Urinary (or bladder) incontinence is when you are not able to keep urine from leaking from your urethra, the tube that carries urine out of your body from your bladder. It can range from an occasional leakage of urine, to a complete inability to hold any urine.
The three main types of urinary incontinence are:
Bowel incontinence, a separate topic, is the inability to control the passage of stool.
Alternative NamesLoss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary
ConsiderationsIncontinence is most common among the elderly. Women are more likely than men to have urinary incontinence.
Infants and children are not considered incontinent, but merely untrained, up to the time of toilet training. Occasional accidents are not unusual in children up to age 6 years. Young (and sometimes teenage) girls may have slight leakage of urine when laughing.
Nighttime urination in children is normal until the age of 5 or 6.
NORMAL URINATION
Normally, the bladder begins to fill with urine from the kidneys. The bladder stretches to allow increasing amounts of urine.
The first urge to urinate occurs when around 200 mL (just under 1 cup) of urine is stored in the bladder. A healthy nervous system will respond to this stretching sensation by alerting you to the urge to urinate, while also allowing the bladder to continue to fill.
The average person can hold around 350 to 550 mL (more than 2 cups) of urine. Two muscles help control the flow of urine:
When it is time to empty the bladder, the bladder wall (detrusor) muscle contracts or squeezes to force urine out of the bladder. Before this muscle squeezes, your body must be able to relax the sphincter to allow the urine to pass out of the body.
The ability to control urination depends on having normal anatomy, a normally functioning nervous system, and the ability to recognize and respond to the urge to urinate.
Common CausesCauses include:
Incontinence may be sudden and temporary, or ongoing and long-term. Causes of sudden or temporary incontinence include:
Causes that may be more long-term:
See your doctor for an initial evaluation and to come up with a treatment plan. Treatment options vary, depending on the cause and type of incontinence you have. Fortunately, there are many things you can do to help manage incontinence.
The following methods are used to strengthen the muscles of your pelvic floor:
To find the pelvic muscles when you first start Kegel exercises, stop your urine flow midstream. The muscles needed to do this are your pelvic floor muscles. Do NOT contract your abdominal, thigh, or buttocks muscles. And Do NOT overdo the exercises. This may tire the muscles out and actually worsen incontinence.
Two methods called biofeedback and electrical stimulation can help you learn how to perform Kegel exercises. Biofeedback uses electrodes placed on the pelvic floor muscles, giving you feedback about when they are contracted and when they are not. Electrical stimulation uses low-voltage electric current to stimulate the pelvic floor muscles. It can be done at home or at a clinic for 20 minutes every 1 - 4 days.
Biofeedback and electrical stimulation will no longer be necessary once you have identified the pelvic floor muscles and mastered the exercises on your own.
Vaginal cones enhance the performance of Kegel exercises for women. Other devices for incontinence are also available.
For leakage, wear absorbent pads or undergarments. There are many well designed products that go completely unnoticed by anyone but you.
See also: Urinary incontinence products
Other measures include:
Your doctor may recommend medication or surgery, especially if home care measures are not helping or if your symptoms are getting worse.
Medications that may be prescribed include drugs that relax the bladder, increase bladder muscle tone, or strengthen the sphincter.
Surgery may be required to relieve an obstruction or deformity of the bladder neck and urethra.
See also:
If you have overflow incontinence or cannot empty your bladder completely, a catheter may be recommended. But using a catheter exposes you to potential infection.
PREVENTION
Performing Kegel exercises while you are pregnant and soon after delivery may help prevent incontinence related to childbirth.
Call your health care provider ifDiscuss incontinence with your doctor. Gynecologists and urologists are the specialists most familiar with this condition. They can evaluate the causes and recommend treatment approaches.
Call your local emergency number (such as 911) or go to an emergency room if any of the following accompany a sudden loss of urine control:
Call your doctor if:
Your doctor will take your medical history and perform a physical examination, with a focus on your abdomen, genitals, pelvis, rectum, and neurologic system.
Medical history questions may include:
Diagnostic tests that may be performed include:
Other tests may be performed to rule out pelvic weakness as the cause of the incontinence. One such test is called the Q-tip test. This test involves measurement of the change in the angle of the urethra when it is at rest and when it is straining. An angle change of greater than 30 degrees often indicates significant weakness of the muscles that support the bladder.
ReferencesGerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 3.
Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008;299:1446-1456.
Rogers RG. Clinical practice: urinary stress incontinence in women. N Engl J Med. 2008;358:1029-1036.
Shamliyan TA, Kane RL, Wyman J, Wilt TJ. Systematic review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med. 2008;148:459-473.
Urinary (or bladder) incontinence is when you are not able to keep urine from leaking out of your urethra, the tube that carries urine out of your body from your bladder. You may leak urine from time to time. Or, you may not be able to hold any urine.
