Urinary Incontinence

About Urinary Incontinence

General Information

Urinary incontinence is the involuntary release of urine from the bladder. It is one of the most common chronic health problems, affecting as many as 13 million Americans. Urinary incontinence is not a disease itself, but is a side effect of an underlying condition or problem. For many people who suffer with urinary incontinence, it’s not just a medical problem. It also affects them emotionally, psychologically, and socially. Fortunately, in many cases incontinence can be treated. It does not have to be an inevitable consequence of aging, childbirth or menopause.

Types Urinary Incontinence

Urinary incontinence can vary in severity and type. There are five main types based on symptoms and circumstances at the time of the urine leak.

Following are details on the five types of incontinence:

Type	Description	Additional Information
Stress Incontinence	Loss of urine caused by exerting pressure on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy.	Most common type of incontinence. Often affects women. In women: May be caused by pregnancy, childbirth, and menopause. In men: May be caused by removal of the prostate gland.
Urge Incontinence	A sudden, intense urge to urinate, followed by the loss of urine.	Body doesn’t give you much notice of the need to urinate. May need to urinate often. May even wake up several times during the night with the urge to urinate. Bladder is “overactive” and contracts even when the bladder isn’t full. May be caused by a urinary tract infection, bowel problems, or damage to the nervous system.
Overflow Incontinence	A frequent or constant dribble of urine.	Bladder becomes so full that it literally overflows. Occurs because the bladder doesn’t completely empty as it should. May feel like you can’t completely empty your bladder. When you try to urinate, the urine stream may be weak. Common in people with a weak bladder or a blocked urethra, men with prostate gland problems, heavy alcohol users, and diabetics.
Mixed Incontinence	Having more than one of the other types of incontinence – usually stress and urge incontinence together.	Usually one type is more troublesome than the other. Each type may have its own unrelated cause. Stress, urge and mixed incontinence account for more than 90% of cases.
Functional Incontinence	Inability, from a physical or mental disability, to get to a toilet in time to urinate.	Many older adults, especially those in nursing homes, experience this type of incontinence.

Risk Factors and Symptoms

Risk Factors for Urinary Incontinence

Due to pregnancy, childbirth, menopause, and anatomical differences, women are twice as likely as men to develop incontinence. Men with prostate gland problems are also at a higher risk of incontinence.

Age is another risk factor for developing incontinence; however, incontinence is not a “normal” part of aging.

Additional risk factors include:

Kidney disease
Obesity
Diabetes
Smoking
Use of certain medications
Constipation
Pelvic surgery
Chronic bladder infections
Bladder stones

Reducing the Risk

You may not be able to prevent incontinence. Many risk factors are out or our control. However, there are measures you can take to reduce the risk and alleviate the affects of incontinence.

Maintain a healthy weight
Do Kegel exercises during pregnancy
Reduce or eliminate caffeine intake
Eat a healthy, high-fiber diet
Drink alcohol in moderation

Diagnosis and Treatment

Diagnosing the Cause of Urinary Incontinence

Your physician may order an imaging exam that will allow a radiologist to examine the structure or function of your bladder and urinary tract for any abnormalities.

A pelvic MRI is the most accurate exam for identifying the cause of urinary incontinence.

Complementary imaging exams may also help identify the source of the problem. Urodynamic imaging uses x-rays to take real-time images of the bladder while it is filling or emptying. Cystography uses x-rays and a contrast dye to visualize the bladder while it is in full and empty states.

A pelvic ultrasound may also be used to study the bladder and urinary tract; however, it is less common.