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What is urinary incontinence?

Urinary incontinence (UI) is the loss of urine control, or the inability to hold urine until reaching a restroom. UI can develop at any age. Urinary incontinence may be a temporary condition, resulting from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.

Our approach

More than 25 million people in the United States experience urinary incontinence—and 85 percent are women. With proper evaluation and treatment, incontinence can be improved or completely cured. At Northwell Health, our clinical experts have extensive training in the treatment of urinary incontinence. Physicians use the latest technology, including antibiotic coated devices to minimize the risk of infection. Many continue to develop new treatment modalities, publish scholarly papers and teach colleagues on state-of-the-art continence care.

Our physicians are uniquely capable of providing patients with an array of treatment options that include techniques for patients who do not respond to conventional therapies.  The clinical staff consults and works with patients to develop a tailored treatment plan that, if necessary, will include a multidisciplinary approach to care. This approach includes physicians with diverse training in multiple specialties working closely with pelvic physical therapists who develop exercises to improve incontinence and skilled technicians with training to use the latest in technology to monitor bladder function, size and activity.

Symptoms

The following are the most common symptoms of urinary incontinence:

  • Inability to urinate
  • Pain related to filling the bladder and/or pain related to urination without a proven bladder infection
  • Progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying
  • An increased rate of urination without a proven bladder infection
  • Needing to rush to the restroom and/or losing urine if a restroom is not reached in time
  • Abnormal urination or changes in urination related to the nervous system
  • Abnormality, such as stroke, spinal cord injury, or multiple sclerosis that interferes with urination
  • Leakage of urine that prevents activities and/or causes embarrassment
  • Leakage of urine that began or continued after surgery
  • Frequent bladder infections

Risk factors

Female urinary incontinence

This problem is not limited to older women. It can occur in patients as young as 13 and as old as 100. Women should not accept urinary incontinence as a way of life. It does not have to be a normal part of aging. It is often caused by specific changes in body function that may result from diseases, use of medications, and/or the onset of an illness. Sometimes it is the first and only symptom of a urinary tract infection. Women are most likely to develop urinary incontinence either during pregnancy and childbirth, or after the hormonal changes of menopause, because of weakened pelvic muscles.

Male urinary incontinence

Incontinence is not an inevitable result of aging, but is particularly common in older men. It is often caused by specific changes in body function that may result from diseases, use of medications and/or the onset of an illness. For men with urinary incontinence, it is important to first consult a healthcare provider for a complete physical examination that focuses on the urinary and nervous systems, reproductive organs and examination of urine samples. In many cases, patients will then be referred to a urologist, a doctor who specializes in diseases of the urinary tract.

How is it diagnosed?

In order to determine the type of UI that you have, your doctor will first ask for your medical history. Women should be prepared to share details of any pregnancies and deliveries they’ve had, as well as if they’re experiencing menopause, since these can all be major causes of UI. Your doctor will also perform a physical examination. They may also request a urinalysis to test for signs of infection or blood in your urine, or ask you to urinate in a container to measure the amount of urine you produce.

Types

  • Urge incontinence: The inability to hold urine long enough to reach a restroom. It can occur in people who have conditions such as diabetes, stroke, dementia, Parkinson's disease and multiple sclerosis, but may be an indication of other diseases or conditions that would also warrant medical attention. Frequently, overactive bladder can be idiopathic, or not secondary to an identifiable cause.
  • Stress incontinence:  This type of incontinence involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects or other body movements that put pressure on the bladder.
  • Overflow incontinence: Leakage that occurs when the quantity of urine produced exceeds the bladder's capacity to hold it.

Types of treatment

Your treatment plan will be customized to your unique needs based on a conversation with your doctor. Treatment may include any of the following:

  • Modifying your diet
  • Doing Kegels, now known as pelvic floor muscle exercises, to strengthen your muscles that control urination
  • Retraining your bladder (gradually holding in urine for increased periods of time)
  • Double voiding (learning to completely empty your bladder)
  • Taking medications, such as agents to calm an overactive bladder
  • Eliminating medications that may cause incontinence
  • Electrical stimulation to strengthen your pelvic floor muscles
  • Medical devices, such as pessaries and vaginal inserts, can be worn to prevent urine leakage
  • Interventional therapies (such as Botox injections into the bladder or nerve stimulators)
  • Surgical procedures can help support the tissues under the urethra
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