What is urinary incontinence?
Urinary incontinence is the accidental release of urine. It can happen when you cough, laugh, sneeze, or jog. Or you may have a sudden need to go to the bathroom but can't get there in time. Bladder control problems are very common, especially among older adults. They usually do not cause major health problems, but they can be embarrassing.
Incontinence can be a short-term problem caused by a urinary tract infection, a medicine, or constipation. It gets better when you treat the problem that is causing it. But this topic focuses on ongoing (chronic) urinary incontinence.
There are two main kinds of chronic incontinence. Some women have both.
Stress incontinence occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.
Urge incontinence happens when you have a strong need to urinate but can't reach the toilet in time. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water.
Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine.
Mixed incontinence is a combination of different types of bladder control problems, usually stress and urge incontinence. These problems often occur together in older women.
What causes urinary incontinence?
Chronic bladder control problems may be caused by:
Weak muscles in the lower urinary tract. See a picture of the urinary tract
Problems or damage either in the urinary tract or in the nerves that control urination.
Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles cannot support your bladder properly, the bladder drops down and pushes against the vagina. You cannot tighten the muscles that close off the urethra. So urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.
Urge incontinence is caused by an overactive bladder muscle that pushes urine out of the bladder. It may be caused by irritation of the bladder, emotional stress, or brain conditions such as Parkinson's disease or stroke. Many times doctors don't know what causes it.
What are the symptoms?
The main symptom of urinary incontinence is the accidental release of urine. If you have stress incontinence, you may leak a small to medium amount of urine when you cough, sneeze, laugh, exercise, or do similar things.
If you have urge incontinence, you may feel a sudden urge to urinate and the need to urinate often. With this type of bladder control problem, you may leak a larger amount of urine that can soak your clothes or run down your legs.
If you have mixed incontinence, you may have symptoms of both problems.
How is urinary incontinence diagnosed?
Your doctor will ask about what and how much you drink. He or she will also ask how often and how much you urinate and leak. It may help to keep track of these things for 3 or 4 days before you see your doctor.
Your doctor will examine you and may do some simple tests to look for the cause of your bladder control problem. If your doctor thinks it may be caused by more than one problem, you will likely have more tests.
Treatment for stress incontinence includes:
Most bladder control problems can be improved or cured.
Doing Kegel exercises to strengthen the pelvic floor muscles. It is one of the best ways to improve stress incontinence.
Using a removable device called a pessary (which is placed inside the vagina). It can help reduce stress incontinence by putting pressure on the urethra.
Taking medicines, but they may have bothersome side effects.
Having surgery to support the bladder or move it back to a normal position, if other treatment doesn't help.
For urge incontinence, your doctor may:
Suggest behavior changes to fix the problem. For example, bladder training helps you to increase how long you can wait before you have to urinate. Prescribe medicine to treat urge bladder problems. If you have more than one kind of bladder control problem, first your doctor will treat the one that bothers you the most. Then he or she will treat the other cause, if needed.
Your doctor may suggest things you can do at home, such as going to the bathroom at set times and completely emptying your bladder when you urinate. It may also help to cut back on caffeine drinks, such as coffee, tea, or sodas.
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