How Is Incontinence Diagnosed
Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:
- How often do you urinate?
- Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
- How long have you been experiencing incontinence?
These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, its important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.
There are also several specific tests that your provider might do to diagnose incontinence, including:
While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. Youll then bring this journal with you to your appointment and talk about it with your provider.
Lower Urinary Tract Symptoms
The lower urinary tract includes the bladder and the tube that urine passes through as it leaves the body .
Lower urinary tract symptoms are common as people get older.
They can include:
- problems with storing urine, such as an urgent or frequent need to pass urine or feeling like you need to go again straight after you’ve just been
- problems with passing urine, such as a slow stream of urine, straining to pass urine, or stopping and starting as you pass urine
- problems after you’ve passed urine, such as feeling that you’ve not completely emptied your bladder or passing a few drops of urine after you think you’ve finished
Experiencing LUTS can make urinary incontinence more likely.
Page last reviewed: 07 November 2019 Next review due: 07 November 2022
Bladder Leaks In New Mothers
New mothers can experience bladder leaks. It is a common problem after childbirth. This is postpartum urinary incontinence.
Newborn mothers might have trouble controlling their bladders. The pressure on the bladder during pregnancy does take a toll on it. The pressure from delivery also takes a toll.
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What The Doctor Does
Doctors first ask questions about the person’s symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the incontinence and the tests that may need to be done.
Doctors ask questions about the circumstances of urine loss, including amount, time of day, and any precipitating factors . People are asked whether they can sense the need to urinate and, if so, whether the sensation is normal or comes with sudden urgency. Doctors may also ask the person to estimate the amount of urine leakage. Doctors will also ask whether the person has any additional problems with urination, such as pain or burning during urination, a frequent need to urinate, difficulty starting urination, or a weak urine stream.
Sometimes doctors may ask people to keep a record of their urination habits over a day or two. This record is called a voiding diary. Each time the person urinates, the volume and time are recorded. After an episode of incontinence, the person also records any related activities, especially eating, drinking, drug use, or sleep.
Although urodynamic testing is important, results do not always predict response to drug treatment or assess the relative importance of multiple causes.
Evaluation Of Urinary Incontinence
Urinary incontinence usually does not indicate a disorder that is life threatening nevertheless, incontinence may cause embarrassment or lead people to restrict their activities unnecessarily, contributing to a decline in quality of life. Also, rarely, sudden incontinence can be a symptom of a spinal cord disorder. The following information can help people decide when a doctor’s evaluation is needed and help them know what to expect during the evaluation.
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What Causes Bedwetting In Children
Nighttime wetting is often related to slow physical development, a family history of bedwetting, or making too much urine at night. In many cases, there is more than one cause. Children almost never wet the bed on purposeand most children who wet the bed are physically and emotionally normal.
Sometimes a health condition can lead to bedwetting, such as diabetes or constipation.
How Soon After Starting Kegel Exercises Will Urinary Incontinence Get Better
It may take 4 to 6 weeks before you notice any improvement in your symptoms.10
Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms dont get better, Kegel exercises can help prevent your incontinence from getting worse.
You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.
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Medical Treatments For Nocturia
Your doctor may prescribe medications when preventive measures and lifestyle changes fail to reduce the frequency of your nighttime urination. Doctors prescribe a class of drugs called anticholinergics to treat symptoms of OAB, if thats the cause of your nocturia. They reduce bladder spasms that create the urge to go.
Your doctor may suggest you take a diuretic for regular urine production. A diuretic can itself cause nocturia. But if you take it early enough in the day, it may help you get rid of excess fluid while youre awake. This should decrease your urine production at night.
Other drugs that may help are:
- desmopression in cases of diabetes insipidus to cause the kidneys to produce less urine
- tamsulosin , finasteride , or dutasteride to treat prostate enlargement
- antibiotics if you have a urinary tract infection
Your doctor may also adjust your diabetic medications to lower your blood sugar if theyre causing nocturia.
