Urinary incontinence means you lose bladder control or can’t store urine like you should.
This problem is not a normal part of aging. It often affects older persons because muscles and nerves used in bladder control don’t work as well with aging.
Signs, Symptoms & Causes
Overactive Bladder
With this condition, you have at least 2 of these problems:
An urgency to pass urine
Urge incontinence
You pass urine 8 or more times a day and 2 or more times during night.
Acute Incontinence
This form comes on suddenly. Often, it is a symptom of a new illness or problem. Examples are a bladder infection, diabetes (new or out-of-control), and inflammation of the prostate, urethra, or vagina. It can also be a side effect of some medicines, such as water pills.
This form is often easily reversed when the problem that caused it is treated.
Persistent Incontinence
This form comes on gradually over time. There are many types of this form. The ones below are the most common types:
Stress Incontinence. Urine leaks out when there is a sudden rise in pressure on the bladder from weak pelvic floor muscles. This can happen when you cough, sneeze, laugh, lift, exercise, or strain to pass stool. This type is more common in women than in men.
Mixed Incontinence. This type is a mix of stress and urge incontinence. Many women have both types of incontinence.
Overflow Incontinence. This is the constant dribbling of urine because the bladder overfills. This may be due to an enlarged prostate, diabetes, or multiple sclerosis.
Urge Incontinence. The urge to pass urine is strong and comes on so fast, that the urine is released before you can get to the toilet. Some people are able to get to the toilet in time but feel the urge to urinate more than eight times a day. Often, they don’t urinate much when they get there. It can happen during sleep or when you hear or touch running water. The most common cause is an overactive bladder. Other causes include an enlarged prostate gland, spinal injury, or Parkinson’s disease.
Functional Incontinence. With this type, you have trouble getting to the bathroom fast enough, even though you have bladder control. This can happen in a person who is physically challenged.
Treatment
The first step is to find out if another problem causes the incontinence and to treat that problem. Other treatments include:
Pelvic floor exercises, called Kegel exercises.
Medication.
Collagen injections. These treat a certain type of stress incontinence.
Surgery, as needed, to correct the problem.
Self-Care
Avoid caffeine. Limit or avoid fluids 2 to 3 hours before bedtime.
Limit carbonated drinks, alcohol, citrus juices, greasy and spicy foods, and items with artificial sweeteners.
Empty your bladder before you leave the house, take a nap, or go to bed.
Train your bladder. Track how often you urinate or leak urine every day. Slowly add 15 minutes between bathroom visits. Urinate each time, even if you don’t feel the urge.
Wear clothes you can pull down easily when you use the bathroom.
Wear absorbent pads or briefs, if needed.
Keep the pathway to your bathroom free of clutter and well lit. Leave the bathroom door open until you use it. Use a night light in the bathroom when it is dark.
Use an elevated toilet seat and grab bars if these will make it easier for you to get on and off the toilet.
Keep a bedpan, plastic urinal (for men), or portable commode chair near your bed.
Ask your doctor if your type of incontinence could be managed by using self-catheters. These help to empty your bladder all the way. A doctor needs to prescribe self-catheters.
Kegel Exercises
Kegel exercises are pelvic floor exercises. These help treat or cure stress (but may not help if you have urge incontinence). Persons who have leaked urine for years can benefit greatly from these exercises. How do you do them?
First, start to urinate, then hold back and try to stop. If you can slow the stream of urine, you are using the right muscles. You should feel muscles squeeze around the urethra and the anus. The urethra is the tube through which urine is passed. The anus is the opening through which stool is passed.
Next, relax your body, and close your eyes. Imagine that you are going to pass urine, but hold back from doing so. You should feel the muscles squeeze like you did in the step before this one.
Squeeze the muscles for 3 seconds. Then relax them for 3 seconds. When you squeeze and relax, count slowly. Work up to doing 3 sets of 10 contractions each day, holding each contraction for 10 seconds at a time. You can do these exercises at any time but not at the same time as you are urinating.
When you do these exercises, do not tense the muscles in your belly or buttocks. Do not hold your breath, clench your fists or teeth, or make a face.
Squeeze your pelvic floor muscles right before and during whatever it is (coughing, sneezing, jumping, etc.) that causes you to lose urine. Relax the muscles once the activity is over.
Women can also use pelvic weights prescribed by their doctor. A women inserts a weighted cone into the vagina and squeezes the correct muscles to keep the weight from falling out.
It may take several months to benefit from pelvic floor exercises. They should be done daily.
Triage Questions
Question 1
Does loss of bladder control occur with any of these problems?
A spine or back injury
Slurred speech or not being able to speak
Loss of sight. Double or blurred vision.
Sudden, severe headaches
Paralysis, weakness, or loss of feeling in an arm or leg, and/or the face on the same side of the body
Change in personality, behavior, and/or emotions
Confusion and dizziness
Sudden new seizures with collapse and shaking of the limbs
