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 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 caused by overfill and overflow of the 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. Things that may increase your chances of urinary incontinence are:
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.
The doctor will ask about symptoms and past health. They will ask how often you empty your bladder and patterns of urine leakage. A physical exam will be done to look for any physical causes. A urologist may be recommended.
The flow of urine can be tested with:
Images of the urinary tract may be taken 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 lower episodes of stress or urge incontinence in those who are overweight or obese.
Behavior changes and improving pelvic floor muscle strength can help. Behavior changes include:
Methods to increase strength in the pelvic floor muscles include:
Surgical procedures may be done if other treatments are not helping. Surgical options include:
First steps include behavior changes and improving strength of 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 help if other treatment do not give relief. A device will send pulses to the nerves that control the bladder. The pulse can improve bladder control.
Treatment is to allow the bladder to completely empty. If a blockage is causing the problems, surgery may be needed to open the urine pathways.
A catheter may be needed It will allow urine to fully drain from the bladder. Catheters can be used 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—Women's College Hospital
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Urinary incontinence. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/urinary-incontinence. Accessed December 19, 2020.
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Last reviewed January 2021 by EBSCO Medical Review Board Adrienne Carmack, MD