Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Urinary incontinence is the loss of voluntary bladder control that can lead to urine leakage. Incontinence can be temporary or long-lasting. It is a symptom, not a condition.

Causes

The causes may vary with the type of incontinence.

The leakage may be caused by:

This is also known as overactive bladder. It may be caused by:

This occurs when the bladder will not empty. The urine builds up and overflows. This leads to leaking of urine. It may be caused by:

This is when you have normal bladder control, but you are unable to reach the toilet in time. It may be a result of a condition like severe arthritis. Drugs that cause confusion or sedation can also lead to functional incontinence.

Risk Factors

Factors that may increase your risk of incontinence include:

Symptoms

Urinary incontinence is a symptom of other conditions. Any loss of bladder control can be considered incontinence.

With stress incontinence, leakage may happen when there is extra pressure on your bladder. This can happen when you laugh, sneeze, lift heavy objects, or exercise.

With urge incontinence, you may have a loss of bladder control following a strong urge to urinate. You may not be able to hold urine long enough to make it to a toilet.

Call your doctor if you have a loss of urine control. Your doctor can help you determine the underlying cause.

Diagnosis

Your doctor will ask about your symptoms and medical history. You will be asked about your urine leakage and how often you empty your bladder. A physical exam will be done to look for any physical causes. These include blockages or nerve problems. Your doctor may ask you to keep a diary of your urinary habits.

You may be referred to a specialist. Urologists are doctors who focus on urinary issues.

Tests to help find the cause of the incontinence may include:

Treatment

Treatments may include:

Behavioral therapy includes:

  • Making muscles stronger by doing Kegel exercises
    • These strengthen the muscles that hold the bladder in place and control urine flow.
    • Painless electrical stimulation is sometimes used. It can strengthen the muscles more quickly. It is helpful for stress incontinence.
  • Creating a regular schedule to empty your bladder (called bladder training). This training may also involve drinking fewer liquids

Losing weight may help reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a weight loss program that is right for you.

Medicines may be prescribed to relax the bladder muscles. These types of medicines are called anticholinergics. They are often used in treating urge incontinence. Examples include:

  • Oxybutynin (Ditropan)
  • Tolterodine (Detrol)
  • Darifenacin (Enablex)
  • Solifenacin (Vesicare)
  • Fesoterodine (Toviaz)

Absorbent diapers are often used by men with incontinence.

Catheters are sometimes used to treat more severe cases. External (condom) or internal (Foley) catheters may be used.

Another option is a penile clamp. These clamps are padded and have a sleeve to absorb leakage.

Condom Catheter

condom catheter
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  • Take care of your skin by gently cleaning yourself after an episode of incontinence. Let the skin air dry.
  • Make it easier to get to the bathroom. For example, rearrange furniture and remove throw rugs. Add night-lights in the hallway and in the bathroom.
  • If needed, keep a bedpan or urine canister handy in your bedroom.

Devices like Urgent PC and Inter-Stim may be used to stimulate the nerves. This may involve implanting a thin lead wire with a small electrode tip. This electronic stimulation therapy can be done as a series of treatments in your doctor's office.

In men, surgery may be done to relieve a physical blockage due to an enlarged prostate.

Other procedures involve surgical repair or implants into the bladder sphincter. The sphincter is the gate that allows the urine to flow through.

Prevention

Incontinence is really a symptom of another condition. There are several ways to prevent incontinence:

  • Reduce your intake of substances that lead to incontinence. These include caffeine, alcohol, and certain drugs.
  • Lose weight.
  • Avoid and treat constipation.