What causes urinary incontinence?

Urinary incontinence can be caused by many different medical problems, including weak pelvic muscles or diabetes. Some common causes include:

• For women, thinning and drying of the skin in the vagina or urethra, especially after menopause
• For men, enlarged prostate gland or prostate surgery
• Weakened and stretched pelvic muscles after childbirth
• Certain medicines
• Build-up of stool in the bowels
• Overweight and obesity, which increases pressure on the bladder and muscles that control the bladder
• Urinary tract infections
• Vascular disease
• Diseases such as diabetes, Alzheimer’s disease, and multiple sclerosis
• Aging
• Dementia

Urinary incontinence treatment

Treatment depends on what’s causing the problem and what type of incontinence you have. If your urinary incontinence is caused by a medical problem, the incontinence will go away when the problem is treated. Kegel exercises and bladder training help some types of incontinence through strengthening the pelvic muscles. Medicine and surgery are other options.

What are Kegel exercises?

Kegel exercises help strengthen the muscles that control the bladder. They can be done anywhere, any time. Although designed for women, the Kegel exercises can also help men. It may take 3 to 6 months to see an improvement.

What is bladder training?

Bladder training (timed voiding) is a way of learning to manage urinary incontinence. It is generally used for stress incontinence, urge incontinence, or a combination of the 2 types (mixed incontinence).

Bladder training can help in the following ways:

• Lengthen the amount of time between bathroom trips
• Increase the amount of urine your bladder can hold
• Improve your control over the urge to urinate

Other ways to treat urinary incontinence include medicines or the use of medical devices. For example, estrogen cream inserted in the vagina can be helpful for some women who have mild stress incontinence. Several prescription medicines are available to treat urge incontinence. For men, prescription medicine is available to shrink the prostate and improve flow of urine through the prostate. Medical devices that deliver biofeedback or electrical nerve stimulation can be effective. Talk to your doctor about possible options for your type of incontinence, including a combination treatment approach.

In some cases, surgery may be an option. Treatment depends on what type of urinary incontinence you have and what is causing it.

Questions to Ask Your Doctor

• What type of urinary incontinence do I have?
• What is the likely cause of my urinary incontinence? Can this condition be treated?
• If so, will treating the condition cure my urinary incontinence? When can I expect relief from my symptoms?
• Should I start doing Kegel exercises? How often?
• Would a bladder training program help manage my urinary incontinence?
• Will any lifestyle changes help manage my urinary incontinence?
• I’m embarrassed by my urinary incontinence. Until my symptoms improve, what else can I do to help manage my condition?