Urinary incontinence is the loss of voluntary bladder control leading to urine leakage. It can be temporary or chronic (lasts for a long time). Incontinence is a symptom, not a condition in and of itself.
Endocrinological disorders (for example,
More permanent urinary incontinence may be one of four types. Some people have a mixture of these types. In some cases, incontinence may have several different causes. The cause may also be unclear.
This results when certain activities lead to increased pressure on the bladder. Triggers may be laughing, sneezing,
lifting heavy objects
, or exercise. This is the most common type of incontinence. It may be caused by:
Urge incontinence is a loss of bladder control following a strong urge to urinate. The person is not able to hold urine long enough to make it to a restroom. This is also known as overactive bladder. It may be caused or worsened by:
This occurs when there is normal bladder control, but an inability to reach the toilet in time. An example would be severe
. Drugs that cause confusion or sedation can also cause functional incontinence.
These risk factors increase your chance of developing urinary incontinence.
Tell your doctor if you have any of these risk factors:
Urinary incontinence is a symptom of other conditions. Any loss of bladder control can be considered incontinence.
The doctor will ask about your symptoms and medical history. You will be asked how often you empty your bladder and patterns of urine leakage. Your doctor will perform a physical exam to look for any physical causes, such as blockages or nerve problems. You will keep a diary of your bladder habits. You may be referred to a urologist or a urogynecologist.
Tests may include:
Stress test—You relax then cough as your doctor watches for loss of urine. This will confirm if you have stress incontinence.
Blood tests to detect diabetes
—a test that uses sound waves to examine structures inside the body to determine the residual urine volume after voiding
Cystoscopy—a thin tube with a tiny camera is inserted in the urethra to view the urethra and bladder
Urodynamic tests—tests used to measure the flow of urine and pressure in the bladder
This strengthens the muscles that hold the bladder in place and those that control urine flow.
Painless electrical stimulation is sometimes used to strengthen the muscles more quickly and is helpful for stress incontinence.
This can be done by setting a regular, timed schedule for emptying your bladder and by drinking fewer liquids.
If you are a woman who is overweight or
obese, losing weight may help to reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a
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that is right for you.
Medicines may be prescribed to relax the bladder muscles. These types of medicines, called anticholinergics, are often used in treating urge incontinence. Examples include:
Nerve stimulation is effective for urge urinary incontinence. It can be done by stimulating a nerve in your ankle. Or, it can be done by implanting a device that stimulates the bladder nerves.
In women, surgery can repair weakened muscles related to bladder function. Other procedures involve collagen injections into the urethra. The bladder sphincter can be repaired or implants can be inserted.
Absorbent diapers are often used with incontinence.
Plugs and patches that hold urine in place are available for women.
are sometimes used to treat more severe cases. Alternatively, pessaries may be used in women.
Pessaries are devices that raise the uterus or the prolapsed bladder. This decreases pressure on the bladder.
Incontinence is really a symptom of another condition. There are several ways to prevent incontinence:
If advised by your doctor, do Kegel exercises.
Reduce your intake of substances that lead to incontinence (eg, caffeine, alcohol, and certain drugs).
Corcos J, Gajewski J, Heritz D, et al. Canadian Urological Association guidelines on urinary incontinence.
Can J Urol
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Overactive bladder. American Urological Association Foundation website. Available at:
. Updated July 2009. Accessed October 31, 2009.
Overactive bladder treatment. National Association for Continence website. Available at:
. Updated July 2009. Accessed November 2, 2009.
Sobhgol SS, Charandabee SM. Related factors of urge, stress, mixed urinary incontinence, and overactive bladder in reproductive age women in Tabriz, Iran: a cross-sectional study.
Int Urogynecol J Pelvic Floor Dys Function
Surgical management of urinary incontinence. American Urological Association Foundation website. Available at:
. Updated September 2003. Accessed October 31, 2009.
Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management.
2/5/2009 DynaMed's Systematic Literature Surveillance
: Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women.
N Engl J Med.
3/5/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: Vardy MD, Mitcheson HD, Samuels TA, et al. Effects of solifenacin on overactive bladder symptoms, symptom bother and other patient-reported outcomes: results from VIBRANT—a double-blind, placebo-controlled trial. Int J Clin Pract. 2009;63(12):1702-1714.
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