What is urinary incontinence?
Urinary incontinence (UI) is the loss of urine control. It means you may not be able to hold your urine until you can reach a restroom. It may also be a short-term problem caused by another health issue or it may be a long-term problem that you’ll have to manage. UI can range from a slight loss of urine to severe, frequent wetting. The following are some of the different types of UI:
- Urge incontinence. This is when the need to urinate comes on very quickly. Often, you may not be able to get to a restroom in time. It’s common in people who have certain conditions such as diabetes, stroke, dementia, Parkinson disease, and multiple sclerosis. It may be a sign that these other conditions need attention. It’s more common in older adults and may be a sign of a urinary tract infection or an overactive bladder.
- Stress incontinence. This is the most common type of incontinence. It’s more common in women. You may leak urine during exercise, coughing, sneezing, laughing or lifting heavy objects; or when doing other movements that put pressure on the bladder.
- Functional incontinence. This is when you have urine control, but can’t get to a restroom in time. This may be due to conditions that make it hard to move, such as arthritis.
- Overflow incontinence. This is the leakage of urine caused by an over-filled bladder.
- Mixed incontinence. A mix of more than one of the types listed above.
What causes urinary incontinence?
Changes from certain diseases or medicines may cause UI. It may also happen at the start of an illness. Women are most likely to have incontinence during or after pregnancy and childbirth. Hormone changes of menopause may also cause it. This is because of weakened and stretched pelvic muscles. Some of the other common causes include:
- Birth defects
- Urinary tract infection (may be the first and only symptom)
- For men, an enlarged prostate gland or treatment of a prostate problem
- Stool buildup in the bowels
- Being overweight (this increases pressure on the bladder and the muscles that control it)
- Nerve damage from spinal cord injuries, diabetes, Parkinson disease, and multiple sclerosis
- Overactive bladder (the bladder squeezes at the wrong times and without warning)
The most common symptoms of UI are:
- Not being able to urinate
- Pain linked to filling the bladder or urinating without bladder infection
- Stream of urine gets weaker and weaker with or without a feeling that you have not emptied your bladder completely
- Urinate more frequently without bladder infection
- Needing to rush to the restroom or losing urine if you don't get to a restroom in time
- Abnormal urination or changes related to stroke, spinal cord injury, or multiple sclerosis
- Urine leakage associated with activities
- Leakage of urine that starts or continues after surgery
- Leakage of urine that causes embarrassment
- Frequent bladder infections
PIH Health Urology Specialist, Scott K Yun MD says, “Urinary incontinence treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.”
Treatment for UI depends on the cause and may include the following:
Behavioral therapies will to help you regain bladder control. They include:
- Bladder training. This teaches you to resist the urge to void and expand the times between voiding over time.
- Scheduled toileting. This therapy uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder every 2 to 4 hours to prevent leaking.
- Pelvic muscle rehab. This will improve pelvic muscle tone and prevent leakage. This treatment includes:
- Kegel exercises. Regular, daily exercise of pelvic muscles can make the bladder muscles stronger and improve, and even prevent, urinary incontinence. This is most helpful for younger women. Should be performed 30 to 80 times daily for at least 8 weeks.
- Biofeedback. Used along with Kegel exercises, biofeedback helps you gain awareness and control of your pelvic muscles.
- Vaginal weight training. Small weights are held within the vagina by tightening the vaginal muscles. This may be done for 15 minutes, twice daily, for 4 to 6 weeks.
- Pelvic floor electrical stimulation. Mild electrical pulses stimulate muscle contractions. This may be done along with Kegel exercises.
Other treatments may include:
- Medicines. This includes specific medicines for incontinence as well as estrogen therapy. These may be helpful along with other treatments for women with urinary incontinence who are past menopause.
- Surgery. This is an option if the incontinence is related to problems such as urethral hypermobility, an abnormally positioned bladder or a blockage. It may be used if other treatments don’t work, or if the incontinence is severe.
- Diet changes. This includes avoiding caffeine and alcohol and preventing chronic constipation. This may also include reducing fluid intake.
Dr. Yun also says, “Fear of wetting oneself out in public often keeps people from enjoying activities with family and friends. It’s important to talk to your doctor so you can be referred to a urologist for management and treatment options – and for help getting you back to living life, without fear.”
To schedule an appointment with a PIH Health Urology Specialist, call 562.907.7600. Learn more at PIHHealth.org/Urology.