Incontinence

Urinary incontinence (UI) is loss of urine control due to changes in body function that result from diseases, use of certain medications or onset of an illness. It can occur in men and women at any age, but is particularly common in older women, over age 50. Urinary incontinence may be a temporary or permanent issue stemming from a medical procedure, pregnancy/childbirth or hormonal changes with menopause. The severity can range from slight urine leaks to severe, frequent wetting.

If you are having symptoms of urinary incontinence, find a doctor by calling 800-777-7775.

Symptoms of Urinary Incontinence

The following are common symptoms of urinary incontinence. If you experience any of these symptoms, consider seeing your doctor for an evaluation.

• Increased rate of urination without bladder infection
• Feeling that the bladder does not empty completely or weak urine stream
• Inability to urinate
• Pain related to filling or emptying the bladder with no underlying infection
• Need to rush to the restroom or not making it in time
• Abnormal urination
• Leakage that prevents daily activities or causes embarrassment
• Leakage after surgery
• Frequent bladder infections

Types of Urinary Incontinence

Stress incontinence—The most common type of incontinence occurs with physical movements that put strain or pressure on the bladder. Examples are sneezing, coughing, lifting and laughing.

Urge incontinence—When the bladder gives you the sensation of “needing to go” immediately—often too late. Urgency can occur with only a small amount of urine in the bladder because the muscles are squeezing when they shouldn’t. Abnormal nerve signals may cause bladder spasms which lead to frequent trips to the bathroom. An overactive bladder may also produce this type of urgency.

Functional incontinence—Occurs when medical conditions or physical mobility limitations interfere with toileting. Examples could include arthritis, being wheelchair bound, or cognitive impairment due to dementia.

Overflow incontinence—Occurs when there is too much urine for the bladder to contain or the bladder never completely empties, causing constant dribbling. It is generally a result of weak bladder muscles or a blocked urethra, but can also be a result of nerve damage from diabetes, urinary stones or tumors.

Diagnosing Urinary Incontinence

It is important to make an appointment with a physician for a physical exam and urinary system evaluation. Evaluation procedures may include: a bladder stress test, urinalysis and urine culture, ultrasound, cystoscopy, and/or urodynamics. Your physician may refer you to a urologist, a doctor that specializes in diseases of the urinary tract.

Maintain a diary prior to the appointment noting your pattern of voiding (urinating). Include the time of day/night, the approximate amount of urine you produce, and your fluid intake. Share your incontinence diary with your physician.

Incontinence Treatment Options

Treatment for urinary incontinence may include behavioral therapy, physical therapy, dietary modifications, medication or surgery.

• Physical therapy for pelvic muscles can help improve pelvic muscle tone and prevent leakage. Rehabilitation options include:
  • Kegel exercises
  • Biofeedback
  • Vaginal weight training
  • Pelvic floor electrical stimulation for urge reduction
• Behavioral therapy, such as bladder training and toileting schedules, can help manage urgency and poor bowel/bladder habits.
• Dietary changes may include avoiding foods or drinks that irritate the bowels and bladder, such as caffeinated drinks or alcohol.
• Medical therapy may include use of medications that help decrease urge and reduce overactive bladder by relaxing the muscles of the bladder.
• Surgical treatment may be used to correct structural problems, such as a blockage or abnormally positioned bladder. Other surgical options include slings, injection therapy and neuromodulation (InterStim) to control the nerves of the bladder.