What Is The Prognosis For Urethral Incontinence
While the prognosis is determined by the specific cause, in general the prognosis is good. Control of urine leakage will vary from dog to dog, but most dogs can be managed successfully with medications, lifestyle changes such as more frequent trips outside to urinate, and close monitoring.
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What Are The Clinical Signs Of Urethral Incontinence
The most common clinical sign is pooling or spotting of urine underneath your dog when she is sleeping or relaxed. Many dog owners report finding wet spots on the bedding or floor where their dog has recently been laying down or sleeping. Occasionally owners will report dribbling of urine while their dog is walking or after she urinates. In many instances the dog seems unaware of what is happening. It is estimated that urethral incontinence may affect over 20% of all spayed female dogs, especially large-breed dogs. Urethral incontinence is most common in middle-aged to senior, medium to large-breed female dogs although any dog may be affected.
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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How To Practice Kegels
Before you begin to try any Kegel exercises, you need to identify your pelvic muscles. In order to do this, ensure your aware of the muscles you use to control urination. Try and stop yourself from urinating mid-flow. The muscles you use here are the correct ones.
You should then squeeze these for up to 4 seconds, then relax the muscles for 4 seconds. If your stomach and thigh muscles weaken when you do this, you are doing this method wrong.
Gradually increase the length of time you are able to squeeze until you see a noticeable improvement in the strength of your muscles.
In order for this method to be effective, it is recommended that you repeat this exercise 10 to 15 times per session.
If you lack the sufficient time to practice these at home, try and incorporate them into your daily routine. Do this exercise 3 times daily.
Watch Your Liquid Intake Before Bed
If you suffer from Nocturnal Enuresis, its important to cut down on caffeine and alcohol in the evening. You should also ensure you only consume fluid up to 2 hours prior to bedtime. One tip is to make sure you visit the toilet right before bed. However, you do need to ensure you do not become dehydrated.
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What Can You Do About Your Leaky Bladder
This is nothing to feel embarrassed about. Several celebrities have spoken about their experiences with this condition. It doesnt have to ruin your experience of being a new mom.
The good news is that there are several things you can do to deal with this condition. You can do Kegel exercises to strengthen your pelvic floor. Its best to do these exercises each day.
Did you know you can train your bladder? Yes, this is possible. Go to the bathroom every 30 minutes before the urge comes to go.
Youll then need to extend the time you go to the bathroom. This training can help to normalize your urination intervals.
Do you notice that certain beverages or foods are making it harder to control your bladder? These might include soft drinks and coffee. You should stop consuming them.
Postpartum pads are a discrete way to deal with this issue. These pads absorb small leaks of urine. Always bladder leak pads make for a great option.
Why You Are Leaking Urine
- You Cant Wake During the Night
Between the ages of 2 and 6, most people develop the ability to wake during the night if the body senses that the bladder is full. However, if an individual is a very heavy sleeper, this can mean that they dont wake up if they need the toilet, meaning they may go while they are asleep.
Epidemiologic evidence from several studies has shown that urinary incontinence is 50 % more common in women with Diabetes than those with normal glucose levels. High blood sugar can cause an increase in the amount of urine produced, resulting in urgency and more frequent urination.
A combination of pressure on the bladder, hormones and the tear of childbirth means your pelvic floor muscles can suffer. As a result, you are likely to have a weak bladder, and can occasionally leak urine during the night and day.
When To Seek Medical Advice
See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.
This can also be the first step towards finding a way to effectively manage the problem.
Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis.
The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.
Find out about diagnosing urinary incontinence.
Essentials For Older People: Urinary Incontinence
Although incontinence is more common among older people, it is not a normal part of aging.
