Risk Factors For Urinary Incontinence
The following factors may put you at higher risk for developing UI.
Being female Women experience stress incontinence twice as often as men. Men, on the other hand, are at greater risk for urge and overflow incontinence.
Advancing age As we get older, our bladder and urinary sphincter muscles often weaken, which may result in frequent and unexpected urges to urinate. Even though incontinence is more common in older people, it is not considered a normal part of aging.
Excess body fat Extra body fat increases the pressure on the bladder and can lead to urine leakage during exercise or when coughing or sneezing.
Other chronic diseases Vascular disease, kidney disease, diabetes, prostate cancer, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, and other conditions may increase the risk of urinary incontinence
Smoking A chronic smoker’s cough can trigger or aggravate stress incontinence by putting pressure on the urinary sphincter.
High-impact sports While sports don’t cause incontinence, running, jumping, and other activities that create sudden pressure on the bladder can lead to occasional episodes of incontinence during sports activities.
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What Is The Treatment For Urinary Incontinence
The most appropriate treatment for urinary incontinence will depend on what is causing it.
If the problem is with your pelvic floor muscles, physiotherapy can make a big difference. Medicine can help to relax the bladder muscles, which can help with urge incontinence. Talk to your doctor about whether medicine is right for you.
Some lifestyle changes may also help to treat urinary incontinence. These include:
If medicine, physiotherapy or lifestyle changes dont work, surgery to support your bladder and urethra is an option for some types of urinary incontinence.
You can also try to train your bladder to improve control and increase the amount of urine you can hold. Talk to your doctor or incontinence health professional about a bladder training program.
If you are caring for someone with incontinence, make sure they can access the toilet easily and that its clearly signposted. Make sure their clothing is easy to remove and monitor their routine so you can remind them to go to the toilet regularly. You can read more about caring for someone with incontinence on the Continence Foundation of Australia website.
Expert Review And References
- Urinary incontinence. American Society of Clinical Oncology . Cancer.Net. Alexandria, VA.: American Society of Clinical Oncology 2013.
- Landier W, Smith S. Late effects of cancer treatment. Yarbro, CH, Wujcki D, & Holmes Gobel B. . Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett 2011: 71: pp. 1756-1779.
- Shenot PJ. Urinary incontinence in adults. Beers, M. H., & Berkow, R., . Merck Manual for Healthcare Professionals. Rahway, NJ: Merck Research Laboratories 2012.
- Vorvick LJ. Urinary incontinence. PubMed Health. U.S. National Library of Medicine 2011.
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How I Manage Incontinence And Bladder Control
What many refer to sarcastically as adult diapers became, and to this day are, one of my best friends. I wear adult underwear any time I step foot out my front door, and if Im having a bad day in my house too. I dont want any mishap on my furniture, or when my family or friend are visiting. When you have end-stage COPD incontinence becomes a regular occurrence. Whenever I go out I not only wear protective underwear, I also carry an extra pair and some feminine wipes with me. I keep them in a small zippered bag, if I lose control and pee my pants, as soon as I can I go to a restroom, clean up, and Im good to go again. The best part is no one knows what has occurred but me, no embarrassment, no weird looks. I know a lot of people refuse to wear adult underwear, they feel there is a stigma attached. In their minds wearing adult underwear is undignified, unmanly or un-womanly. Dont become one of them, there are all types of products for dealing with incontinence.
Editors Note: We are extremely saddened to say that on March 2, 2018, Mary Ultes passed away. Mary was an engaged advocate for the COPD community who strived to help people live fulfilling lives. She is deeply missed.
What To Do About It
It is important to talk to your healthcare provider to determine the underlying cause of your problem. They will consider your symptoms and then help create a plan of action. Some of the treatment options for loss of bladder and bowel control may include the following:
When other treatments do not produce desired results, you may consider undergoing surgery. Your doctor tries to repair any damage to the nerves and muscles to prevent loss of bladder and bowel control.
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Begin By Talking To Your Doctor
What should you do if youre experiencing bladder problems? First, speak up. People often dont bring up issues of incontinence with their clinical providers, either due to embarrassment or because they feel there are no available options that can helpor that surgery may be the only option, says Tomas Griebling, M.D., professor of urology and senior associate dean for medical education at the University of Kansas School of Medicine. But the symptoms can almost always be eased, Hochman says.
So start by working with a general practitioner, who can determine whether there may be an underlying cause for your symptoms. Urgency, incontinence, and urinary frequency can be caused by urinary tract infections or kidney stonesor, in men, a prostate infection or prostate enlargement. Medication you take to treat other conditions, such as anxiety, depression, high blood pressure, insomnia, and pain, can also lead to bladder leaks.
