Sarah loves to spend time with her friends talking about her grandchildren and going to exercise classes with neighbors. But she’s started to have a problem that keeps her from getting out. It’s embarrassing, but lately Sarah hasn’t been able to get to the bathroom before she wets her pants. She doesn’t know what’s happening, but the problem is keeping Sarah at home.
Sarah might have a problem with bladder control called urinary incontinence (the accidental leakage of urine). While it can happen to anyone, urinary incontinence is more common in older people. Women are more likely than men to be incontinent. If this problem is happening to you or someone you love, there is help. Incontinence can often be cured or controlled. You can talk to a healthcare provider to learn more about what to do.
Causes of incontinence
Incontinence can happen for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation, and some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it might be due to:
- Weak bladder muscles
- Overactive bladder muscles
- Damage to nerves that control the bladder from diseases such as multiple sclerosis or Parkinson’s disease
- Blockage from an enlarged prostate in men
- Diseases such as arthritis that may make it difficult to get to the bathroom in time
The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. Incontinence typically occurs if the muscles relax without warning.
The first step in treating incontinence is to see a doctor. He or she will give a physical exam and take medical history. The doctor will ask about symptoms and the medicines in use. He or she will want to know about recent illnesses or surgeries. Your doctor also may do a number of tests. These might include:
- Urine and blood tests
- Tests that measure how well the bladder empties
In addition, the doctor might ask that a daily diary be kept that records when urination occurs and when urine is leaked. A visit to an urologist — a doctor who specializes in urinary tract problems — might also be suggested.
Types of incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder — for example, during exercise, coughing, sneezing, laughing, or lifting heavy objects. Stress incontinence is the most common type of bladder control problem in younger and middle-age women. It may begin around the time of menopause.
- Urge incontinence happens when people have a sudden need to urinate and aren’t able to hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
- Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injury can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control, but have a problem getting to the toilet quickly enough because of arthritis or other disorders that make it hard to move.
Today, there are more treatments for urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.
Bladder control training might help. The doctor might suggest trying the following:
- Pelvic muscle exercises (also known as Kegel exercises) work the muscles that are used to stop urinating. Making these muscles stronger helps a person to hold urine in the bladder longer.
- Biofeedback uses sensors to make a person more aware of signals from the body. This might help with regaining control over the muscles in the bladder and urethra. Biofeedback also can be helpful when learning pelvic muscle exercises.
- Timed voiding can help with control of the bladder. In timed voiding, urination happens on a set schedule (for example, every hour). The time can slowly be extended between bathroom trips. When timed voiding is combined with biofeedback and pelvic muscle exercises, it might be easier to control urge and overflow incontinence.
- Lifestyle changes might help with incontinence. You or your loved one can benefit from: losing weight, quitting smoking, saying “no” to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation, and avoiding lifting heavy objects.
Visit NIHSeniorHealth to learn more about bladder training and lifestyle changes to manage urinary incontinence.
Information courtesy of the National Institute of Health (NIH)