Urinary incontinence (UI) is a loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age. Women experience UI twice as often as men.
Most bladder control problems happen when muscles are too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. This is urge incontinence or overactive bladder. There are other causes of incontinence, such as prostate problems and nerve damage.
Treatment depends on the type of problem you have and what best fits your lifestyle. It may include simple exercises, medicines, special devices or procedures prescribed by your doctor, or surgery.
The most common types of urinary incontinence in women are stress urinary incontinence and urge urinary incontinence. Women with both problems have mixed urinary incontinence. Stress urinary incontinence is caused by loss of support of the urethra which is usually a consequence of damage to pelvic support structures as a result of childbirth. It is characterized by leaking of small amounts of urine with activities that increase abdominal pressure such as coughing, sneezing, and lifting. Additionally, frequent exercise in high-impact activities can cause athletic incontinence to develop. Urge urinary incontinence is caused by uninhibited contractions of the detrusor muscle. It is characterized by leaking large amounts of urine in association with an insufficient warning to get to the bathroom in time.
Polyuria (excessive urine production) of which, in turn, the most frequent causes are: uncontrolled diabetes mellitus, primary polydipsia (excessive fluid drinking), central diabetes insipidus, and nephrogenic diabetes insipidus. Polyuria generally causes urinary urgency and frequency but doesn’t necessarily lead to incontinence.
Enlarged prostate is the most common cause of incontinence in men after the age of 40; sometimes prostate cancer may also be associated with urinary incontinence. Moreover, drugs or radiation used to treat prostate cancer can also cause incontinence.
Disorders like multiple sclerosis, spina bifida, Parkinson’s disease, strokes, and spinal cord injury can all interfere with the nerve function of the bladder.
- Stress incontinence, also known as effort incontinence, is due essentially to insufficient strength of the pelvic floor muscles to prevent the passage of urine, especially during activities that increase intra-abdominal pressure, such as coughing, sneezing, or bearing down.
- Urge incontinence is the involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate.