Urinary incontinence is the loss of voluntary bladder control that can cause leakage of urine. It can be temporary or last for a long time.
There are four types of long term or permanent incontinence:
People may have just one or a combination of these types.
Incontinence has several different causes. The cause could also be unclear.
Temporary incontinence can be caused by:
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Stress incontinence is an accidental loss of urine during physical activity or coughing, sneezing, and laughing. It may be caused by:
Urge incontinence is the accidental loss of urine when the bladder spasms for no reason. It may be caused or worsened by:
Overflow incontinence is leaking of urine due to overfilling up and overflowing from bladder. It may be caused or worsened by:
Functional incontinence may be caused by:
Some incontinence may be caused by a fistula. A fistula is an abnormal opening between the bladder and another nearby structure. The fistula can make it difficult for the bladder to act as it should.
Urinary incontinence is more common in women age 65 years or older.
Factors that may increase the risk of urinary incontinence include:
Any loss of bladder control can be considered incontinence.
Call your doctor if you have a loss of urine control. Your doctor can help you determine the underlying cause.
You will be asked about your symptoms and medical history. You will be asked how often you empty your bladder and patterns of urine leakage. A physical exam will be done to look for any physical causes, such as blockages or nerve problems. You may be referred to a specialist.
Your bodily fluids will be tested. This can be done with:
The flow of your urine will be assessed. This can be done with:
Your bodily structures may need to be viewed. This can be done with:
Treatments are based on the cause of the urinary incontinence.
Temporary incontinence may be relieved by managing the conditions associated with the incontinence.
Weight loss may help reduce the number of episodes due to stress or urge incontinence in people who are overweight or obese. Talk to your doctor about a weight loss program that is right for you.
Initial treatment relies on behavior changes and strengthening pelvic floor muscles. Behavior changes include:
Methods to increase strength in the pelvic floor muscles include:
Surgical procedures may be done for incontinence that is not responding to these treatments. Surgical options include:
Initial treatment depends on behavior changes and strengthening pelvic floor muscles. Behavior changes include:
Kegel exercises can help strengthen pelvic floor muscles and relieve some symptoms.
Medications may be recommended. Anticholinergics are the most common medication. They can relax the muscles of the bladder. Other medications may be used in combination to help manage symptoms, such as botulinum toxin injections.
Nerve stimulation may be used if urge incontinence does not respond to behavior modification or medication. A device will send pulses to the nerves that control the bladder. This has been shown to help stimulate bladder control. In some cases, the device is implanted in the back.
Treatment for overflow incontinence is to allow the bladder to completely empty. If a blockage is causing the problems, surgery may be needed to open the urine pathways.
Other causes of overflow incontinence may require the use of a tube called a catheter to allow urine to drain from the bladder. People can use certain catheters at home.
Absorbent pads or diapers can be used to manage urinary leakage. Plugs and patches can also be used to help hold urine in place.
A supportive device called a pessary may also be used. Pessaries are devices that raise the uterus or the prolapsed bladder. It can decrease pressure on the bladder.
Incontinence is a symptom of many other conditions. There are several ways to prevent incontinence:
National Institute of Diabetes and Digestive and Kidney Diseases
Urology Care Foundation
Women's Health Matters
Corcos J, Gajewski J, et al. Canadian Urological Association guidelines on urinary incontinence. Can J Urol. 2006;13:3127-3138.
Incontinence. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143. Updated March 2013. Accessed October 28, 2014.
Norton P, Brubaker L. Urinary incontinence in women. Lancet. 2006;367:57-67.
Overactive bladder. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=112. Updated March 2013. Accessed October 28, 2014.
Sobhgol SS, Charandabee SM. Related factors of urge, stress, mixed urinary incontinence, and overactive bladder in reproductive age women in Tabriz, Iran: a cross-sectional study. Int Urogynecol J Pelvic Floor Dys Function. 2008;19(3):367-373.
Urinary incontinence. Family Doctor—American Academy of Family Physicians. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/urinary-incontinence.html. Updated April 2014. Accessed October 28, 2014.
Urinary incontinence in women. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900573/Urinary-incontinence-in-women. Updated August 15, 2016. Accessed September 12, 2016.
Urinary incontinence in women. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen. Updated September 18, 2013. Accessed October 28, 2014.
Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management. J Urol. 2006;175:S5-10.
2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.
1/11/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: AHRQ evidence report on treatment for overactive bladder in women 2009. Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/research/findings/evidence-based-reports/bladder-evidence-report.pdf. Published August 2009. Accessed October 28, 2014.
3/5/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Vardy MD, Mitcheson HD, Samuels TA, et al. Effects of solifenacin on overactive bladder symptoms, symptom bother and other patient-reported outcomes: results from VIBRANT—a double-blind, placebo-controlled trial. Int J Clin Pract. 2009;63(12):1702-1714.
12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int. 2010;106(6):816-821.
12/13/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: University of Texas at Austin, School of Nursing, Family Nurse Practitioner Program. Recommendations for the management of urge urinary incontinence in women. Agency for Healthcare Research and Quality website. Available at: http://www.guideline.gov/content.aspx?id=16322. Published May 2010. Accessed October 28, 2014.
3/5/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007471.
4/29/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Chang SR, Chen KH. Association of mode of delivery with urinary incontinence and changes in urinary incontinence over the first year postpartum. Obstet Gynecol. 2014;123(3):568-577.
7/28/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mangera A, Apostolidis A, et al. An updated systematic review and statistical comparison of standardised mean outcomes for the use of botulinum toxin in the management of lower urinary tract disorders. Eur Urol. 2014;65(5):981-990.
Last reviewed November 2015 by Adrienne Carmack, MD Last Updated: 9/12/2016