Urinary incontinence is a loss of bladder control. It means that urine leaks from the bladder. Loss of bladder control gets more common as people get older. It is a problem for as many as 1 in 3 Americans age 60 or older.
What is the cause?
There are different types of incontinence:
Stress incontinence is a leaking of urine that happens from increased pressure in your belly when you lift things, exercise, cough, sneeze, or laugh. It is caused by pelvic muscles that are too relaxed. It is a common problem for women. The pelvic muscles may have been stretched or torn during child-bearing or by pelvic surgery. Also, during the first 3 months of pregnancy, the growing uterus presses on the bladder and may cause leakage of urine. This is often less of a problem after the fourth month of pregnancy because the uterus rises out of the pelvis and doesnâ€™t put as much pressure on the bladder. Later in pregnancy, when the baby drops, leaking urine may be a problem again.
Urge incontinence happens when you feel the urge to urinate and you cannot hold your urine until you get to the bathroom. It often happens with Parkinson’s disease, stroke, or multiple sclerosis. But healthy people can have it, too. When a cause cannot be found for it, the problem may be called an irritable or overactive bladder.
Overflow incontinence is common in older people, especially men who have an enlarged prostate gland. The enlarged prostate squeezes the urethra, which is the tube that drains urine from the bladder. The bladder never empties completely and is often full. This causes small amounts of urine to leak.
Functional incontinence happens when you are unable to get to the bathroom in time to urinate because medical problems such as Alzheimer’s disease or severe arthritis keep you from moving quickly.
Incontinence may be caused or made worse by problems such as:
A stone in the bladder
Thinning of vaginal tissue due to decreased estrogen after a woman goes through menopause
What are the symptoms?
Symptoms may include:
Leakage of urine when you exercise, laugh, cough, sneeze, or lift something
Urine often leaking in dribbles
Trouble holding urine long enough to get to the toilet
A smell of urine on your clothes and in the house
How is it diagnosed?
Your healthcare provider will ask about your medical history and examine you. Blood and urine samples will be checked for infection or other problems.
You may be referred to a specialist for further testing or treatment.
How is it treated?
Treatment depends on what is causing the problem. Treatment may include:
Kegel exercises to strengthen weak pelvic muscles. Your provider can teach you how to do these exercises.
Bladder training, which teaches you to empty your bladder on a schedule rather than waiting until you feel the urge. For example, you might sit on the toilet 20 to 30 minutes after each meal, at least twice between meals, and before you go to bed. You can adjust the schedule as you learn the frequency that works best. You can even set a timer to remind you when bathroom visits are due.
Cones inserted in a womanâ€™s vagina to help strengthen the pelvic floor muscles
Incontinence pads and undergarments
A collecting device fitted over a manâ€™s penis to hold urine
A catheter inserted into the bladder to drain urine
Surgery. There are several surgical procedures for incontinence depending on the type.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. In addition:
Avoid things that can irritate the bladder, such as alcohol, carbonated drinks, coffee or tea, chocolate, citrus fruits, tomatoes, or acidic fruit juices.
Don’t try to control urine leakage by cutting back on fluids. It won’t help and may be harmful. Drink plenty of fluids throughout the day until about 3 hours before bedtime.
To help keep your bladder from getting too full, be sure to empty your bladder every 2 to 4 hours during the day and before you go to bed.
Avoid nonprescription medicines that relieve the symptoms of colds, flu, or allergies.
If you use incontinence pads for protection, change them regularly.
Keep your genital area clean and as dry as possible.
Urinate before and after sex.
Find ways to stay within easy reach of a bathroom.
Have a night-light and grab bars in your bathroom to help prevent falls when you are in a hurry.
Ask your provider:
How and when you will hear your test results
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-08 Last reviewed: 2014-12-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Urinary Incontinence: References
Balachandran, A, Duckett, J. (2014). What is the role of the multidisciplinary team in the management of urinary incontinence? Int Urogynecol J. 2014 Nov 22
Geraerts, I, Van Kampen, M. (2014). Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapsed outcomes: randomised controlled trial.BJOG. 121(13):1741-2.
Sengoku A, Okamura K, Kimoto Y, Ogawa T, Namima T, Yamanishi T, Yokoyama, T, Akino, H, Maeda, Y. (2014). Botulinum toxinâ€‰A injection for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury: Multi-institutional experience in Japan. Int J Urol. 2014 Nov 18.