Urinary incontinence is a loss of control of the bladder. In some cases, it may result in a total loss of the bladder’s contents or it may just cause minor leakage. The condition may be temporary or chronic, depending on its cause.
Incontinence can be a symptom of many different health problems, ranging from cancer to kidney stones to an enlarged prostate. It can also be a natural result of the aging process, since your bladder muscles become weaker as you get older.
According to the American Academy of Family Physicians, millions of Americans suffer from urinary incontinence. While the condition is more common among women and those over 50 years of age, anyone be affected by temporary or chronic incontinence. (AAFP)
You should see a doctor for any instance of incontinence. The condition interferes with your daily life, and can possibly be a symptom of a very serious condition.
Urinary incontinence is divided into three different categories, or types. However, you may experience a mix of the types or all three.
One in ten people over age 65 has a problem with bladder control. Among the more common problems are not being able to hold your urine until you get to the bathroom and urinating unexpectedly when sneezing, coughing, or laughing. In most cases, bladder control problems can be successfully treated.
Urge incontinence occurs when you feel a sudden and strong urge, or need, to urinate. Very soon after the urge strikes, you lose control of your bladder. Often, you do not have time between the urge and the loss of urine to make it to a bathroom.
This type occurs when you urinate but do not completely empty the bladder. Later, you may lose some urine. Overflow incontinence can also be called dribbling.
There are many causes of urinary incontinence—including physical damage, aging, cancer, infection, and neurological disorder. Some of these conditions will only result in temporary urinary problems and are easily treated, while others are more serious and persistent.
Some cases of incontinence are temporary. Often, these instances are caused by an external, or lifestyle, factor. Drinking alcohol, caffeinated beverages, or too much of any fluid can cause a temporary loss of bladder control. Some medications—such as blood pressure drugs, muscle relaxants, sedatives, and some heart medications—may also lead to a short spell of incontinence.
Certain conditions may also cause temporary incontinence. Constipation can increase the need to urinate because the compacted stool can make the nerves controlling your bladder overact. A urinary tract infection may also lead to instances of incontinence.
As you age, your bladder muscle becomes weaker and incontinence becomes more likely. Any issues with your blood vessels will make this situation worse. The healthier you are, the better your chances of avoiding incontinence as you age.
Any damage caused to your pelvic floor muscles can lead to incontinence, since these muscles support your bladder. In some cases, they can be damaged or weakened by surgery—usually during a procedure to remove the uterus—or during childbirth.
In nearly all men, the prostate gland enlarges with age. It is common for men to experience some incontinence as a result.
Prostate cancer in men, or bladder cancer in men or women, can cause incontinence. In some cases, the cancer’s treatment will cause incontinence as a side effect. A tumor, whether malignant or benign, can also cause incontinence by blocking the usual flow of urine. Kidney or bladder stones can have the same effect.
Less Common Causes
Prostatitis, or the inflammation of the prostate, and interstitial cystitis, a chronic condition of the bladder that causes pain, can occasionally cause incontinence.
Any instance of incontinence is reason to seek medical help. It may be a symptom of a more serious condition that needs to be treated. Even if the underlying cause is not life threatening, incontinence can be a major disruption in your life, and you should discuss your treatment options with your doctor.
You should seek immediate emergency medical attention if you lose control of your bladder and also experience any of the following symptoms:
- trouble speaking or walking
- weakness or tingling in any part of your body
- loss of vision
- loss of consciousness
During your appointment, your doctor will ask you a series of questions and perform a physical exam. He or she will want to know how long you have been incontinent, which type of incontinence you are experiencing, and many other details of your physical symptoms. You will also be asked about your daily habits, what you typically eat and drink, and any medications or supplements that you take.
If your doctor cannot diagnose the underlying cause after the questions and physical exam, he or she will probably order additional tests. One possible test is a cystoscopy, in which a small camera is inserted into your bladder so your doctor can see it up close.
You may also need to provide a urine sample for analysis. Your doctor may want to measure the amount of urine that you get rid of, the amount left over in your bladder, and the pressure in your bladder. This information is gathered by inserting a catheter, or a small tube, into your urethra and then your bladder.
There are certain steps you can take at home to make living with incontinence easier. Your doctor can explain how you can strengthen your pelvic floor muscles, if this is the cause of your incontinence. It may involve urinating on a strict schedule or doing exercises to work the muscles.
You can also arrange your home to help you better manage your incontinence. You can make sure you have a clear and easy path to the bathroom, keep a night light on to make getting to the toilet easier in the dark, and use absorbent undergarments when you leave the house to prevent accidents.
You cannot prevent all cases of urinary incontinence, but there are some steps you can take to reduce your risk. Try to live a healthy lifestyle—maintain a healthy weight, avoid smoking, get plenty of exercise, and eat well. Be sure to have enough fiber in your diet, in order to prevent constipation. You should also avoid foods and drinks that seem to lead to episodes of incontinence, such as coffee or alcohol.
Written by: Mary Ellen Ellis
Medically reviewed by George Krucik, MD