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What is Urinary Incontinence?

Urinary incontinence is loss of normal control of the bladder and involuntary loss of urine. For many people with urinary incontinence, it is an embarrassing problem that negatively impacts quality of life. There are many causes of urinary incontinence. Effective treatment is available for all types of urinary incontinence, but a comprehensive evaluation is needed prior to initiating therapy.

Urinary incontinence is more common in women than in men. Older women experience urinary incontinence more often than younger women. The probable cause for the higher incidence in women can be attributed to pregnancy and childbirth, menopause and the anatomic structure of the female urinary tract.

Individuals with urge urinary incontinence may experience strong, sudden, urgent and uncontrollable need to urinate, frequent urination and also involuntary loss of urine. (overactive bladder). Women with stress incontinence leak with coughing, sneezing, lifting or other physical activities that place stress on the pelvic floor muscles.

Causes of Urinary incontinence

  • Weak pelvic floor muscles
  • Problems with the nerves that control urination
  • Physiological conditions such as pregnancy, childbirth, weight gain or other conditions that stretch the pelvic floor muscles
  • Overactive bladder muscle
  • Weak bladder sphincter muscles
  • Urinary tract infection
  • Urinary retention, incomplete bladder emptying
  • Constipation and impaction
  • Bladder cancer or bladder stones
  • Neurological disorders

Types of Urinary Incontinence

Urinary incontinence can be categorized into five basic types depending on the symptoms:

  • Stress Incontinence
  • Urge Incontinence
  • Overflow Incontinence
  • Functional Incontinence
  • Mixed Incontinence
  • Stress Incontinence: Leakage of small amounts of urine during physical activity such as coughing, sneezing, lifting heavy objects, and straining, which suddenly increases the pressure within the abdomen.
  • Urge Incontinence: Leakage of large amounts of urine with a sense of urgency, before making it to the bathroom, at unexpected times, including during sleep.
  • Overflow Incontinence: Uncontrollable leakage of small amounts of urine because of an overdistended or incompletely emptied bladder.
  • Functional Incontinence: This refers to urine loss resulting from the inability to get to a toilet.
  • Mixed Incontinence: Mixed incontinence is the presence of two or more types of incontinence in an individual. Most commonly, urge and stress incontinence occur together.

Symptoms remain the mainstay of diagnosis and you may be ordered additional tests to identify and confirm the cause for incontinence. These tests include a bladder stress test, urine analysis, urine culture, ultrasound of the bladder, cystoscopy, and multichannel urodynamics.

Treatment for Urinary Incontinence

Treatment depends on the cause and severity of incontinence. Treatment options include medications, injections, vaginal devices and behavioral therapy that include pelvic muscle exercises with or without Physical Therapy, bladder retraining, electrical stimulation, and catheterization. If these conservative treatment measures fail to treat your condition, your physician may recommend surgical procedures such as a suburethral sling or neuromodulation.