Urinary incontinence is the loss of voluntary bladder control that can lead to urine leakage. Incontinence can be temporary or long-lasting. It's a symptom, not a condition.
Types of Urinary Incontinence
Leakage may be caused by:
- Weak muscles that suspend the bladder
- Weak muscles that control urine flow
- Damage to the muscles that control urine flow following prostate surgery
Urge Incontinence (Overactive Bladder)
The causes of overactive bladder include:
- Urinary tract infection
- Diabetes type 1 and type 2
- Bladder irritation (such as kidney stone or tumor)
- Drugs (such as hypnotics or diuretics)
- Nerve damage due to:
- Spinal cord injury
- Multiple sclerosis
- Parkinson's disease
Overflow incontinence occurs when the bladder will not empty, which causes urine to build up and overflow. This leads to 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 (such as antidepressants, hypnotics, antipsychotics, beta-blockers, antihistamines and calcium channel blockers)
- Vitamin B12 deficiency
- Weak bladder muscles
- Nerve damage
Functional incontinence occurs when you have normal bladder control, but you're 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.
Are You at Risk?
Factors that may increase your risk of incontinence include:
- Age: older than 65
- History of prostate surgery
- Prostate enlargement due to benign prostatic hyperplasia (BPH), infection or prostate cancer
- Urinary tract infection
- Chronic lung disease
- Dementia, including Alzheimer’s disease
- Multiple sclerosis
- Spinal cord injury or disease
- Use of certain substances or medicines:
- Cholinergic agents
Symptoms of Urinary Incontinence
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 a loss of urine control. Your doctor can help you determine the underlying cause.
Your doctor will ask about your symptoms, medical history and perform a physical exam. Your doctor may ask you to keep a diary of your urinary habits.
Tests to help find the cause of the incontinence may include:
- Stress test — you relax and then cough as your doctor watches for loss of urine (this will confirm if you have stress incontinence)
- Urine tests
- Prostate exam
- Blood tests
Treating Male Urinary Incontinence
Behavioral therapy includes:
- Making muscles stronger by doing Kegel exercises, which strengthen the muscles that hold the bladder in place and control urine flow
- Painless electrical stimulation can strengthen the muscles more quickly; helpful for stress incontinence
- Creating a regular schedule to empty your bladder (called bladder training); may also involve drinking fewer liquids
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.
Your doctor may prescribe anticholinergics to relax the bladder muscles and treat urge incontinence.
Devices for Incontinence
Depending on the severity of your condition, your options may include:
- Absorbent diapers
- Catheters; external (condom) or internal (Foley) catheters
- Penile clamp, which is padded and has a sleeve to absorb leakage
Tips for your home that can help:
- Take care of your skin by gently cleaning yourself after an episode of incontinence. Let the skin air dry.
- Make it easier to get to the bathroom. For example, rearrange furniture and remove throw rugs. Add night-lights in the hallway and in the bathroom.
- If necessary, keep a bedpan or urine canister handy in your bedroom.
Devices like Urgent PC and Inter-Stim can stimulate the nerves. Your doctor implants a thin lead wire with a small electrode tip. Therapy can be done as a series of treatments in your doctor's office.
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.
Steps to prevention include:
- Reduce your intake of substances that lead to incontinence. These include caffeine, alcohol, and certain drugs.
- Lose weight.
- Avoid and treat constipation.
MAKE AN APPOINTMENT
Call the Urology Clinic.
Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.