Doctor's Notes on Urinary Incontinence
Incontinence refers to the involuntary loss of urine. This loss of urine is commonly due to weak muscles that control the exit of the bladder, or by the inability to hold urine when the urge to urinate occurs. Several types of incontinence exist, and the most common types include stress incontinence, which is associated with coughing, sneezing, or exercising, and urge incontinence, when the bladder feels as if it needs to be relieved immediately, regardless of how much urine is in the bladder.
Symptoms of incontinence include
- uncontrollable leakage of urine,
- feeling the need to urinate immediately (urgency),
- difficulty starting the urine stream (hesitancy),
- urinating more than usual (frequency),
- pain or burning with urination (often associated with infection),
- blood in the urine,
- having to get up at night to urinate (nocturia),
- dripping or dribbling urine after urination is completed, and
- bearing down to start the urine stream (straining).
What Is the Treatment for Incontinence?
Treatment for incontinence depends on the type of incontinence and may include:
- Lifestyle changes
- Change drinking habits
- Exercise regularly
- Maintain a healthy weight
- Avoid constipation
- Don’t smoke
- Train your bladder
- Do pelvic floor muscle exercises
- Control the urge to urinate
- For urgency incontinence
- For men who have an enlarged prostate:
- 5-alpha reductase inhibitors
- Phosphodiesterase-5 inhibitors
- Medical devices
- Catheter for overflow incontinence
- Pessary for women for stress incontinence
- Bulking agents injected near the urinary sphincter to treat stress incontinence
- Electrical nerve stimulation for urgency incontinence and other symptoms to help change the bladder’s reflexes
Must Read Articles:
BedwettingRead about bedwetting (nocturnal enuresis or urinary incontinence) causes, symptoms, and treatments and solutions, including moisture detectors and medication (imipramine, DDAVP).
Bladder Control MedicationsPeople who have bladder control problems have trouble stopping the flow of urine from the bladder. This problem is also called urinary incontinence. A number of medications are available to treat urinary incontinence.
Bladder Control ProblemsBladder control problems, or urinary incontinence, affect over 13 million people in the U.S. Causes include urinary tract infection, overactive bladder, blocked urethra, medication side effect, and muscle weakness. Symptoms and signs include hematuria, straining, dribbling, frequency, and urgency. Treatment may incorporate behavioral therapy, medication, and surgery.
Enlarged Prostate (BPH)Enlarged prostate (benign prostatic hyperplasia BPH) As the prostate gland grows, it may press on the urethra and cause difficulty with urination. Symptoms and signs of an enlarged prostate include blood in the urine, the inability to urinate, frequent urination, and a slow flow or dribbling urine.Medications and surgery are available if an enlarged prostate is causing problems. A man's prostate gland usually starts to enlarge after he reaches age 40 years or middle age.
Foley CatheterA Foley catheter is a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also known as an indwelling catheter.
Frequent UrinationHaving to urinate more than eight times a day or waking up to go to the bathroom more than once a night is considered frequent urination. Symptoms include urgency, frequency, hesitancy, dribbling, straining, hematuria, and urinary incontinence. Treatment of frequent urination depends upon the underlying cause.
Inability to UrinateThe inability to urinate (urinary retention) may be caused by an enlarged prostate, a urinary tract infection, or ruptured disc. Symptoms include abdominal pain and fever. Acute urinary retention requires a trip to the emergency department.
Incontinence FAQsGet answers to frequently asked questions about urinary incontinence types, causes, health factors, symptoms, tests, treatment, and exercises to strengthen the pelvic floor muscles.
Overactive BladderOveractive bladder (OAB) is a type of urinary incontinence. Causes include urinary tract infection, kidney and bladder stones, bladder tumors, diabetic neuropathy, stroke, multiple sclerosis, spinal cord injury, dementia, and Parkinson's disease. Nocturia, urinary urgency, and urinary frequency are symptoms. Treatment will likely include a combination of behavioral therapy and medication.
Prolapsed BladderA prolapsed bladder, or cystocele, occurs when tissues that support the bladder weaken or stretch, causing the bladder to descend into the vagina. Read about symptoms, surgery, and recovery time.
Prolapsed UterusProlapsed uterus is a condition where a portion or all of the uterus prolapses into our outside of the vagina. Causes of prolapsed uterus include pregnancy, obesity, menopause, advanced age, excessive weight lifting, and conditions that strain the abdomen (chronic coughing with bronchitis, asthma, or constipation). Treatment of a prolapsed uterus is surgery or a pessary.
StrokeStroke is a medical emergency. When a person has a stroke, part of the blood supply to the brain is cut off or greatly decreased. There are two main types of stroke, ischemic and hemorrhagic. Stroke symptoms include dizziness, sudden headache, weakness in an arm or leg on the same side, weakness in the muscles of the face, difficulty speaking, vision problems, and more. Treatment of stroke depends on the type and severity of the stroke suffered.
Urologic Dysfunction After MenopauseUrologic conditions that can occur around the time a woman goes through menopause include bladder control problems, bladder prolapse (descent of the bladder into the vagina), and urinary tract infections. Diagnosis of urologic problems may include: urinalysis, microscopy of the urine, and urine culture. Treatment may include behavioral modification, medication, and surgery.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.