Understanding Urinary Incontinence

Urinary incontinence is loss of bladder control.  This means that a person is not able to regulate when they urinate, which can cause accidents.  Urinary incontinence is a common medical condition that affects millions of adults in the United States.  There are several different types of urinary incontinence and the medical conditions that cause them are varied. 

Types of Urinary Incontinence

1. Stress Incontinence causes a person to leak urine when stress is put on weak bladder or pelvic muscles (sneezing, coughing, laughing, lifting, and exercise).  This is a very common type of incontinence in women- especially those who are pregnant, have given birth, or are experiencing menopause.  Male stress incontinence is more rare, but can occur after prostate surgery. 

2. Urge Incontinence causes accidents of varying degrees to occur when a sudden, powerful urge to urinate comes on and the person is not able to make it to the bathroom in time.  This is due to overactive or damaged nerves that control the bladder or bladder muscles that spasm/contract involuntarily.  Urge incontinence is common in those who have medical conditions that damage the bladder nerves or muscles controlling it- particularly infections in the urinary tract (UTI), bladder, or kidneys, Multiple Sclerosis, stroke, Alzheimer’s disease, Parkinson’s disease, diabetes, and injuries - including surgery. 

3. Overflow Incontinence causes a person to dribble or leak small amounts of urine when the bladder is overfilled and never able to be completely emptied.  Certain medications and medical conditions like diabetes or Multiple Sclerosis may affect nerves and muscles that would normally indicate to a person when the bladder is full and then allow for successful emptying.  Tumors, kidney stones, and an enlarged prostate can also block the flow of urine, which will keep the bladder full and cause overflow incontinence. 

4. Functional Incontinence is a little different because it occurs when a person who has full control over their bladder is unable to reach the bathroom in time due to poor mobility, poor eyesight, confusion, inability to communicate the need to use a toilet, unwillingness to use the toilet due to a mental health disorder or intoxication, or inability to time a trip to the bathroom correctly.  Common medical conditions in the elderly associated with functional incontinence include dementia (such as Alzheimer’s disease), arthritis, and vision problems.  A person of any age who is recovering from surgery or, for example, has a broken leg and can’t move around easily may also have functional incontinence. 

5. Mixed Incontinence is a combination of two different types of incontinence.  Stress and urge incontinence are the most typical combination. 

Managing Urinary Incontinence

The first thing a person should do if they think that they are suffering from urinary incontinence is to see their doctor.  A general practitioner may diagnose them with a type of incontinence and/or refer them to a specialist for further examination.  Although many people feel uncomfortable discussing incontinence with their doctor, it’s important to remember that this is a common medical condition and if there is an underlying cause, it should be treated promptly.  After a diagnosis is made, treatment options can be given to cure or manage urinary incontinence.

Depending on the type of urinary incontinence and the underlying cause, different suggestions may be given by a doctor to manage the condition.  Women with weak pelvic muscles may be encouraged to do Kegal exercises to help relieve stress incontinence.  If urge incontinence is caused by an infection, antibiotics may clear the issue up entirely.  People with blockages causing overflow incontinence like tumors, kidney stones, or enlarged prostates may require medication or surgery to remove the blockage. 

Functional incontinence in individuals who have difficulty getting to the bathroom quickly can benefit from bedside commodes or mobility assistance.  Those suffering from Alzheimer’s disease or other forms of dementia that can lead to confusion and forgetfulness may do well with a caregiver reminding them to use the toilet regularly and helping them find their way if they indicate that they need to go.

For immediate management of urinary incontinence, there are a variety of products available.  Please see How to Choose an Incontinence Product for information on determining which product or combination of products best suits your needs.