Reviewed by: Brindusa Vanta, MD, DHMHS
What Is Urinary Incontinence?
Urinary incontinence can feel frustrating and embarrassing, but if you're experiencing urinary incontinence, you're not alone. Over 25 million people in the U.S. experience some form of urinary incontinence, with most being women over age 50. Though less commonly, it also affects men and younger people.
Urinary incontinence is unintentional urine leakage. This can be losing a few drops when you sneeze or losing control of your bladder before you reach a toilet. It can interrupt daily life if you feel frequent, sudden, intense urges to urinate. There are several types of urinary incontinence, including:
- Stress incontinence
- Urge incontinence
- Overflow incontinence
- Mixed incontinence
- Functional incontinence
It's important to recognize urinary incontinence as a genuine medical condition. It has nothing to do with a conscious choice, but rather is a sign that your body is not functioning properly. That said, it can be managed, and sometimes resolved, with diagnosis, help from a doctor, and lifestyle changes.
Causes of Urinary Incontinence
Urinary incontinence has many potential underlying causes, but often this condition involves weakness or damage to the pelvic floor, bladder, urethra, sphincter, or nerves in the area.
Several medical conditions can cause or exacerbate urinary incontinence, especially if they relate to the pelvic area or the nerves associated with it.
Neurological disorders impact the nerves and their ability to function. In some cases, they can cause loss of bladder control. A malfunctioning sacral nerve or neurogenic bladder, a condition caused by nerve damage from injury or illness, can lead to incontinence.
Urinary incontinence isn't as common in men, but when it occurs, it's often a result of a prostate problem. Benign prostatic hyperplasia is an enlarged prostate, which may lead to incontinence related to an overactive bladder. Prostate cancer and its treatment may also cause urinary incontinence.
Bladder infections can also lead to incontinence because of irritation in the area and a strong urge to urinate. Urinary retention can cause leakage when the bladder does not empty completely.
Menopause brings many hormonal changes to women's bodies; as estrogen levels decrease, the urethra's lining can thin and pelvic muscles may relax. With less support in the pelvic floor, urinary incontinence becomes more common.
Certain lifestyle factors can also put you at a higher risk of developing urinary incontinence. These include:
- Obesity: People who are overweight or obese may experience urinary incontinence due to increased pressure putting additional strain on the bladder and pelvic floor.
- Smoking: Smokers increase their risk of incontinence because of the chronic cough many develop. As they cough, they put pressure on the pelvic muscles, which can cause the muscles to weaken and no longer support the bladder and urethra properly.
- Alcohol consumption: While alcohol itself does not directly cause incontinence, it is an exacerbating trigger for those already prone to leaking. Because alcohol is a diuretic, it boosts the production of urine and the need to use the restroom, which can increase the chances of leakage.
- Lack of physical activity: A sedentary lifestyle can aggravate incontinence because people who don't move around much have weaker muscles. As pelvic floor muscles weaken, incontinence can worsen.
- Medications: Some medications may induce or aggravate incontinence. The most common include high blood pressure prescriptions, antidepressants, diuretics, and sleep aids.
Types of Urinary Incontinence
Urinary incontinence is an umbrella term for several conditions that may impact people differently. Some are temporary while others are chronic. Each of these types of urinary incontinence can be linked to different symptoms and causes.
- Stress incontinence: Stress incontinence occurs when the pelvic muscles are weakened, stretched, or damaged, leading to urine leakage during activities that put pressure on the abdomen, including running, coughing, laughing, or sneezing. It is often seen in women who have given birth vaginally.
- Urge incontinence: Sometimes called overactive bladder, urge incontinence causes sudden, severe urges to urinate. It sometimes results in losing bladder control while rushing to find a toilet. Urge incontinence can also be caused by the brain sending faulty signals or bladder muscles squeezing before the bladder is full, creating the sensation of needing to urinate.
