Urinary Incontinence

What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of urine control, or the inability to hold your urine until you can reach a restroom. More than 13 million people in the United States experience incontinence male and female (women are twice as likely to develop a UI than men), young and old. Urinary incontinence 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.

What causes urinary incontinence?

Incontinence is not an inevitable result of aging, but is particularly common in older people. 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.

What are some of the different types of urinary incontinence?

• urge incontinence
  the inability to hold urine long enough to reach a restroom. It is often found 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.
• stress incontinence
  the most common type of incontinence that involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.
• functional incontinence
  leakage due to a difficulty reaching a restroom in time because of physical conditions such as arthritis.
• overflow incontinence
  leakage that occurs when the quantity of urine produced exceeds the bladder's capacity to hold it.

What are the signs and symptoms of urinary incontinence?

The following are the most common symptoms for urinary incontinence, however, each individual may experience symptoms differently.

• 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 you do not get to restroom in time
• abnormal urination or changes in urination related to a nervous system abnormality such as stroke, spinal cord injury, multiple sclerosis
• 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. Consult your physician for a diagnosis.

How may incontinence be treated?

Specific treatment for urinary incontinence will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

For people with urinary incontinence, it is important to see a physician for a complete medical examination. Treatment often begins with a detailed personal and family history of health and related problems, a physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. In many cases, patients will then be referred to a urologist, a physician who specializes in diseases of the urinary tract.

Treatment may include:

• certain behavioral techniques
  (including pelvic muscle exercises, biofeedback, and bladder training)
• medications
• surgery
  if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage
• diet modifications
  (i.e., eliminating caffeine in coffee, soda, and tea, and/or eliminating alcohol)

Managing urinary incontinence:

Specifically designed absorbent underclothing is available which is no more bulky than normal underwear and can be worn easily under everyday clothing. Also, incontinence may be managed by inserting a catheter into the urethra and collecting the urine into a container. Consult your physician with your questions regarding the management and treatment of urinary incontinence.