With aging, bladder capacity decreases, ability to delay urination declines, involuntary bladder contractions occur more often, and bladder contractions weaken. Thus, urination becomes more difficult to postpone and tends to be incomplete. The muscles, ligaments, and connective tissue of the pelvis weaken, contributing to incontinence. In postmenopausal women, decreased estrogen levels lead to atrophic urethritis and atrophic vaginitis and to decreasing the strength of the urethral sphincter. In men, prostate size increases, partially obstructing the urethra and leading to incomplete bladder emptying and strain on the bladder muscle. These changes occur in many normal, continent older people and may facilitate incontinence but do not cause it.
). These effects, such as constipation, dry mouth, blurred vision, and sometimes even confusion, can be particularly troublesome in older people.
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When You Should See A Health Care Professional
You shouldnt have to wear a pad to soak up urine every day. Also ask yourself these questions:
Is the urge to urinate interfering with your work because of leaking or frequent bathroom breaks?
Do you map out where bathrooms are when you run errands?
Is incontinence interfering with your sex life or intimacy with your partner?
These are all signs of a problem, and that it may be time for you to talk with a gynecologist.
What Are The Treatments For Urinary Incontinence
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
- Not smoking
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
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What Are The Symptoms Of Nighttime Urination
Most people can get a full six to eight hours of rest without the need to urinate. However, nighttime urination causes you to get up several times at night to use the restroom. In its most severe forms, this condition causes you to get up five to six times at night.
Symptoms associated with nighttime urination include overproduction of urine, urinating too frequently, and feeling the urgent need to urinate but producing little urine.
Nighttime urination can cause problems. You cant feel rested when youre frequently using the restroom. Also, nighttime urination can increase the likelihood for falls and injury in the elderly.
Will I Have Incontinence For My Entire Life
Sometimes incontinence is a short-term issue that will go away once the cause ends. This is often the case when you have a condition like a urinary tract infection . Once treated, frequent urination and leakage problems caused by a UTI typically end. This is also true for some women who experience bladder control issues during pregnancy. For many, the issues end in the weeks after delivery. However, other causes of incontinence are long-term and related to conditions that are managed throughout your life. If you have a chronic condition like diabetes or multiple sclerosis, you may have incontinence for a long period of time. In those cases, its important to talk to your provider about the best ways to manage your incontinence so that it doesnt interfere with your life.
A note from Cleveland Clinic
It can be embarrassing to talk about bathroom habits with your healthcare provider. This embarrassment shouldnt stop you from treating incontinence, though. Often, your healthcare provider can help figure out the cause of your bladder control issue and help make it better. You dont need to deal with it alone. Talk to your healthcare provider about the best ways to treat incontinence so that you can lead a full and active life without worrying about leakage.
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How Can I Manage Incontinence At Home
Incontinence can be uncomfortable and disruptive. It can cause sleeping problems, make you feel ashamed or angry, or affect your daily life in other ways. In addition to working with your health care team to find the best treatment, there are things you can do at home to help make incontinence better or more comfortable.
Limit how much you drink, especially coffee and alcohol. Avoid foods that can irritate the bladder, including dairy products, citrus fruits, sugar, chocolate, soda, tea, and vinegar.
Go to the bathroom right before bedtime and any vigorous activity.
Wear an absorbent pad inside your underwear or disposable incontinence underwear.
Maintain a healthy weight. Extra weight can put pressure on the bladder and muscles that support it.
Go to the bathroom regularly each day. Do not wait too long or put off going.
Quit smoking. Nicotine can irritate the bladder. It can also make you cough and leak urine.
Do Kegel exercises. Ask your health care team about doing Kegel exercises at home. They can make your bladder stronger. To do Kegel exercises, first tighten the muscles you use to stop the flow of urine. Then, relax those muscles. Repeat the exercise several times. During this exercise, relax the muscles in your belly, buttocks, and thigh.
Finally, it can help to find support. Talk with your health care team or join a support group for people with bladder problems. It can help you feel better to know that other people are also dealing with incontinence.