Urinary incontinence
Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary; Overactive bladderUrinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is 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:
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Stress incontinence -- occurs during activities like coughing, sneezing, laughing, or exercise.
Stress incontinence
Stress urinary incontinence occurs when your bladder leaks urine during physical activity or exertion. It may happen when you cough, sneeze, lift so...
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Urge incontinence -- occurs as a result of a strong, sudden need to urinate immediately. Then the bladder squeezes and you lose urine. You don't have enough time after you feel the need to urinate to get to the bathroom before you do urinate.
Urge incontinence
Urge incontinence occurs when you have a strong, sudden need to urinate that is difficult to delay. The bladder then squeezes, or spasms, and you ma...
ImageRead Article Now Book Mark Article - Overflow incontinence -- occurs when the bladder does not empty and the volume of urine exceeds its capacity. This leads to dribbling.
Mixed incontinence occurs when you have more than one type of incontinence, usually both stress and urge urinary incontinence.
Bowel incontinence is when you are unable to control the passage of stool. It is not covered in this article.
Bowel incontinence
Bowel incontinence is the loss of bowel control, causing you to unexpectedly pass stool. This can range from sometimes leaking a small amount of sto...
Causes
Causes of urinary incontinence include:
- Blockage in the urinary system
- Brain or nerve problems
- Dementia or other mental health problems that make it hard to feel and respond to the urge to urinate
- Problems with the urinary system
- Nerve and muscle problems
- Weakness of the pelvic or urethral muscles
- Enlarged prostate
- Diabetes
- Use of certain medicines
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:
- Bedrest -- such as when you are recovering from surgery
- Certain medicines (such as diuretics, antidepressants, tranquilizers, some cough and cold remedies, and antihistamines)
- Mental confusion
- Pregnancy
- Prostate infection or inflammation
- Stool impaction from severe constipation, which causes pressure on the bladder
Impaction
A fecal impaction is a large lump of dry, hard stool that stays stuck in the rectum. It is most often seen in people who are constipated for a long ...
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Urinary tract infection or inflammation
Urinary tract infection
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
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Causes that may be more long-term include:
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Alzheimer disease.
Alzheimer disease
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer disease (AD) is the most common form of dementia. It affects memo...
ImageRead Article Now Book Mark Article - Bladder cancer.
- Bladder spasms.
- Large prostate in men.
- Nervous system conditions, such as multiple sclerosis or stroke.
- Nerve or muscle damage after radiation treatment to the pelvis.
- Pelvic prolapse in women which is falling or sliding of the bladder, urethra, or rectum into the vagina. This may be caused by pregnancy and delivery.
- Problems with the urinary tract.
- Spinal cord injuries.
- Weakness of the sphincter, the circle-shaped muscles that open and close the bladder. This can be caused by prostate surgery in men, or surgery to the vagina in women.
Home Care
If you have symptoms of incontinence, see your health care provider for evaluation, tests, and a treatment plan. Which treatment you get depends on what caused your incontinence and what type you have.
There are several treatment approaches for urinary incontinence:
Lifestyle changes. These changes may help improve incontinence. You may need to make these changes along with other treatments.
- Keep your bowel movements regular to avoid constipation. Try increasing the fiber in your diet.
- Quit smoking to reduce coughing and bladder irritation. Smoking also increases your risk for bladder cancer.
- Avoid alcohol and caffeinated drinks such as coffee, which can stimulate your bladder.
- Lose weight if you need to.
- Avoid foods and drinks that may irritate your bladder. These include spicy foods, carbonated drinks, and citrus fruits and juices.
- If you have diabetes, keep your blood sugar under good control.
For urine leaks, wear absorbent pads or undergarments. There are many well-designed products that no one else will notice.
Well-designed products
There are many products to help you manage urinary incontinence. You can decide which product to choose based on:How much urine you loseComfortCostD...
Bladder training and pelvic floor exercises. Bladder retraining helps you gain better control over your bladder. Kegel exercises can help strengthen the muscles of your pelvic floor. Your provider can show you how to do them. Many women do not do these exercises correctly, even if they believe they are doing them correctly. Often, people benefit from formal bladder strengthening and retraining with a pelvic floor specialist.
Medicines. Depending on the type of incontinence you have, your provider may prescribe one or more medicines. These medicines help prevent bladder muscle spasms, relax the bladder, and improve bladder function. Your provider can help you learn how to take these medicines and manage their side effects.
Surgery. If other treatments do not work, or you have severe incontinence, your provider may recommend surgery. The type of surgery you have will depend on:
- The type of incontinence you have (such as urge, stress, or overflow)
Urge
Urge incontinence occurs when you have a strong, sudden need to urinate that is difficult to delay. The bladder then squeezes, or spasms, and you ma...
ImageRead Article Now Book Mark ArticleStress
Stress urinary incontinence occurs when your bladder leaks urine during physical activity or exertion. It may happen when you cough, sneeze, lift so...
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- The cause (such as pelvic prolapse, enlarged prostate, enlarged uterus, or other causes)
Enlarged prostate
The prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...
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If you have overflow incontinence or you cannot fully empty your bladder, you may need to use a catheter. You may use a catheter that stays in long-term, or one that you are taught to put in and take out yourself.
Catheter
You have an indwelling catheter (tube) in your bladder. "Indwelling" means inside your body. This catheter drains urine from your bladder into a ba...
Bladder nerve stimulation. Urge incontinence and urinary frequency can sometimes be treated by electrical nerve stimulation. Pulses of electricity are used to reprogram bladder reflexes. In one technique, the provider inserts a stimulator through the skin near a nerve in the leg. This is done weekly in the provider's office. Another method uses battery-operated implanted device similar to a pacemaker that is placed under the skin in the lower back.
Botox injections. Urge incontinence can sometimes be treated with an injection of onabotulinum A toxin (also known as Botox). The injection relaxes the bladder muscle and increases the storage capacity of the bladder. The injection is delivered through a thin tube with a camera on the end (cystoscope). In most cases, the procedure can be done in the provider's office.
When to Contact a Medical Professional
Talk to your provider about incontinence. Some providers who treat incontinence are gynecologists and urologists that specialize in this problem. 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:
- Difficulty talking, walking, or speaking
- Sudden weakness, numbness, or tingling in an arm or leg
- Loss of vision
- Loss of consciousness or confusion
- Loss of bowel control
Contact your provider if you have:
- Cloudy or bloody urine
- Dribbling
- Frequent or urgent need to urinate
- Pain or burning when you urinate
- Trouble starting your urine flow
- Fever
References
Heesakkers JPFA, Blok B. Electrical stimulation and neuromodulation in storage and emptying failure. In: Partin AW, Dmochowski RR, Kavoussi LR , Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 122.
Lentz GM, Miller JL. Lower urinary tract function and disorders: physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 21.
Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.
Resnick NM. Incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 23.
Reynolds WS, Dmochowski R, Karram MM, Mahdy A. Surgical management of refractory overactive bladder and detrusor compliance abnormalities. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 90.
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Bladder function - neurological control
Animation
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Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
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Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
Review Date: 10/15/2022
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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