What is urinary incontinence?

Urinary incontinence means that you can’t always control your bladder function when you urinate. As a result, you wet your clothes. This can be embarrassing, but it can be treated.

About 12 million adults in the United States have urinary incontinence. It’s most common in women over 50 years old, but it can also affect men and younger people, especially women who have just given birth. Be sure to talk to your doctor if you have this problem. If you hide your incontinence, you risk getting rashes, sores, and skin and urinary tract infections. Also, you may find yourself avoiding friends and family because of fear and embarrassment.

 

What Causes Incontinence?

Urinary incontinence can be caused by many different medical problems, including weak pelvic muscles or diabetes. (See section below)

 

Causes of urinary incontinence:

• For women, thinning and drying of the skin in the vagina or urethra, especially after menopause

• For men, enlarged prostate gland or prostate surgery

• Weakened pelvic muscles

• Certain medicines

• Build-up of stool in the bowels

• Not being able to move around

• Urinary tract infection

• Problems such as diabetes or high calcium levels

Are there different types of incontinence?

Yes. There are 4 types of urinary incontinence. A brief explanation of each follows.

Stress incontinence
Stress incontinence is when urine leaks because of sudden pressure on your lower stomach muscles, such as when you cough, laugh, lift something or exercise. Stress incontinence usually occurs when the pelvic muscles are weakened, for example by childbirth or surgery. Stress incontinence is common in women.

 

Urge incontinence
This occurs when the need to urinate comes on too fast—before you can get to a toilet. Your body may only give you a warning of a few seconds to minutes before you urinate. Urge incontinence is most common in the elderly and may be a sign of an infection in the kidneys or bladder.

 

Overflow incontinence
This type of incontinence is a constant dripping of urine. It’s caused by an overfilled bladder. You may feel like you can’t empty your bladder all the way and you may strain when urinating. This often occurs in men and can be caused by something blocking the urinary flow, such as an enlarged prostate gland or tumor. Diabetes or certain medicines may also cause the problem.

 

Functional incontinence
This type occurs when you have normal urine control but have trouble getting to the bathroom in time. You may not be able to get to the bathroom because of arthritis or other diseases that make it hard to move around.

Is urinary incontinence just part of aging?

No. But changes with age can reduce how much urine your bladder can hold. Aging can make your stream of urine weaker and can cause you to feel the urge to urinate more often. This does not mean you will have urinary incontinence just because you’re aging. With treatment it can be controlled or cured.

 

How can it be treated?

Treatment depends on what’s causing the problem and what type of incontinence you have. If your urinary incontinence is caused by a medical problem, the incontinence will go away when the problem is treated. Pelvic floor muscle exercises and bladder training help some types of incontinence. Medicine and surgery are other options.

 

What are Pelvic Floor Muscle Exercises?

Stress incontinence can be treated with special exercises called pelvic floor muscle exercises (see section below). These exercises help strengthen the muscles that control the bladder. They can be done anywhere, any time. Although designed for women, these exercises can also help men. It may take 3 to 6 months to see an improvement.

 

Pelvic Floor Muscle Exercises

• To locate the right muscles, try stopping or slowing your urine flow without using your stomach, leg or buttock muscles. When you are able to slow or stop the stream of urine, you have located the right muscles.

• Squeeze your muscles. Hold for a count of 10. Relax for a count of 10.

• Do this 20 times, 3 to 4 times a day.

• You may need to start slower, perhaps squeezing and relaxing your muscles for 4 seconds each and doing this 10 times, 3 or 4 times a day. Work your way up from there.

Why do I leak urine when I cough or sneeze?

You have what is called “stress incontinence”. It happens when extra pressure is placed on the abdomen which, in turn, puts pressure on the bladder. Coughing, sneezing, laughing, lifting heavy objects, playing tennis and jumping are examples of activities that can cause stress incontinence.

 

Normally, the bladder is held firmly in place by muscles and connective tissue in the pelvis. If these muscles are weak, extra abdominal pressure can push the bladder and urethra (bladder opening) downward, open the urethra, and cause small amounts of urine to spurt out. Stress incontinence can also happen if the sphincter (the muscle surrounding the urethra) is weak or damaged.

 

I have to get up to go to the bathroom two or three times every night. Is this normal, or should I be concerned?

A frequent night time visit to the bathroom to urinate is called “nocturia”. Several things can cause this condition.

 

Some fluids, including coffee and alcohol, increase the need to urinate frequently. If you drink a lot—especially the fluids that increase urination—you may have to go to the bathroom frequently during the night. Decreasing the amount you drink in the evening may decrease the number of times you need to go to the bathroom at night.

 

Some people have weak hearts and other conditions that cause fluid to collect in their legs and ankles during the day. When they lie down at night, the fluid from their legs and ankles moves back into their circulatory system, through the kidneys and into the bladder. This causes them to have to go to the bathroom during the night.