Urinary Incontinence

Urinary incontinence is the accidental release of urine. It can happen when you cough, laugh, sneeze, or jog. You may have a sudden need to go to the bathroom but can’t get there in time. Bladder control problems are very common, especially among older adults. They usually do not cause major health problems, but they can be embarrassing.

Incontinence can be a short-term problem caused by a urinary tract infection, a medicine or constipation. It gets better when you treat the problem that is causing it.  There are two main kinds of chronic incontinence. Some women have both.

• Stress incontinence occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.
• Urge incontinence happens when you have a strong need to urinate but can’t reach the toilet in time. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water. Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine.

Mixed incontinence is a combination of different types of bladder control problems, usually stress and urge incontinence. These problems often occur together in older women.

Chronic bladder control problems may be caused by:

• Weak muscles in the lower urinary tract.
• Problems or damage either in the urinary tract or in the nerves that control urination.

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles cannot support your bladder properly, the bladder drops down and pushes against the vagina. You cannot tighten the muscles that close off the urethra. Urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.

Urge incontinence is caused by an overactive bladder muscle that pushes urine out of the bladder. It may be caused by irritation of the bladder, emotional stress, or brain conditions such as Parkinson ’s disease or stroke. Many times we don’t know what causes it.

How is urinary incontinence diagnosed?

When you come for evaluation, you will ask about what and how much you drink. We will also discuss how often and how much you urinate and leak. It may help to keep track of these things for 3 or 4 days before you come for your visit.

We will perform a thorough examination and may do some simple tests to look for the cause of your bladder control problem. If we think your incontinence may be caused by more than one problem, you will likely have more tests or you may be referred to a specialist.Most bladder control problems can be improved or cured.

Treatment for stress incontinence includes: Kegel exercises to strengthen the pelvic floor muscles, using a removable device called a pessary which can help reduce stress incontinence by putting pressure on the urethra, taking medicines, or having surgery to support the bladder or move it back to a normal position.

For urge incontinence, we may suggest behavior changes to fix the problem. For example, bladder training helps you to increase how long you can wait before you have to urinate. We also may prescribe medicine to treat urge bladder problems.

If you have more than one kind of bladder control problem, multiple treatment recommendations may be suggested.  Regardless of what your specific cause of bladder dysfuntion, we will walk you through the process, help you understand what is happening, and try to alleviate the problem as best we can. Find helpful information here.

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