Urinary Incontinence

Overview

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. But it can also affect 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.

Is urinary incontinence just part of growing older?

No. But changes with age can reduce how much urine your bladder can hold. Aging 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.

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Learn More About Urinary Incontinence

Bladder Training for Urinary Incontinence

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Symptoms

There are 5 types of urinary incontinence, described below.

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 more than one of the types of incontinence listed above.

Causes & Risk Factors

What causes urinary incontinence?

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

  • 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

Diagnosis

How is urinary incontinence diagnosed?

It is important to talk to your family doctor about your symptoms. This is the best way for your doctor to determine which type of urinary incontinence you have. Your doctor may also request a sample of urine. You may need to keep a diary of your urination habits (when you go and how much). Your doctor may order a pelvic ultrasound to evaluate your bladder. Your doctor will use all this information to determine your type of urinary incontinence.

Prevention

Can urinary incontinence be prevented or avoided?

You may be able to prevent urinary incontinence by working to keep pelvic muscles strong. But even so, it doesn’t guarantee that you will never have urinary incontinence.

There are also lifestyle changes you can make to help prevent urinary incontinence. You may find it helpful to make some changes in your diet. Alcohol, caffeine, foods high in acid (such as tomato or grapefruit), and spicy foods can irritate your bladder. Talk to your doctor if you think your diet may contribute to your incontinence.

Some people find that limiting how much they drink before bedtime helps reduce nighttime incontinence.

Losing weight if you are overweight can also help reduce 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?

Kegal 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. For more information, see “Kegel Exercises for Your Pelvic Muscles.”

What is bladder training?

Bladder training 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

Some bladder training techniques are explained in “Bladder Training for Urinary Incontinence”.

Are there other ways to treat incontinence?

Yes. Medicines or medical devices can treat some types of urinary incontinence. For example, estrogen cream to put 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. Talk to your doctor about possible medicine options for your type of incontinence.

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

Living with urinary incontinence

Do not let urinary incontinence control your life. Do not let it keep you at home or affect your typical activities. All it takes is a little planning. For example, if you know you are going to not be near a bathroom, consider using a panty liner or pad. When you are at an event away from home, scope out the locations of bathrooms. Take frequent bathroom breaks. Try to drink less while you are out.

Most importantly, talk to your doctor and those close to you about your urinary incontinence. You may be embarrassed at first, but they can help you work on solutions—especially your doctor. It is important to know that you aren’t alone in this.

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?