- Overflow incontinence: Overflow incontinence is caused by the bladder producing more urine than can be held or when the bladder can't empty completely. People with this condition also often have a frequent urge to urinate, but only pass a small amount. This type of incontinence is most common in men who have had prostate surgery or other prostate issues.
- Mixed incontinence: People with mixed incontinence experience both stress and urge incontinence symptoms. They both leak when they are active and feel a frequent, severe urge to urinate.
- Functional incontinence: Functional incontinence is caused by an inability to get to a toilet in time. This could be due to a musculoskeletal condition, such as needing to transfer from a wheelchair.
Diagnosis and Evaluation of Urinary Incontinence
Doctors often diagnose urinary incontinence with a series of tests and a discussion of symptoms you're experiencing. Be honest with your doctor to give them adequate information so they can accurately diagnose your condition.
Your doctor will likely perform a pelvic exam to identify the strength of your pelvic muscles and any potential complications. You may have to complete a stress test, such as coughing to see if leakage occurs, and your doctor will check for signs of prolapse.
Urologic evaluation involves several tests that can help identify the cause of incontinence. It often checks for UTIs and includes urodynamic studies to provide doctors with more information about your health.
Your doctor may ask you to complete a bladder diary with information about how much you drink, how much and how frequently you urinate, and when you feel urges to urinate or experience leakage. This will help your doctor understand what is causing the incontinence events and treat them accordingly.
Urodynamic testing refers to a series of tests designed to identify how well your urinary tract functions. It includes identifying the rate and force at which you urinate and how completely you void your bladder, among other things.
Thankfully, several treatment options exist for those with urinary incontinence that can reduce, or potentially even eliminate, symptoms. The most common treatments involve changes to your lifestyle, medical treatments, and surgical interventions.
Many risk factors can worsen symptoms of urinary incontinence, and by eliminating them, you may be able to reduce the intensity and frequency of incontinence incidents.
- Weight loss: By losing weight, you can lessen the pressure on the abdomen, therefore reducing stress on the pelvic floor.
- Quitting smoking: People who quit smoking also reduce how frequently they cough, decreasing stress on the pelvic floor.
- Pelvic floor muscle exercises: Pelvic floor muscle exercises, such as Kegels, can strengthen the muscles and reduce the frequency of incontinence.
- Absorbent products: Even with treatment, some people will still have times when they leak. Nexwear incontinence products can protect you from embarrassing leaks and keep your skin dry.
Medical treatments are sometimes offered to relieve incontinence symptoms. These may be medications or injections or involve physical therapy.
- Medications: Some medications can help with certain types of incontinence by alleviating the symptoms. These can include anticholinergics, and mirabegron.
- Bladder retraining: Bladder retraining involves training your muscles to hold your urine longer when you feel the urge to go. By holding your urine for a few minutes past when the urge comes, you can teach your body to be able to hold urine longer.
- Botox injections: People with urge incontinence may benefit from a Botox injection into the bladder muscle. By paralyzing the bladder muscle, the urge to urinate may decrease.
In some cases, surgery and other devices may be needed to manage incontinence. These can include using indwelling catheters, external collecting systems, and urine drainage bags.
Indwelling catheters are catheters entered into the bladder to drain urine. The catheter is held in place with a balloon, and urine is removed into a bag outside the body. These catheters need to be replaced at least once per month to prevent infection.
External Collecting Systems
Men can sometimes use external collecting systems to manage their incontinence. This involves wearing a specially designed condom that is connected to an external drainage bag.
Urine Drainage Bags
Urine drainage bags hold urine from both indwelling and external collecting devices. Leg bags can be strapped on for when people with these systems need to leave home, but still require frequent draining and changing.
The Bottom Line
No matter the type of incontinence you deal with, the right treatment plan created with your doctor can help you reduce how it impacts your life.
Often, managing incontinence involves the use of incontinence pads and other products, and Nexwear can help make that process as effortless as possible. Nexwear offers high-quality, durable products that will keep you comfortable, and they are shipped discreetly. Set up an auto-delivery subscription and you will never have to worry about when you need more products delivered to your door. Check out the selection today.