Your doctor might ask you to keep a diary of how often you urinate, when you have leaks, and how much liquid you consume. That will help define the problem and pinpoint the triggers.
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When Should I See A Health Care Professional
See a health care professional if you have symptoms of a bladder problem, such as trouble urinating, a loss of bladder control, waking to use the bathroom, pelvic pain, or leaking urine.
Bladder problems can affect your quality of life and cause other health problems. Your health care professional may be able to treat your UI by recommending lifestyle changes or a change in medicine.
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When Should I See My Doctor
Most women who leak urine after childbirth find that it goes away in the first few weeks, as the stretched muscles and tissues recover.
However, for some women it can take months while other women find their pelvic floor never recovers fully.
If you are still experiencing leakage after 6 months, talk to your midwife or doctor. Dealing with it early on can reduce the risk of it becoming a life-long problem.
Stress incontinence is common, but many women are too embarrassed to talk about it. However, doctors, midwives, maternal and child health nurses and continence nurses are used to talking about it. If you are experiencing leakage, they will have suggestions that can help.
What Are The Different Types Of Bladder Control Issues
There are different types of bladder control issues, including:
- Stress incontinence. Sudden stress on your bladder causes stress incontinence. Common causes include coughing, sneezing, laughing, lifting and physical activity. Younger and middle-aged women and people assigned female at birth near or experiencing menopause are most likely to have stress incontinence.
- Urge incontinence. Urge incontinence occurs when you have an urge to pee but cant make it to the bathroom in time. Urge incontinence commonly affects people with diabetes, stroke, multiple sclerosis, Alzheimers disease and Parkinson disease.
- Overflow incontinence. Overflow incontinence occurs when your bladder is full, and you cant empty it completely. As a result, pee may constantly dribble because you have a full bladder but you cant sense the need to use the bathroom. An enlarged prostate that blocks your urethra or a spinal cord injury may prevent you from being able to empty your bladder when you pee.
- Functional incontinence. Conditions that prevent you from reaching the bathroom in time cause functional incontinence. Arthritis, injuries, neurological conditions, dementia and medications that cause grogginess may prevent you from moving quickly enough to the bathroom or communicating to others that you have to go to the bathroom.
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Managing Bladder Or Urinary Incontinence
Sometimes urinary incontinence can last a short time, depending on what’s causing it. But sometimes incontinence can be long-term and uncomfortable, making some everyday activities difficult to manage.
Your health care team will ask you questions to determine the type of bladder incontinence you might have. Then, you might need tests to verify the type and learn the cause of it which will help them know the best way to manage it.
- Pelvic floor muscle strengthening may be recommended. A physical therapist that specializes in pelvic floor muscle exercises can help. This might help muscle strength and bladder control get better by doing exercises that tighten and relax muscles that control the flow of urine.
- Bladder training canhelp manage how often you need to urinate throughout the day, by assigning certain time intervals to empty your bladder.
Use The Right Absorbent Products
Coping with accidents is much easier if you use the right tools for the job.
Choices include panty liners, sanitary pads, absorbent adult briefs, and reusable garments with protective outer layers. Pads and panty liners might help if you have small, occasional leaks — but they may not always be enough.
Because the urine-holding capacity of each product can vary, you may have to try several products and brands before you find the right one for you.
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What Is Bowel Incontinence
Bowel incontinence is when youâre not able to control your bowel movements. Its a common problem, especially among older adults, and ranges from irregular stool leaks while passing gas to a total loss of control of your bowels.
Accidental bowel leakage isnât usually a serious medical problem. But it can dramatically interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment.
Many effective treatments can help people with bowel incontinence. These include:
Talking to your doctor is the first step toward freedom from bowel incontinence.
How Is Urinary Incontinence Treated
You and your doctor or nurse will work together to create a treatment plan. You may start with steps you can take at home. If these steps do not improve your symptoms, your doctor or nurse may recommend other treatments depending on whether you have stress incontinence or urge incontinence or both.
Be patient as you work with your doctor or nurse on a treatment plan. It may take a month or longer for different treatments to begin working.
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What Your Treatment Will Involve
Your healthcare professionals recommended treatment plan will depend on the cause of your incontinence. An underlying medical condition may require medication, surgery, or other treatments.
In certain situations, they may not be able to cure your bladder incontinence. In these cases, they will likely provide steps you can take to manage your condition.
Treatment options for urinary incontinence may include:
You cant prevent all cases of urinary incontinence, but there are steps you can take to reduce your risk of developing it.
