What is urinary incontinence?
Urinary incontinence is the loss of bladder control that causes accidental urine leaking. It affects twice as many women as men because pregnancy, childbirth, and menopause can affect the bladder and other urinary organs. It can happen at any time and is not associated with aging, but it mostly affects older women.
Your bladder holds urine. During urination, the bladder muscles tighten and push urine through the urethra. The urethra muscles relax to let the urine flow out. When the muscles relax without warning or don’t work the way they should, urine can leak out.
Signs of urinary incontinence
Urinary incontinence is not a disease in itself, but it can be a symptom of an underlying problem. The kind of symptoms you have will help determine the type of urinary incontinence.
Some symptoms may include:
- Sudden, uncontrollable urge to urinate
- Leaking urine during exercise, sneezing, or coughing
- Frequent urination
- Constant dribbling
- Inability to empty the bladder
Many people live with urinary incontinence, but it may affect your quality of life. You may feel embarrassed or worried about being too far from a restroom. You may also feel like you can’t do normal daily activities or enjoy life. These are common feelings, which may indicate it’s time to talk to your doctor about how to manage your symptoms.
Types of urinary incontinence
There are 4 general types of urinary incontinence. These include:
Stress urinary incontinence is the most common type of urinary incontinence. This is not caused by emotional stress but by strain on the bladder like jumping, bending, lifting, exercise, and even coughing or sneezing. Being overweight can also strain the bladder. If you have weak pelvic floor muscles, this strain can cause urine to leak. It can be a small amount of urine or just a few drops.
Stress incontinence is more likely to occur in women.
Overflow incontinence occurs when the body makes more urine than the bladder can hold. This may also occur if the bladder is full and can’t empty, which causes it to leak. The bladder muscle may not squeeze as it should or something might be blocking the flow. Overflow incontinence causes frequent urinating in small amounts and constant dribbling.
This type is more common in men and is often associated with prostate surgery or prostate problems.
Also known as “urge” or “urgency incontinence,” this condition causes the bladder muscles to contract and signal a need to urinate even if the bladder is empty. It causes an overwhelming urge to urinate immediately and may cause accidents if you don’t make it to the restroom in time.
Urgency incontinence can be caused by physical problems like damage to the spine, brain, or the nerves between the spine and the bladder. It can also be caused by a bladder infection.
Causes of urinary incontinence
Urinary incontinence is a symptom, rather than a disease. It is usually caused by another condition or problem, including:
Tests for urinary incontinence
Your doctor will take a list of your symptoms and your personal and medical history to determine any factors related to your condition. They may also perform a prostate or internal pelvic exam to check for signs of the cause of your incontinence.
Your doctor may also do some of the following tests:
Urine tests and blood tests
Your doctor may test a sample of your urine for infections and other potential causes of incontinence.
An ultrasound may be helpful to check for structural problems in the pelvis or complications in the urinary organs (kidneys, bladder, and urethra).
During this test, your doctor may fill your bladder with water through a thin tube. This allows them to check how much fluid and pressure your bladder can hold before it leaks.
Bladder stress test
Your doctor may ask you to cough, sneeze, or bear down to see if your bladder leaks with physical stress.
Your doctor will insert a tube with a camera into your urethra to check your bladder and urethra for damaged tissue.
Treatments for urinary incontinence
Many older people develop urinary incontinence, but it is not a normal part of aging. This can be treated through lifestyle changes and through diagnosing and treating the underlying cause.
Your doctor may recommend the following natural treatments for reducing urinary incontinence:
- A fiber-rich diet to prevent constipation
- Quitting smoking
- Weight loss
- Limited caffeine
- Limited heavy lifting
- Pelvic floor exercises like Kegels
- Scheduled urination
- Absorbent hygiene products
Your doctor may also recommend these medical or invasive options for more severe cases of incontinence:
- Medication to strengthen bladder or urethra muscles
- Medical devices like a catheter or a vaginal pessary
- Collagen insertion to thicken tissues around your bladder and urethra
- Botox injections in the bladder to relax muscles
- Nerve stimulation to help strengthen control
Harvard Health Publishing Harvard Medical School: "Types of urinary incontinence."
National Institutes of Health National Institute on Aging: "Urinary Incontinence in Older Adults."
Office on Women's Health: "Urinary incontinence."
Urology Care Foundation: "Incontinence: Symptoms & Treatment."
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