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What is urinary Incontinence?

Urinary incontinence (UI) is the loss of urine control; you may not be able to hold your urine until you can reach a restroom. It may be a short-term problem caused by another health issue, or it may be a long-term problem that you'll have to manage. UI can range from a slight loss of urine to severe, frequent wetting. Fear of wetting yourself can keep you from enjoying activities with your family and friends; incontinence during sex can cause stress. UI is not a normal part of again, but it is common in older people. The following are some of the different types of UI:

  • Urge incontinence is when the need to urinate comes on quickly;you may not be able to get to a restroom in time. It is common in people who have certain conditions, such as diabetes, stroke, dementia, Parkinson disease, and multiple sclerosis. It may be a sign that these other conditions need attention. It is more common in older adults and may be a sign of urinary tract infection or an overactive bladder. 
  • Stress incontinence is the most common type; it is more common in women. You may leak urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other movements that put pressure on the bladder.
  • Functional incontinence is when you have urine control, but cannot get to a restroom in time. This may be due to conditions that make it hard to move, such as arthritis.
  • Overflow incontinence is the leakage of small amounts of urine caused by an overfilled bladder; it may feel like you cannot fully empty your bladder.
  • Mixed incontinence is a mix of more than one of the types listed above. 


What causes urinary incontinence?

Changed from certain diseases or medications may cause UI; it may also happen at the start of an illness. Women are most likely to have incontinence during pregnancy and childbirth; hormone changes of menopause may cause it as well because of weakened and stretched pelvic muscles. Some of the other common causes include:

  • Pregnancy and childbirth
  • Menopause
  • Birth defects
  • Aging
  • Urinary tract infection (may be the first and only symptom)
  • For men, an enlarged prostate gland or treatment of a prostate problem
  •  Stool build-up in the bowels
  • Being overweight which increases pressure on the bladder and the muscles that control it
  • Nerve damage from spinal cord injuries, diabetes, Parkinson disease, and multiple sclerosis
  • Overactive bladder


What are the symptoms of urinary incontinence?

The following are the most common symptoms of UI:

  • Not being able to urinate
  • Pain related to filled the bladder or urination without bladder infection
  • Stream of urine gets weaker with or without a feeling that you have not emptied your bladder completely
  • Urinate more without bladder infection
  • Needing to rush to the restroom or losing urine if you do not get to a restroom in time
  • Abnormal urination or changes related to stroke, spinal cord injury, or multiple sclerosis
  • Urine leakage that prevents activities
  • Leakage of urine that starts or continues after surgery
  • Leakage o urine that causes embarrassment
  • Frequent bladder infections

The symptoms of UI may look like other conditions or health problems; always consult your provider for a diagnosis.


How is urinary incontinence diagnosed?

The most important step in diagnosing UI is talking to a healthcare provider. Don’t let embarrassment keep you from getting help. It’s important to see a provider for a physical exam that focuses on the urinary and nervous systems, reproductive organs and includes testing urine samples. You may be referred to a urologist or urogynecologist, a healthcare provider who specializes in diseases of the urinary tract.


How is urinary incontinence treated?

Your healthcare provider will figure out the best treatment based on:

  • How old you are
  • Your overall health and health history
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment for UI depends on the cause and may include the following:

Behavioral therapies : These will help you regain bladder control and include:

  • Bladder training teaching you to resist the urge to void and expand the times between voiding over time. 
  • Scheduled toileting uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder every 2-4 hours to prevent leaking. 

Pelvic muscle rehab: This will improve pelvic muscle tone and prevent leakage. Treatment includes:

  • Kegel exercises: regular, daily exercise of pelvic muscles can make the bladder muscles stronger and improve, and even prevent urinary incontinence. This is the most helpful for younger women and should be performed 30-80 times daily for at least 8 weeks. 
  • Biofeedback used with Kegel exercises, this treatment helps you gain awareness and control of your pelvic muscles.
  • Vaginal weight training; small weights are held within the vagina by tightening the vaginal muscles. This may be done for 15 minutes, twice daily, for 4-6 weeks.
  • Pelvic floor electrical stimulation; mild electrical pulses stimulate muscle contractions. This may be done along with Kegel exercises. 

You can also manage incontinence with other devices and products which include catheters, pelvic organ slings, urethral plugs, urine collection systems, and penile compression devices. Talk to your provider about which treatment would work best for you.