Urinary Incontinence

If urinary incontinence is having a significant impact on your quality of life, a urologist can suggest an appropriate treatment.

Urinary incontinence (UI) can be an occasional inconvenience or, depending on the severity of symptoms, a recurring problem. A loss of bladder control is sometimes triggered by actions that may include laughing hard or coughing. UI can also involve an urge to urinate that can't be successfully controlled until a bathroom can be reached.

• While more common in older adults, urinary incontinence can affect anyone.
• Women are more likely to have stress-related incontinence, and men are more likely to have urge incontinence.

Stress Incontinence

This type of UI is caused by pressure that's exerted on the bladder when laughing, coughing, or sneezing. Urination leaks may also be triggered by heavy lifting, exercise, or any other activities or movements that place pressure on the lower abdomen.

Urge Incontinence

Individuals with urge incontinence aren't able to make it to a bathroom in time to urinate. Symptoms may also include a frequent need to urinate that often continues into the night. Urge incontinence is sometimes caused by a minor infection. Other times, underlying conditions such as diabetes contribute to the development of this type of incontinence.

Overflow and Functional Incontinence

With overflow incontinence, dribbling occurs because the bladder isn't fully empty. Incontinence that's functional is due to some type of mental or physical impairment. For instance, someone with arthritis may have physical difficulty getting to the bathroom in time. Some patients experience a mix of different types of UI.

Persistent Urinary Incontinence

If urinary incontinence is occurring on a regular basis or it comes on suddenly, it's often due to physical changes or an underlying health issue. Possible causes include age-related changes to bladder muscles, having an enlarged prostate or prostate cancer, and neurological issues such as Parkinson's disease.

Diagnosis and Treatment

A urologist normally uses a patient's symptoms as a guide to determine what type of urinary incontinence is involved. In addition to a physical exam, diagnosis may involve a urinalysis to look for infections and a post-void residual measurement of urine output. Some doctors also ask patients to keep a "bladder diary" to track urination patterns and instances of incontinence.

Treatment for urinary incontinence typically starts with conservative options such as bladder training, pelvic floor exercises, and making lifestyle changes such as managing fluids better, losing weight, and avoiding excessive alcohol consumption. Some patients benefit from:

• Electrical stimulation
• Medications that calm the bladder and relax muscles
• Topical estrogen to help women improve the tone of urethra and vaginal tissues
• Vaginal or urethral inserts
• Botox injections
• Absorbent pads and catheters

Urinary Incontinence Surgery

If non-surgical attempts at managing urinary incontinence aren't effective, surgery may be recommended. With a sling procedure, mesh or synthetic material is used to keep the urethra closed. Surgery may also involve providing extra support to the bladder and urethra or prolapse surgery to stabilize pelvic organs. Men may be advised to consider an artificial urinary sphincter to prevent urine leakage.

If urinary incontinence is temporary, it may be correctable with changes to medication or avoiding excessively spicy, sugary, or acidic foods. It's sometimes underlying issues like "urinary tract infections and constipation that are causing UI symptoms. If this is the case, treating the underlying conditions should minimize or eliminate incontinence problems.