Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women.
When incontinence lasts longer, it may be due to:
Weak bladder or pelvic floor muscles
Overactive bladder muscles
Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson’s disease
Diseases such as arthritis that may make it difficult to get to the bathroom in time
Pelvic organ prolapse, which is when pelvic organs (such as the bladder, rectum, or uterus) shift out of their normal place into the vagina or anus. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak.
Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:
Prostatitis, a painful inflammation of the prostate gland
Injury or damage to nerves or muscles from surgery
An enlarged prostate gland, which can lead to benign prostate hyperplasia, a condition in which the prostate grows as men age
Types of urinary incontinence
There are different types of incontinence:
Stress incontinence occurs when urine leaks as pressure is put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-aged women. It also may begin later, around the time of menopause.
Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
Treating and managing urinary incontinence
Today, there are more treatments and ways to manage urinary incontinence than ever before.
Bladder control training
Pelvic muscle exercises (also known as Kegel exercises) strengthen the muscles that support the bladder, which can help you hold urine in your bladder and avoid leaks. Learn more about pelvic floor exercises and how to do them.
Urgency suppression helps control strong urges to urinate so you can make it to a toilet on time. For example, you can try distracting yourself to help keep your mind off needing to urinate, taking long relaxing breaths, holding still, and squeezing the pelvic floor muscles.
Timed voiding is used to help control your bladder through scheduling time to urinate. For example, you can set a plan to urinate every hour. As time goes on, you can slowly extend the time between toilet breaks.
Medical treatments
Medications that come in a pill, liquid, or patch may be prescribed to help with bladder control problems. However, some medications for overactive bladder have been associated with a higher risk of cognitive decline in adults over age 65. Talk with your doctor about what medications, if any, would work best for you.
Vaginal estrogen cream may help relieve urge or stress incontinence. A low dose of estrogen cream is applied directly to the vaginal walls and urethral tissue.
Bulking agents can be used to help close the bladder opening. Doctors can inject a bulking gel or paste that thickens the area around the urethra. This can reduce stress incontinence but may need to be repeated.
Medical devices may also be used to manage urinary incontinence, such as a catheter that drains urine from your bladder; a urethral insert that helps prevent leakage; and a vaginal pessary ring that provides pressure to lessen leakage.
Biofeedback uses sensors to make you aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra.
Electrical nerve stimulation sends mild electric currents to the nerves around the bladder that help con
Behavioral and lifestyle changes
Changing your lifestyle may help with bladder problems. Losing weight, quitting smoking, saying “no” to alcohol, choosing water instead of other drinks, and limiting drinks before bedtime can help with some bladder problems. Preventing constipation and avoiding lifting heavy objects may also help with incontinence. Even after treatment, some people still leak urine from time to time. There are bladder control products and other solutions, including disposable briefs or underwear, furniture pads, and urine deodorizing pills that may help.
Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on urinary incontinence in men and urinary incontinence in women.
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