For example, try to:
Tips To Get Your Bladder Under Control
Take control of your bladder
Do you find yourself struggling to make it to the bathroom in time? Urinary incontinence is a common condition. Your doctor can help you understand whats causing it and recommend a treatment plan.
Lifestyle changes can also help get your bladder under control. Learn about six steps you can take to reduce your risk of accidents and help you get back to enjoying everyday activities, leak-free.
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Botulinum Toxin A Injections
Botulinum toxin A can be injected into the sides of your bladder to treat urge incontinence and overactive bladder syndrome .
This medication can sometimes help relieve these problems by relaxing your bladder. This effect can last for several months and the injections can be repeated if they help.
Although the symptoms of incontinence may improve after the injections, you may find it difficult to fully empty your bladder. If this happens, you will need to be taught how to insert a catheter into your urethra to drain the urine from your bladder.
Botulinum toxin A is not currently licensed to treat urge incontinence or OAB, so you should be made aware of any risks before deciding to have the treatment. The long-term effects of this treatment are not yet known.
Forms Of Urinary Incontinence That Affect Men Only
- Benign prostatic hyperplasia affects about 50 percent of men over the age of 60, and 90 percent over the age of 85 an enlarged prostate can cause sudden and frequent urges to urinate.
- Peyronies disease is the result of injury or damage to penile tissue, causing an abnormal curvature.
- Painful inflammation of the prostate gland
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Amping Up Your Treatment: Medications And Surgery
When more conservative measures have failed, medications – then surgery – are the alternatives, says Galloway.
Medications: No drug helps with stress incontinence, but a class called anticholinergics does help with urge incontinence.
These drugs include Detrol, Oxytrol, Ditropan, and Sanctura — all with similar effectiveness and similar side effects, like dry mouth and constipation, says Galloway.
Medications like Enablexand Vesicare are more effective in controlling the bladder, but don’t cause constipation, he adds.
A transdermal patch called Oxytrol has also been effective, says Galloway, who adds that skin irritation at the patch site does occur in some patients.
Surgery: There are 300 surgical options to treat incontinence, says Brubaker.
“The hard part is picking the surgery that has the best chance of working well for that woman long-term,” he says. “Surgery can create problems. It can cause difficulty in urinating, worsen an urge incontinence problem, or it can do nothing to solve the problem.”
“It helps the urethral sphincter remain closed when abdominal pressure tries to open it. At least, we think that’s how it works,” he says. “We have only five-year outcomes on one group of these devices. But they look promising.”
“Before having any surgery, ask your doctor for names of other patients who have had the procedure in question,” says Galloway.
“Talk to them, find out how it worked. You’ll be in a much better position to decide what to do.”
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There Are Different Types
If you experience incontinence when you sneeze, cough, or exercise, you may have stress incontinence, which is leakage from added pressure on the abdomen that pushes urine past the urethra.
If you stand up and are unable to hold off on emptying your bladder before you reach the bathroom, you may have urge incontinence, otherwise known as an overactive bladder.
Many women have a combination of stress and urge incontinence called mixed incontinence. And although less likely, some women experience overflow, a rare condition which causes frequent urinary leaks due to a constant full bladder.
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Try Pelvic Floor Therapy
Pelvic floor therapy is a type of specialized physical therapy that strengthens the muscles that support your bladder and bowels. This can be very effective in treating urinary incontinence caused by an overactive bladder.
During pelvic floor therapy, a physical therapist may lead you through exercises that target your pelvic floor, use mild electrical stimulation to help you have more awareness of your pelvic floor muscles, and use other specialized techniques. If youre interested in pelvic floor therapy, talk with a doctor about getting a referral.
How Is Loss Of Bladder Control Treated
Non-surgical treatments are often recommended to help treat bladder control issues. These include:
- Physical therapy and exercise
- Reducing intake of alcohol and caffeine
- Electrical stimulation of the nerves that control the bladder
- Bladder retraining by going to the bathroom at set times
- Kegel exercises to strengthen pelvic muscles
- Biofeedback to help patients learn to control the bladder muscles
Depending on the type of leakage and how bothersome it isand if patients do not respond to the non-surgical treatmentssurgery and other interventions can be very successful. In most cases, they can be done as an outpatient procedure.
Last reviewed by a Cleveland Clinic medical professional on 08/26/2015.
References
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Why Do I Feel Like I Still Have To Pee After Peeing
If a person has a constant urge to pee but little comes out when they go, they may have an infection or other health condition. If a person frequently needs to pee but little comes out when they try to go, it can be due to a urinary tract infection , pregnancy, an overactive bladder, or an enlarged prostate.
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Causes Of Urinary Incontinence
Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
Find out more about the causes of urinary incontinence.
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