What is urinary incontinence?
Urinary incontinence (UI) is the loss of urine control, or the inability to hold urine until reaching a restroom. According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can develop at any age, and 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.
Female urinary incontinence—85 percent of those with UI in the U.S. are women. This problem can occur in patients as young as 13 and as old as 100. Women should not accept urinary incontinence as a way of life or 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. Sometimes it is the first and only symptom of a urinary tract infection.
For men with UI, 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.
Our clinical experts have extensive training in the treatment of UI. We use the latest technology, including antibiotic coated devices to minimize the risk of infection. Many of our physicians continue to develop new treatments, publish scholarly papers and teach colleagues on state-of-the-art continence care.
Our many treatment options include techniques for patients who do not respond to conventional therapies. Our 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.
The following are the most common symptoms of UI. However, each individual may experience symptoms differently.
Symptoms may include:
- 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
- Leakage of urine that began or continued after surgery
- Leakage of urine that causes embarrassment
- Frequent bladder infections
The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult a doctor for a diagnosis.
Types of urinary incontinence include:
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.
Specific treatment for urinary incontinence will be determined by a doctor based on:
- Age, overall health and medical history
- Extent of the disease
- Tolerance for specific medications, procedures or therapies
- Expectations for the course of the disease
- Patient opinion or preference
Treatment may include:
Behavioral therapies to help people regain control of their bladder, including:
- Bladder training teaches people to resist the urge to void and gradually expand the intervals between voiding.
- Toileting assistance uses routine or scheduled toileting, habit training schedules and prompted voiding to empty the bladder regularly to prevent leaking.
- Pelvic muscle rehabilitation to improve pelvic muscle tone and prevent leakage, including:
- Kegel exercises—regular, daily exercising of pelvic muscles that can improve, and even prevent, urinary incontinence.
- Biofeedback—used in conjunction with Kegel exercises; biofeedback helps people gain awareness and control of their pelvic muscles.
- Electrical stimulation of the pelvic floor—involves mild electrical pulses that stimulate muscle contractions. This should be performed in conjunction with Kegel exercises.
- Surgery—if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage.
- Diet modifications—eliminating caffeine in coffee, soda, tea and/or eliminating alcohol.