Incontinence (inability to control urine flow)

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Overview

Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities. But incontinence can often be stopped or controlled.

 Located in the lower abdomen, the bladder is a hollow organ that is part of the urinary system, which also includes the kidneys, ureters, and urethra. During urination, muscles in the bladder tighten to move urine into the tube-shaped urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don’t work the way they should, urine can leak, resulting in urinary incontinence.


Symptoms

The symptoms tell you what kind of urinary incontinence you have.


Not all incontinence is long term. Some causes are temporary so that the incontinence ends when the cause goes away. Vaginal infections can cause temporary incontinence. Irritation, medications, constipation and restricted mobility can cause it. Urinary tract infections (UTIs) are a common cause of temporary incontinence and should be addressed.


It remains important that if the cause isn't temporary or easily treated, the leakage is probably one of the four types described above. With SUI, the pelvis or sphincter muscles (or both) aren't strong enough to hold the urine by closing the bladder and urethra. With OAB, the bladder muscles contract too much, pushing urine out even when you are not ready to release it. Mixed incontinence is usually both SUI and OAB. With overflow incontinence, the bladder gets too full without releasing.


These are the symptoms for each:


SUI

The key symptom of SUI is leaking when you are active. The activity and amount of leaking depends on how severe the SUI is. To learn more about SUI, visit our SUI article page and www.UrologyHealth.org/SUI.


OAB

The main symptom of OAB is a sudden, strong urge to urinate that you can't control. The urge may or may not cause your bladder to leak urine. To learn more about OAB, visit our OAB article page and www.UrologyHealth.org/OAB.


You can also download our " Overactive Bladder Assessment Tool" [pdf]. Print the questions and answer them. Use your answers talk to your doctor about your symptoms. The quiz will help you and your doctor know which OAB symptoms you have. It will help your doctor figure out how best to treat you.


Mixed incontinence (SUI and OAB)

The symptoms of mixed incontinence include leaking and a sudden, strong urge to urinate. Mixed incontinence is when you have more than one type of incontinence. Most often, people with mixed incontinence have SUI and OAB.


To find out more about SUI, visit our SUI article page and www.UrologyHealth.org/SUI.

To find out more about OAB, visit our OAB article page and www.UrologyHealth.org/OAB.


Overflow Incontinence

Frequent small urinations and constant dribbling are the main symptoms of overflow incontinence. The bladder is unable to empty. Symptoms happen when the bladder is full. This type is less often in women however, dropped bladders, prior bladder surgeries or diabetes may affect this. It is more common in men with a history of prostate problems or surgery.




Causes

Common causes of urinary incontinence may include:


Aging

As you get older, the muscles supporting your bladder typically become weaker, which raises your risk for incontinence.


To maintain strong muscles and a healthy bladder, it’s important to stay as active as you can, eat a diet rich in nutrients, and maintain a healthy weight. This may improve your chances of avoiding incontinence as you age.


Damage

Your pelvic floor muscles support your bladder. Damage to these muscles can cause incontinence. It can be caused by certain types of surgery, such as a hysterectomy. It’s also a common result of pregnancy and childbirth.


Enlarged prostate

In men, the prostate gland surrounds the neck of the bladder. This gland releases fluid that protects and nourishes your sperm. It tends to enlarge with age. It’s common for males to experience some incontinence as a result.


Cancer

Prostate or bladder cancer can cause incontinence. In some cases, treatments for cancer can also make it harder for you to control your bladder. Even benign tumors can cause incontinence by blocking your flow of urine.


Other potential causes

Other potential causes of incontinence may include:


constipation

urinary tract infections (UTIs)

kidney or bladder stones

prostatitis, or inflammation of your prostate

interstitial cystitis, or a chronic condition that causes inflammation within your bladder

side effects from certain medications, such as blood pressure drugs, muscle relaxants, sedatives, and some heart medications


Risk factors

Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities. But incontinence can often be stopped or controlled.


What happens in the body to cause bladder control problems? Located in the lower abdomen, the bladder is a hollow organ that is part of the urinary system, which also includes the kidneys, ureters, and urethra. During urination, muscles in the bladder tighten to move urine into the tube-shaped urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don’t work the way they should, urine can leak, resulting in urinary incontinence.


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Complications

Complications of chronic urinary incontinence include:


Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.

Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.

Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.

Prevention

Different events throughout your life can lead to many of the things that cause incontinence. The muscles that support your pelvic organs can weaken over time. For women, these muscles can also be weakened by big life events like pregnancy and childbirth. However, in the same way you work out to build strength in your legs or arms, you can do exercises to strengthen your pelvic floor muscles. Doing exercises to strengthen your pelvic muscles may not prevent you from having any issues with incontinence, but it can help you regain control of your bladder. Maintaining a healthy body weight can also help with bladder control. Talk to your healthcare provider about the best ways to maintain strong pelvic floor muscles throughout your life.