Urinary Incontinence Home A-Z Health Information Health Library A-Z Urinary Incontinence Overview Urinary incontinence is a commonly encountered condition that refers to loss of bladder control, resulting in the unintentional passing of urine. Incontinence can occur at any age and is more prevalent in women, particularly after childbirth or during menopause. Urinary incontinence can sometimes be linked to other underlying health issues, so understanding its nature is crucial for effective management. Types Urinary incontinence can be of many types; these include:Stress incontinence: This is characterised by occasional urine leakage when bladder is under pressure, e.g., when sneezing, coughing, laughing, exercising, or lifting heavy weights.Urge incontinence: This is characterised by a sudden, strong, uncontrollable urge to urinate.Overflow incontinence: This is characterised by inability to completely empty the bladder, which results in frequent leakage of small amounts of urine over time (instead of one big gush). Overflow incontinence is more common in individuals with chronic conditions like diabetes, stroke, or multiple sclerosis (MS).Neurogenic incontinence: This is characterised by bladder dysfunction or the lack of bladder control due to brain, spinal cord, or nerve problems. Neurogenic incontinence is extremely common in people with spinal cord injuries, cerebral palsy, and stroke; sometimes, it may also be congenital (caused by birth defects).Total incontinence: This is characterised by the inability of the bladder to store urine, which results in frequent urine leakage.Mixed incontinence: A combination of factors is responsible for urine leakage. Causes Several factors can contribute to urinary incontinence, and they often differ between individuals. Some common causative factors are enumerated below:Weak pelvic floor muscles: Childbirth, pregnancy, and menopause can weaken the muscles that support the bladder, leading to stress incontinence.Overactive bladder: This condition is characterised by an urgent need to urinate, often resulting in urge incontinence. It can happen without warning and may lead to frequent trips to the bathroom.Neurological conditions: Multiple sclerosis, Parkinson’s disease, and stroke can affect the nerves that are responsible for normal bladder control and function.Urinary tract infections (UTIs): Infections can irritate the bladder, causing temporary incontinence. Once the infection is treated, incontinence usually resolves.Medications: Some medications, such as diuretics, can increase urine production and lead to incontinence.Obesity: Excess body weight can put pressure on the bladder, contributing to stress incontinence.Chronic coughing: Conditions like chronic bronchitis can weaken pelvic floor muscles, leading to leakage when coughing.Hormonal changes: Fluctuations in hormone levels, particularly during menopause, can impact bladder function and support. Symptoms The symptoms of urinary incontinence can vary based on the type of incontinence experienced. Lower urinary tract symptoms (LUTS) are common features associated with urinary incontinence; these include:Problems with storing urine, e.g., a sudden or frequent urge to pass urine or feeling that you need empty your bladder again just after you have done so.Problems with passing urine, e.g., straining to pass urine, slow stream of urine, or stopping and starting when you pass urine.Problems after passing urine, e.g., feeling of not completely emptying the bladder or leakage of few urine drops after urination. Diagnosis Discussing the patients’ symptoms, medical history, and any medications they are taking can help understand the situation better. Additionally, keeping a bladder diary, i.e., a record of the urination frequency, fluid intake, and leakage episodes (if any) can provide valuable information about your condition. The following tests can be conducted to diagnose urinary incontinence:Physical examination: A physical examination of the pelvis can be conducted to assess the strength of the pelvic floor and check for any abnormalities.Urinalysis: A simple urine test can help detect infections or blood in the urine, and urinary incontinence attributed to infections can be treated following a positive diagnosis.Urodynamic testing: This involves measuring how well your bladder and urethra are storing and releasing urine. It can help determine the cause of incontinence more precisely.Imaging tests: In some cases, an ultrasound or MRI may be necessary to check for anatomical abnormalities responsible of urinary incontinence. Treatment The treatment of urinary incontinence depends on the underlying cause and type of incontinence. Here are some common approaches:Pelvic floor exercises (Kegel exercises): These helps strengthen the pelvic floor muscles, helping the patient control the sphincter muscles better and prevent leakage.Bladder training: This involves scheduling bathroom visits and gradually increasing the time between urinations to help retrain the bladder.Medications: For urge incontinence, medications that relax the bladder may be prescribed. Hormonal therapies can help some women post-menopause.Lifestyle modifications: Simple changes, such as weight loss, reducing caffeine and alcohol intake, and quitting smoking, can significantly correct the symptoms.Absorbent products: If leakage occurs, using absorbent pads or adult diapers can provide a sense of security while managing the condition.Physical therapy: Working with a physical therapist trained in pelvic floor rehabilitation can provide personalised strategies for managing incontinence.Surgical options: In severe cases, surgical procedures may be recommended to support the bladder or to enhance control. Prevention While not all types of urinary incontinence can be prevented, one or more of the following steps can be taken to reduce the risk of developing this condition: Maintain a healthy weight: Obesity management can help decrease pressure on the bladder.Stay active: Regular exercise strengthens pelvic floor muscles and improves bladder function.Pelvic floor exercises: Incorporate Kegel exercises into your routine to keep your pelvic floor strong.Limit irritants: Reducing caffeine, alcohol, and spicy foods can lessen bladder irritation.Stay hydrated: Drinking enough water can help maintain bladder health; however, excessive water intake should be avoided right before activities.Seek help for constipation: Chronic straining can weaken the pelvic muscles, so addressing constipation is crucial.