What is urinary incontinence?

• Urinary incontinence is when urine leaks out before you can get to a bathroom.

What causes urinary incontinence?

• Sometimes it is caused by an illness, in which case bladder control returns when the illness goes away. For example: bladder infections or vaginal infections can cause incontinence for a short time.
• Some medications can make it difficult to control your bladder. Check with your doctor if you think a new medication is causing incontinence.
• Sometimes incontinence is an ongoing problem, in which case the cause might be:
• The bladder cannot empty completely.
• A weakening of the muscles that help to hold and release urine.
• A blocked urinary passage.
• Damage to the nerves that control the bladder.

How common is urinary incontinence?

• More than 13 million Americans, male and female, young and old, have urinary incontinence.
• Women are more likely to leak urine than men.
• Older women have more bladder control problems than younger women, but it can happen at any time.

Does having a baby cause urinary incontinence?

• Yes, it can, but do not panic. If you lose bladder control after having a baby the problem usually goes away by itself. Your muscles may just need time to recover.
• During and after pregnancy, leakage of urine can occur due to:
• Pressure of the pregnancy on the bladder and pelvic muscles.
• Vaginal delivery.
• Episiotomy (a cut or tear in the muscle at the time of delivery).
• Damage to bladder control nerves.
• If you still have bladder problems six weeks after having your baby, talk to your doctor.

Does menopause affect urinary incontinence?

• Yes, it can. After your periods end, your body stops making the hormone estrogen.
• Some experts think that this loss of estrogen can weaken the vaginal tissue.
• If you have symptoms of urinary incontinence after menopause, schedule an appointment with your doctor for an examination. Often, incontinence can be treated.

What are the different types of urinary incontinence?

• Stress Incontinence: 
• Leakage happens with coughing, sneezing, exercising, laughing, lifting heavy things, or other movements that put pressure on the bladder.
• It is the most common type of incontinence.
• It can be treated and, sometimes, cured.
• Urge Incontinence:
  • Sometimes called “overactive bladder.”
  • Leakage usually happens after a strong, sudden urge to urinate.
  • This sudden urge may happen when you don’t expect it, such as while sleeping or hearing running water.
• Functional Incontinence:
  • Leaking because you can’t get to a toilet in time.
  • People with this type of incontinence may have problems moving, thinking, or speaking that prevent them from reaching a toilet.
  • Examples include people with Alzheimer’s, those confined to a bed or wheelchair, or those with mental impairments.
• Overflow Incontinence:
  • Leaking urine because the bladder does not empty well.
• Mixed Incontinence:
  • Two or more types of incontinence (listed above) are present.
  • Most commonly Stress & Urge incontinence occur together.
• Transient Incontinence:
  • Leaking urine for a short time due to an illness, medication, or other condition.
  • Leaking stops when the illness is treated, medication is changed, or condition resolves.

How do I find out if I have urinary incontinence and what type I may have?

• The first step is to see your doctor.
• Your doctor will ask you questions about your symptoms. Some questions you may be asked:
• How often do you empty your bladder?
• How and when do you leak urine?
• How much urine do you leak?
• You may be asked to keep a “Bladder Diary” for a few days or a week. You will write down when you empty your bladder and how much urine you produce.
• Your doctor may order special tests to see how well your bladder works:
  • Urinalysis is done to check for infection or other causes of incontinence.
  • Urodynamic testing is done to study how the body stores and releases urine. Various pressure readings and measurements may be done.
  • Stress testing is done while you cough or bear down. This is done to check if you leak urine.
  • Ultrasound may be done to check the kidneys, bladder, and urethra.
  • Cystoscopy uses a thin tube with a camera to view the inside of the urethra and bladder.

How is urinary incontinence treated?

• Pelvic Muscle Exercises (Kegel exercises):
• Kegel exercises can help to make your pelvic muscles stronger. Doing these exercises every day can reduce or cure stress leakage.
• Biofeedback:
• Biofeedback helps you learn how your body works and, in turn, how to better control your body's functions.
• Appointments will be scheduled with a special therapist. At the appointment, the therapist places an electrical patch over the bladder and urethral muscles. Next, a wire connected to the patch is linked to a TV screen. This allows you and the therapist to see when the muscels contract, and allows you to learn how to control those muscles.
• Timed Voiding (or "Bladder Drills"):
• Instead of waiting for the urge to urinate, timed voiding keeps you on a set schedule.
• Over time you may lengthen the amount of time between voiding, which allows your bladder to hold urine better.
• Weight Loss:
• Extra weight puts extra pressure on your bladder.
• If you are overweight, your doctor may suggest weight loss as an addition to other therapies for urinary incontinence.
• Medications:
  • There are medications available for certain types of incontinence. Talk to your doctor to see if you are a candidate.
• Pessary:
  • A pessary is a small device that fits in your vagina and helps support the bladder and surrounding tissues.
  • Pessary can be a good solution for women who are not successful with other treatments and do not wish to have surgery.
• Surgery:
  • There are many types of surgery to correct urinary incontinence.
  • Before surgery is considered, you may be asked to try a pessary or other management option.
  • Talk to your doctor to see if you are a good surgical candidate.