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Incontinence & Overactive Bladder Health Center

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Frequently Asked Questions About Urinary Incontinence

  • What is urinary incontinence and what causes it?
  • Answer:

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

  • Who gets urinary incontinence?
  • Answer:

    More than 13 million Americans experience urinary incontinence. 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, 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 and can be made worse by menopause.

  • What are the different types of urinary incontinence?
  • Answer:

    •  Stress incontinence: Leaking small amounts of urine during physical movement (like coughing, sneezing, and exercising ). Stress incontinence is the most common form of incontinence in women. It is treatable.
    • Urge incontinence/overactive bladder: An uncontrollable urge to urinate or 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. 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 unable to get to a toilet in time due to immobility.
    • Overflow incontinence: Leaking small amounts of urine; the bladder never empties completely. This could be due to nerve damage or an obstruction.  
    • 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).

     

  • How is urinary incontinence diagnosed?
  • Answer:

    To diagnose urinary incontinence, your health care provider will first ask you about your symptoms and 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, for example.

    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. This should be done in an upright position.
    • 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. Also residual urine can be estimated in a poorly emptying bladder
    • Cystoscopy: A thin tube with a tiny camera is placed inside the urethra to view the inside of the urethra and bladder and look for abnormalities.
    • Urodynamics: Pressure in the bladder and the flow of urine are measured using a special technique.

     

  • Will weight loss or diet changes help improve urinary incontinence?
  • Answer:

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

  • Is there anything aside from medications that I can use to treat urinary 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 especially when combined with weight loss in the obese patient.
    • 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 to 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.

     

  • What medications are available to treat urinary incontinence?
  • Answer:

    • Ditropan prevents urge incontinence by relaxing muscles of the bladder. The most common side effect is dry mouth, although larger doses may cause blurred vision, constipation, a faster heartbeat, and flushing.
    • Detrol or 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.
    • 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.

     

  • What other urinary incontinence treatments are available?
  • 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 using a "sling" or other materials.
    • 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.

     

WebMD Medical Reference

Reviewed by Varnada Karriem-Norwood, MD on February 21, 2013

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