At other times, leakage of urine is frequent or severe
Are there different types of urinary incontinence?
There are several types of urinary incontinence:
Stress urinary incontinence
Loss of urine when a woman coughs, laughs, or sneezes
Leaks also can happen when a woman walks, runs, or exercises
It is caused by a weakening of the tissues that support the bladder or the muscles of the urethra
Urge incontinence
Leakage of urine caused by overactive bladder muscles that contract too often or problems with the nerves that send signals to the bladder
Mixed incontinence
A combination of both stress and urge incontinence symptoms
Overflow incontinence
Steady loss of small amounts of urine when the bladder does not empty all the way during voiding
It can be caused by an underactive bladder muscle or blockage of the urethra
What are the symptoms of urinary incontinence?
In addition to leaking urine, a woman with incontinence also may have other symptoms:
Urgency
A strong urge to urinate whether or not the bladder is full, often with pelvic pressure
Frequency
Voiding more often than she considers usual
Nocturia
The need to void during hours of sleep
Dysuria
Painful voiding
Enuresis
Bed-wetting or leaking while sleeping
What causes urinary incontinence?
Urinary incontinence can have short-term causes and long-term causes
Short-term causes are easier to treat and include the following:
Urinary tract infection
Loss of bladder control may be caused by an infection of the urinary tract
Infections of the bladder (cystitis) are common in women
These infections are treated with antibiotics
Medications
Loss of bladder control may be a side effect of medications, such as diuretics
Abnormal growths
Polyps, bladder stones, or less commonly, bladder cancer, can cause urinary incontinence
Abnormal growths often cause urge incontinence and may be associated with blood in the urine
If you see blood in your urine, or if you are unsure about the source of any bleeding, it is important to alert your health care provider right away
Long-term causes include the following:
Pelvic support problems
The pelvic organs are held in place by supportive tissues and muscles
These supporting tissues may become torn or stretched, or they may weaken because of aging
If the tissues that support the urethra, bladder, uterus, or rectum become weak, these organs may drop down, causing urine leakage or making it hard to pass urine
Urinary tract abnormalities
A fistula is an abnormal opening from the urinary tract into another part of the body, such as the vagina
It can allow urine to leak out through the vagina
Neuromuscular problems
These disorders can interfere with the transmission of signals from the brain and spinal cord to the bladder and urethra
How is urinary incontinence diagnosed?
A number of steps may be needed to find the cause of urinary incontinence
In some cases, there may be more than one cause
You may be asked to keep a voiding diary for a few days in which you record the time and amount of urine leakage
Also note how much liquid you drank and what you were doing when a leak occurred
A pelvic exam will be done to detect physical conditions that might be linked to the problem
Lab tests may also be done to detect a urinary tract infection
Other tests that assess how your bladder functions include the following:
Urodynamic tests
The bladder is filled through a catheter
These tests check the function of the urethra and bladder
Postvoid residual volume test
The amount of urine that is left in the bladder after urinating is measured with an ultrasound device or by placing a catheter in the bladder
Stress test
You are asked to cough a few times with a full bladder
Any loss of urine is recorded
Cystoscopy
A thin, lighted tube with a lens at the end is used to look inside the bladder and urethra
Dye test
A pad is worn after a nontoxic dye is put in the bladder
If the pad gets stained with the dye, there was a loss of urine
How is urinary incontinence treated?
There are many options for treatment
Often treatments are more effective when used in combination
Treatment options include:
Lifestyle changes
Bladder training
Physical therapy
Devices, medications
Bulking agents
Surgery
What are some of the lifestyle changes that are used…
Making the following changes in your lifestyle, if they apply to you, may help the problem:
Lose weight
In overweight women, losing weight has been shown to decrease the frequency of urine leakage
Avoid constipation
Repeated straining may damage the pelvic floor
Drink less fluids and limit intake of caffeine, which is a diuretic
Seek treatment for chronic coughing
Stop smoking
What is bladder training?
It’s a procedure used to learn how to control the urge to empty the bladder and increase the times between urinating to normal intervals (every 3-4 hours during the day and every 4-8 hours at night)
After a few weeks of this training, leakage may occur less often
What types of physical therapy are used to treat urinary…
There are many types of physical therapy that can be done to treat urinary incontinence
Kegel exercises can help strengthen the pelvic muscles
Kegel exercises, along with bladder training and modifying fluid intake, are often very successful in treating stress incontinence and urge incontinence
If you have trouble doing Kegel exercises, you may want to see a physical therapist who specializes in women’s pelvic health
Biofeedback is a training technique that may be useful if you have problems locating the correct muscles
How are Kegel exercises done?
Kegel exercises tone your pelvic muscles
Here is how they are done:
Squeeze the muscles that you use to stop the flow of urine (but do not do these exercises while you are urinating)
Hold for up to 10 seconds, then release
Do this 10-20 times in a row at least 3 times a day
Do not squeeze the muscles of the leg, buttock, or abdomen
Do these exercises on a regular basis
It may take 4-6 weeks to notice an improvement in urinary incontinence symptoms
What devices are used to treat urinary incontinence?
A pessary is a device that is inserted into the vagina to treat pelvic support problems and urinary incontinence
Pessaries support the pelvic structures, and some compress the urethra
They come in all shapes and sizes
They are useful for women who do not want or cannot have surgery to correct their incontinence
What medications are used for treatment?
Drugs that help control muscle spasms or unwanted bladder contractions can help prevent leaks associated with urge incontinence
These medications also can help reduce the frequency of urination
Your health care provider will help you decide which drug is most likely to work best for you
What are bulking agents?
These agents may be used when the muscle surrounding the urethra is very weak and extensive surgery is not an option or has not worked
A substance is injected into the tissues around the urethra to add bulk
The urethra becomes narrowed, decreasing leakage
This procedure can be done in a doctor’s office or clinic
What types of surgery treat urinary incontinence?
Several surgical procedures have been developed to treat stress urinary incontinence
You and your health care provider should discuss many factors, including your age, lifestyle, and general health, before choosing to have surgery
