In the United States, 20 million women have some form of urinary incontinence. Because of anatomical differences in men and women, there is a substantial difference between the sexes in the various types of incontinence.
Urinary incontinence, the loss of voluntary bladder control causing leakage of urine, can be a temporary or chronic condition. It can occur when you are straining (lifting, sneezing, coughing), when your bladder is full, or when you have a bladder infection. Each cause has its own methods of diagnosis and its own treatment plan. In some cases, incontinence may have several different causes.
Stress incontinence results when certain activities increase abdominal pressure, which in turn puts pressure on the bladder. Leaking can be triggered by laughing, sneezing, lifting heavy objects, or exercise. This is a common type of incontinence and may be caused by the weakening of the muscles that support the bladder or the weakening of the muscle sphincter that controls the flow of urine.
Urge incontinence, previously called overactive bladder, is the loss of bladder control following a strong urge to urinate. Sometimes, you are unable to hold urine long enough to make it to the bathroom. It may be caused by a urinary tract infection, certain medications, or nerve damage from multiple sclerosis, Parkinson's disease, stroke, or spinal cord injuries. The nervous system controls messages sent from the bladder to the brain via the spinal cord, including the signal that it is time to urinate.
With overflow incontinence, there is a constant or frequent small amount of leakage of urine from a bladder that does not empty. As the bladder remains full, the muscle stretches as more urine accumulates in the bladder. Over time the muscles become less effective at contracting to empty the urine. This causes a feeling that you need to urinate frequently. Often, you will not feel that you are emptying your bladder completely.
Conditions such as diabetes may prevent the bladder from emptying completely, resulting in the symptoms described above. Certain medications such as over-the-counter cold pills and tranquilizers may also cause these symptoms.
This type of incontinence is important to treat. If the urine remains long enough in the bladder, infections may occur. These infections could affect the kidneys and potentially pose serious health risks.
There are several things you can try to help manage urinary incontinence:
Medications Certain types of urinary incontinence may be treatable with medications. In postmenopausal women, pelvic floor relaxation is the most common cause of stress incontinence. Urgency and overflow incontinence may respond to anticholinergic medicines that weaken the bladder muscle. Alpha-adrenergic medicines that strengthen the sphincter may also be helpful in some cases. Talk to your physician about the pros and cons of using medications to treat urinary incontinence as some medical problems may contraindicate the use of medications. If you have bladder trouble, check with your physician before using any other medications, including over-the-counter drugs and herbal supplements as many have urinary side effects.
There are several surgical procedures for the various types of incontinence. These procedures are usually reserved for people who have tried conservative treatments without success and are healthy enough to undergo surgery.
Other treatments for urinary incontinence include: