Urinary Incontinence

Urinary incontinence (UI) is the
loss of urine control. You may not be 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. 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 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. The most common
    type of incontinence. It’s more common in women. You may leak urine during exercise,
    coughing, sneezing, laughing, or lifting heavy objects. Or when doing other movements
    that put pressure on the bladder.
  • Functional incontinence. 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. 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. A mix of more
    than one of the types listed above.

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 or after 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
  • Menopause
  • Birth defects
  • Aging
  • Urinary tract infection (may be the first and only symptom)
  • For men, an enlarged prostate gland or treatment of a prostate problem
  • Stool buildup 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)

These are the most common symptoms of UI:

  • Not being able to urinate
  • Pain linked to filling the bladder or
    urinating without bladder infection
  • Stream of urine gets weaker and weaker with or without a feeling that you have not emptied your bladder completely
  • Urinate more without bladder infection
  • Needing to rush to the restroom or
    losing urine if you don’t get to a restroom in time
  • Abnormal urination or changes related to stroke, spinal cord injury, or multiple sclerosis
  • Urine leakage that prevents activities
  • Leakage of urine that starts or continues after surgery
  • Leakage of urine that causes embarrassment
  • Frequent bladder infections

The symptoms of UI may look like other conditions or health problems. Always see your healthcare provider for a diagnosis.

The most important step in
diagnosing UI is talking with a healthcare provider. Don’t let embarrassment keep you
from getting help.

It’s important to see a healthcare
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 or urogynecologist, a healthcare provider who specializes in urinary tract
diseases.

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

Treatment for UI depends on the
cause and may include the following.

Behavioral therapies

These will to help you regain
bladder control. They include:

  • Bladder
    training.
    This teaches you to resist the urge to void and expand the
    times between voiding over time.
  • 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:

  • 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. Should be performed 30 to 80 times
    daily for at least 8 weeks.
  • Biofeedback. Used along with Kegel exercises,
    biofeedback helps you gain awareness and control of your pelvic muscles.

  • 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.

  • Pelvic floor electrical stimulation. Mild
    electrical pulses stimulate muscle contractions. This may be done along with
    Kegel exercises.

Other treatments

  • Medicines. This includes specific
    medicines for incontinence as well as estrogen therapy. These 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 and preventing chronic constipation. This may also
    include reducing fluid intake.
  • Adult diapers. Newer undergarments
    are no more bulky than normal underwear. You can wear them under everyday
    clothing. There are a variety of other protective products as well.

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 with
your healthcare provider about which treatment might work best for you.

Consult your healthcare provider
with your questions about the management and treatment of UI.

  • Urinary incontinence (UI) is the loss
    of urine control. You may not be able to hold your urine until you can get to a
    restroom. It’s a symptom, not a disease.
  • There are many different causes. It
    can be a short-term problem. Or it can be a long-term issue that must be
    managed.
  • Symptoms can range from dribbling
    urine to not having any control over it. Or to not being able to pass urine at all.
    UI is also linked to frequent bladder infections.
  • For people with urinary incontinence,
    the most important step is talking with a healthcare provider about the problem.
  • Treatment depends on the severity of
    symptoms and the type of incontinence. It can include things such as bladder
    training, special exercises, medicines, and even surgery in severe cases.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.