Incontinence is the inability to control the passage of urine. This can range from an occasional leakage of urine, to a complete inability to hold any urine. Urinary incontinence affects approximately 13 million people in the United States and is more common in women than in men. It occurs in 10 percent to 25 percent of women younger than age 65 and in 15 percent to 30 percent of women older than age 60 who do not live in nursing homes. Among nursing home residents, incontinence is even more common, affecting more than 50 percent of female patients.
The two main types of urinary incontinence are:
The main symptom of urinary incontinence is leakage of urine. This leakage can be frequent and heavy, or it can be small and rather rare. For an active woman or for a woman who loses a large amount of urine each time, even one episode per week may be too much.
Some other common symptoms of urinary incontinence include:
Incontinence may be sudden and temporary, or ongoing and long-term. Causes of sudden or temporary incontinence include:
Causes that may be more long-term:
Many times, urinary incontinence can be corrected with the help of medication. Drugs commonly used to treat incontinence include:
Anticholinergic (antispasmodic) drugs - These prescription medications calm an overactive bladder, so they may be helpful for urge incontinence.
Imipramine (Tofranil). This antidepressant may be used to treat incontinence. It causes the bladder muscle to relax, while causing the smooth muscles at the bladder neck to contract.
Hormone Replacement Therapy - After menopause, a woman's body produces less of the hormone estrogen. This drop in estrogen can contribute to changes in the skin lining the urethra and vagina, which can contribute to the development of incontinence in some women. Applying estrogen in the form of a vaginal cream, ring or patch may help relieve some of the symptoms of incontinence in these women.
Antibiotics - If your incontinence is due to a urinary
tract infection or an inflamed prostate gland (prostatitis), your doctor
can successfully treat the problem with antibiotics.
See your doctor for an initial evaluation and to come up with a treatment plan. Treatment options vary, depending on the cause and type of incontinence you have. Fortunately, there are many things you can do to help manage incontinence.
The following methods are used to strengthen the muscles of your pelvic floor:
To find the pelvic muscles when you first start Kegel exercises, stop your urine flow midstream. The muscles needed to do this are your pelvic floor muscles. DO NOT contract your abdominal, thigh, or buttocks muscles. And DO NOT overdo the exercises. This may tire the muscles out and actually worsen incontinence.
Two methods called biofeedback and electrical stimulation can help you learn how to perform Kegel exercises. Biofeedback uses electrodes placed on the pelvic floor muscles, giving you feedback about when they are contracted and when they are not. Electrical stimulation uses low-voltage electric current to stimulate the pelvic floor muscles. It can be done at home or at a clinic for 20 minutes every 1 to 4 days.
Biofeedback and electrical stimulation will no longer be necessary once you have identified the pelvic floor muscles and mastered the exercises on your own.
Vaginal cones enhance the performance of Kegel exercises for women. Other devices for incontinence are also available.
For leakage, wear absorbent pads or undergarments. There are many well-designed products that go completely unnoticed by anyone but you.
Other measures include:
If you have overflow incontinence or cannot empty your bladder completely, a catheter may be recommended. But using a catheter exposes you to potential infection.
American Urological Association
American Foundation for Urologic Disease