The three main types of urinary incontinence are:
Bowel incontinence is when you are unable to control the passage of stool. It is not covered in this article.
Alternative NamesLoss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary
ConsiderationsNORMAL URINATION
Normally, the bladder begins to fill with urine from the kidneys. The bladder stretches to allow more and more urine.
You should feel the first urge to urinate when there is around 200 mL (just under 1 cup) of urine stored in your bladder. A healthy nervous system will respond to this stretching sensation by letting you know that you have to urinate. At the same time, the bladder should keep filling.
The average person can hold around 350 to 550 mL (more than 2 cups) of urine in the bladder. Two muscles help control the flow of urine:
When it is time to empty the bladder, the bladder wall (detrusor) muscle contracts or squeezes to force urine out of the bladder. Before this muscle squeezes, your body must be able to relax the sphincter to allow the urine to pass out of your body.
To control urination, you must have:
Incontinence is most common among the elderly. Women are more likely than men to have urinary incontinence.
Infants and children are not incontinent before they have been toilet trained. Children up to age 6 may still have accidents sometimes. Young (and sometimes teenage) girls may leak a little bit of urine when they laugh.
It is normal for children to wet the bed until age 5 or 6.
Common CausesCauses of urinary incontinence include:
Incontinence may be sudden and go away after a short period of time. Or, it may continue long-term. Causes of sudden or temporary incontinence include:
Causes that may be more long-term:
See your health care provider for tests and a treatment plan. What type of treatment you get depends on what caused your incontinence and what type you have.
The following methods are used to strengthen the muscles of your pelvic floor:
For urine leaks, wear absorbent pads or undergarments. There are many well-designed products that no one else will notice. See also: Urinary incontinence products
Other treatments include:
See also: When you have urinary incontinence
For more information about treating urinary incontinence, see also:
If you have overflow incontinence or cannot empty your bladder completely, you may need to use a catheter. For more information on catheter use, see also:
Call your health care provider ifTalk to your health care provider about incontinence. Health care providers who treat incontinence are called gynecologists and urologists. They can find the cause and recommend treatments.
Call your local emergency number (such as 911) or go to an emergency room if you suddenly lose control over urine and you have:
Call your health care provider if:
Your health care provider will ask about your medical history. You will have a physical exam focusing on your abdomen, genitals, pelvis, rectum, and nervous system.
Your health care provider may ask questions such as:
Tests that may be performed include:
Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 3.
Resnick NM. Incontinence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 25.
Deng DY. Urinary incontinence in women. Med Clin North Am. 2011;95:101-109.
Reviewed ByReview Date: 09/19/2011
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Urinary incontinence can be classified into Functional Incontinence, where you cannot reach the toilet in time due to lack of mobility. Stress Urinary Incontinence when the ladder unexpectedly leaks due to pressure from physical exertion. Urge Urinary Incontinence when the
Incontinence is a term used for the loss of control over bowel or bladder. Urinary incontinence and fecal inconntinence have many physical-biological causes.
It is a type of urinary incontinence wherein, the bladder unexpectedly leaks due to pressure from physical exertion. Women experience this kind of incontinence often.
Most urinary incontinence is caused by leakage when stress is applied to the abdominal muscles by coughing, sneezing, or exercising.
Any pregnant female can experience (temporary) urinary incontinence and urgency. If accompanied by burning or pain, it could be from a urinary tract infection.
Diane Kaschak Newman has written: 'Overcoming overactive bladder' -- subject(s): Popular works, Bladder, Diseases 'The urinary incontinence sourcebook' -- subject(s): Urinary incontinence, Urinary Incontinence
W H A T I S U R I N A R Y I N C O N T I N E N C E. Urinary incontinence, the spontaneous and uncontrolled loss of urine can have a serious negative impact on a woman's physical and psychological well- being. Approximately 50% of women will experience some form of urinary incontinence in their lifetime, as prevalence and age are positively correlated. S Y M P T O M S OF I N C O N T I N E N C E. The primary and main symptom of urinary incontinence is the unintentional release (leakage) of urine, to know more about how and when this occur, we need to know in detail about the type of urinary incontinence.
They include retropubic slings for urinary incontinence, artificial sphincter implants for urinary and fecal incontinence, and bladder and colon diversion surgeries for restoration of voiding and waste function.
In men, an enlarged prostate gland can obstruct the bladder, causing overflow incontinence.
It is used in the treatment of overactive bladder, with symptoms of urinary urge incontinence. Solifenacin is used to treat overactive bladder with symptoms such as urinary incontinence, urinary frequency as well as urinary urgency. It reduces muscle spasms of the urinary tract and bladder.
urinary incontinence
To combat stress urinary incontinence, it is recommended that women lose weight and exercise their pelvic floor with Keigel exercises. Also, reducing liquids, caffeine, spicy foods, and carbonated beverages may also help to combat stress urinary incontinence.