What is urinary incontinence?
Urinary incontinence (UI) is the loss of urine control. You may not being able to hold your urine until you can reach a restroom. It may be a short-term problem caused by another health issue. Or it may be a long-term problem that you’ll have to manage. UI can range from a slight loss of urine to severe, frequent wetting.
Fear of wetting yourself can keep you from enjoying activities with your family and friends. Incontinence during sex can cause great stress.
UI is not a normal part of aging, but it is common in older people.
The following are some of the different types of UI:
- Urge incontinence is when the need to urinate comes on very quickly. Often, you may not be able to get to a restroom in time. It’s common in people who have certain conditions, such as diabetes, stroke, dementia, Parkinson's disease, and multiple sclerosis. It may be a sign that these other conditions that need attention. It’s more common in older adults and may be a sign of a urinary tract infection or an overactive bladder.
- Stress incontinence is the most common type of incontinence. It’s more common in women. You may leak urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other movements that put pressure on the bladder.
- Functional incontinence is when you have urine control, but can’t get to a restroom in time. This may be due to conditions that make it hard to move, such as arthritis.
- Overflow incontinence is the leakage of small amounts of urine caused by an over-filled bladder. It may feel like you can’t fully empty your bladder.
- Mixed incontinence is a mix of more than one of the types listed above.
What causes urinary incontinence?
Changes from certain diseases or medicines may cause UI. It may also happen at the start of an illness.
Women are most likely to have incontinence during pregnancy and childbirth. Hormone changes of menopause may also cause it. This is because of weakened and stretched pelvic muscles.
Some of the other common causes include:
- Pregnancy and childbirth
- Birth defects
- Urinary tract infection (may be the first and only symptom)
- For men, an enlarged prostate gland or treatment of a prostate problem
- Stool build-up in the bowels
- Being overweight (this increases pressure on the bladder and the muscles that control it)
- Nerve damage from spinal cord injuries, diabetes, Parkinson disease, and multiple sclerosis
- Overactive bladder (the bladder squeezes at the wrong times and without warning)
How is urinary incontinence diagnosed?
The most important step in diagnosing UI is talking to a health care provider. Don’t let embarrassment keep you from getting help.
It’s important to see a health care provider for a physical exam that focuses on the urinary and nervous systems, reproductive organs, and includes testing urine samples. You may be referred to a urologist. This is an expert in diseases of the urinary tract.
How is urinary incontinence treated?
Your health care provider will figure out the best treatment based on:
- How old you are
- Your overall health and health history
- How sick you are
- How well you can handle specific medicines, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
Treatment for UI depends on the cause and may include the following.
These will to help you regain bladder control. They include:
o Bladder training. This teaches you to resist the urge to void and expand the times between voiding over time.
o Scheduled toileting. This therapy uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder every 2 to 4 hours to prevent leaking.
Pelvic muscle rehab
This will improve pelvic muscle tone and prevent leakage. This treatment includes:
o Kegel exercises. Regular, daily exercise of pelvic muscles can make the bladder muscles stronger and improve, and even prevent, urinary incontinence. This is most helpful for younger women.
o Biofeedback. Used along with Kegel exercises, biofeedback helps you gain awareness and control of their pelvic muscles.
o Vaginal weight training. Small weights are held within the vagina by tightening the vaginal muscles. This may be done for 15 minutes, twice daily, for 4 to 6 weeks.
o Pelvic floor electrical stimulation. Mild electrical pulses stimulate muscle contractions. This may be done along with Kegel exercises.
- Medicines. This includes specific drugs for incontinence as well as estrogen therapy. This may be helpful along with other treatments for women with urinary incontinence who are past menopause.
- Surgery. This is an option if the incontinence is related to problems such as an abnormally positioned bladder or a blockage. It may be used if other treatments don’t work, or if the incontinence is severe.
- Diet changes. This includes avoiding caffeine and alcohol.
- Adult diapers. Newer undergarments are no more bulky than normal underwear. You can wear them under everyday clothing.
You can also manage incontinence with other devices and products. This includes catheters, pelvic organ slings, urethral plugs, urine collection systems, and penile compression devices. Talk to your health care provider about which treatment might work best for you.
Consult your health care provider with your questions about the management and treatment of UI.