Answer:

When you are not able to hold your urine until you can get to a bathroom, you have what's called urinary incontinence (also called loss of bladder control). There are many causes including infection, medications, weak muscles that control the bladder, a blockage created from an enlarged prostate, complications from surgery, or chronic diseases like diabetes, multiple sclerosis, and Parkinson’s disease. 

Answer:

More than 13 million Americans experience loss of bladder control. However, women suffer from incontinence twice as often as men do.

 

Both women and men can have trouble with bladder control from neurological (nerve) injury, birth defects, strokes, multiple sclerosis (MS), and physical problems associated with aging. Older women have more bladder control problems than younger women do. Loss of bladder control in women most often happens because of problems with the muscles that help to hold or release urine.

Answer:

 

• Stress incontinence - Leaking small amounts of urine during physical movement (coughing, sneezing, exercising). Stress incontinence is the most common form of incontinence in women. It is treatable.
• Urge incontinence - Leaking large amounts of urine at unexpected times, including during sleep, after drinking a small amount of water, or when you touch water or hear it running.
• Functional incontinence - Not being able to reach a toilet in time because of physical disability, obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet. For example, a person with Alzheimer's disease may not think well enough to plan a trip to the bathroom in time to urinate or a person in a wheelchair may be blocked from getting to a toilet in time.
• Overflow incontinence - Leaking small amounts of urine because the bladder is always full. With this condition, the bladder never empties completely.
• Mixed incontinence - A combination of incontinence, most often when stress and urge incontinence occur together.
• Transient incontinence - Leaking urine on a temporary basis due to a medical condition or infection that will go away once the condition or infection is treated. It can be triggered by medications, urinary tract infections, mental impairment, restricted mobility, and stool impaction (severe constipation).

Answer:

To diagnose the problem, your health care provider will first ask you about your symptoms, your medical history, and do a physical exam. You will also be asked about your bladder habits: how often you empty your bladder, how and when you leak urine, or when you have accidents.

Next you may be asked to drink plenty of fluids so a test may be done to figure out how much your bladder can hold and how well your bladder muscles function.  Other tests include:

• Stress test - You relax, then cough hard as the provider watches for loss of urine.

• Urinalysis - You give a urine sample that is then tested for signs of infection or other causes of incontinence.
• Blood tests - You give a blood sample, which is sent to a laboratory to test for substances related to the causes of incontinence.
• Ultrasound - Sound waves are used to take a picture of the kidneys, bladder, and urethra, so any problems in these areas that could cause incontinence can be seen.
• Cystoscopy - A thin tube with a tiny camera is placed inside the urethra to view the inside of the urethra and bladder.

• Urodynamics - Pressure in the bladder and the flow of urine are measured using a special technique.

Answer:

Accidental loss of urine can be caused by extra weight. If you are overweight, diet and exercise program to help you lose weight and  may improve incontinence.

Certain foods and drinks can cause incontinence, such as caffeine (in coffee, soda, chocolate), tea, and alcohol. Restricting these foods and liquids in your diet may reduce incontinence.

Answer:

There are a number of ways to treat incontinence.

• Exercise - Simple exercises to strengthen the muscles that help hold urine, also called Kegel exercises, can help both men and women. Taking a few minutes each day to do these exercises can help to reduce or cure stress leakage .
• Electrical Stimulation - Brief doses of electrical stimulation can strengthen muscles in the lower pelvis.  This treatment can be used to reduce both stress incontinence and urge incontinence.
• Biofeedback - Biofeedback uses measuring devices to help you become aware of your body's functioning. A wire connected to an electrical patch is linked to a screen which can show you when muscles contract, so you can learn to gain control over bladder muscles.
• Timed Voiding or Bladder Training – These techniques help train your bladder and hold urine better. With bladder training you can change your bladder's schedule for storing and emptying urine.
• Dryness Aids - Absorbent pads or diapers help, but they do not cure bladder control problems. Some people use urinals (pans) beside their beds when they sleep if they suffer from urge incontinence.

Answer:

 

• Oxybutynin (Ditropan) prevents urge incontinence by relaxing muscles of the bladder. Their most common side effect is dry mouth, although larger doses may cause blurred vision, constipation, a faster heartbeat, and flushing .
• Tolterodine (Detrol, Detrol LA) is indicated for the treatment of an overactive bladder with symptoms of urinary frequency, urgency, or urge incontinence.
• Estrogen , either oral or vaginal, may be helpful in conjunction with other treatments for postmenopausal women with urinary incontinence.
• Imipramine hydrochloride (Tofranil), a tricyclic antidepressant that relaxes bladder muscles and tightens urethral muscles, may be used instead of or in combination with Ditropan or Detrol LA. Side effects may include fatigue, dry mouth, dizziness, blurred vision, nausea, and insomnia.

Answer:

 

• Implants - Substances are injected (through a needle) into tissues around the urethra. The implant adds bulk and helps the urethra to stay closed.
• Surgery - This treatment is primarily used only after other treatments have been tried. Different types of surgery can be done, including surgeries that raise, or lift, the bladder up to a more normal position. 
• Pessary –This is a stiff ring that is inserted by a health care provider into the vagina, where it presses against the wall of the vagina and the nearby urethra. The pressure helps to hold up the bladder and reduce stress leakage.
• Urethral Inserts – This is a small device that you place inside the urethra. You remove the device when you go to the bathroom and then put it back into your urethra until you need to urinate again.
• Urine Seals - Urine seals are small foam pads that you place over the urethra opening. The pad seals itself against your body, keeping you from leaking. You remove and throw it away after urinating. You then place a new seal over the urethra.