Urinary incontinence is the loss of voluntary bladder control that can lead to urine leakage. Incontinence can be temporary or long-lasting.
The causes may vary with the type of incontinence.
The accidental loss of urine during physical activity or coughing, sneezing, and laughing
The leakage may be caused by:
This is also known as overactive bladder and is the accidental loss of urine when the bladder spasms for no reason. 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 physically 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.
There may be several different causes for incontinence. In some cases, the cause may also be unclear.
Men who are older than 65 are most affected.
Factors that may increase your risk of incontinence include:
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 any loss of urine control. Your doctor can help you determine the underlying cause.
You will be asked 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. You may be asked to 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:
Treatments may include:
Behavioral therapy includes:
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.
Medications may be prescribed to relax the bladder muscles. These types of medications are called anticholinergics. They are often used in treating urge incontinence. Examples include:
Your doctor may also recommend botulinum toxin injections to help ease symptoms.
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.
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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 and can help strengthen muscles that control voiding.
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.
National Institute of Diabetes and Digestive and Kidney Diseases
Urology Care Foundation
Canadian Nurse Continence Advisors Association
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12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int. 2010;106(6):816-821.
7/28/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mangera A, Apostolidis A, et al. An updated systematic review and statistical comparison of standardised mean outcomes for the use of botulinum toxin in the management of lower urinary tract disorders. Eur Urol. 2014;65(5):981-990.
Last reviewed October 2014 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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