Leakage may happen when you laugh, sneeze, lift heavy objects, or exercise. Activities like these can increase pressure on the bladder. The leakage may be caused by:

• Weakening of the muscles that suspend the bladder
• Weakening of the muscles that control urine flow
• Damage to the muscles that control urine flow following prostate surgery
• Obesity

This is also known as overactive bladder. It is 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. It may be caused by:

• Urinary tract infection
• Diabetes type 1 and 2
• Bladder irritation (eg, kidney stone, tumor)
• Drugs (eg, hypnotics, diuretics)
• Caffeine
• Alcohol
• Nerve damage due to:
  • Spinal cord injury
  • Stroke
  • Multiple sclerosis
  • Parkinson's disease
• Constipation

This occurs when the bladder will not empty. As a result, the urine builds up. This will cause an overflow and leaking of urine. It may be caused by:

• Prostate enlargement
• Bladder that is blocked, such as by a scar in the urethra (stricture)
• Fecal impaction putting pressure on the urethra
• Drugs (eg, antidepressants, hypnotics, antipsychotics, beta-blockers, antihistamines, calcium channel blockers)
• Vitamin B12 deficiency
• Weak bladder muscles
• Nerve damage

There is normal bladder control, but you are unable to reach the toilet in time. It may be a result of a condition like severe arthritis. Drugs which cause confusion or sedation can also cause functional incontinence.

Behavioral therapy includes:

• Making muscles stronger by doing Kegel exercises
  • This strengthens the muscles that hold the bladder in place and control urine flow.
  • Painless electrical stimulation is sometimes used. It can strengthen the muscles more quickly. It is helpful for stress incontinence.
• Bladder training: A regular schedule is set to empty your bladder. You will also be asked to drink fewer liquids.

Losing weight may help to 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.

Medicines may be prescribed to relax the bladder muscles. These types of medicines, called anticholinergics, are often used in treating urge incontinence. Examples include:

• Oxybutynin (Ditropan)
• Tolterodine (Detrol)
• Darifenacin (Enablex)
• Solifenacin (Vesicare)
• Fesoterodine (Toviaz)

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.

To stimulate the nerves, there are devices like Urgent PC and Inter-Stim. The procedure may involve implanting a thin lead wire with a small electrode tip. In some cases, the tibial nerve, which extends down to the ankle, is stimulated. This electronic stimulation therapy can be done as a series of treatments in the doctor's office.

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 also be used. Another option is a penile clamp. These clamps are padded and have a sleeve to absorb leakage.

Condom Catheter

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