Urinary Incontinence

Urinary incontinence means you lose bladder control or can’t store urine like you should. This problem is not a normal part of aging. It often affects older persons because muscles used in bladder control don’t work as well with aging.

Irritable Bowel Syndrome (IBS)

Signs, Symptoms & Causes

For Acute Incontinence

Urinary Tract Infections (UTIs)

This form comes on suddenly. Often, it is a symptom of a new illness or problem. Examples are a bladder infection, diabetes (new or out-of- control), and inflammation of the prostate, urethra, or vagina. It can also be a side effect of some medicines, such as water pills.

This form is often easily reversed when the problem that caused it is treated.

Flatulence (Gas)

Peptic Ulcer

For Persistent Incontinence

This form comes on gradually over time. It lingers or remains, even after other problems have been treated. There are many types of this form. The ones below cause 80% of cases.

Lactose Intolerance

• Stress Incontinence. Urine leaks out when there is a sudden rise in pressure in the abdomen. This can happen when you cough, sneeze, laugh, lift, jump, run, or strain to pass stool. This type is more common in women than in men.

• Urge Incontinence. With this type, the urge to pass urine is so strong and comes on so fast, that the urine is released before you can get to the toilet. This type can be caused by an enlarged prostate gland, a spinal cord injury, or an illness, such as Parkinson’s disease.

• Mixed Incontinence. This type is a mix of stress and urge types of incontinence.

• Overflow Incontinence. This is the constant dribbling of urine because the bladder overfills. This may be due to an enlarged prostate, diabetes, or multiple sclerosis.

• Functional Incontinence. With this type, you have trouble getting to the bathroom fast enough, even though you have bladder control. This can happen in a person who is physically challenged.

• Total Incontinence. This is a rare type with complete loss of bladder control. Urine leakage can be constant.

SEE ALL ABDOMINAL & URINARY ARTICLES

Resources

National Association for Continence (NAFC)

800.BLADDER (252.3337)

www.nafc.org

Urology Care Foundation

www.urologyhealth.org

Overactive Bladder

With this condition, you have at least 2 of these problems:

• An urgency to pass urine.

• Urge incontinence.

• You pass urine 8 or more times a day and 2 or more times during night.

Treatment

The first step is to find out if another problem causes the incontinence and to treat that problem. Other treatments include:

• Pelvic floor exercises, called Kegel exercises. (See Self-Care/Prevention.)

• Medication.

• Collagen injections. These treat a certain type of stress incontinence.

• Surgery, as needed, to correct the problem.

Questions to Ask

Question 1

Does loss of bladder control occur with any of these problems?

• A spine or back injury.

• Slurred speech. Not being able to speak. Confusion & dizziness.

• Loss sight. Double or blurred vision. Sudden, severe headaches.

• Paralysis, weakness, or loss of feeling in an arm or leg, and/or the face on the same side of the body. Sudden new seizures with collapse and shaking of the limbs.

• Change in personality, behavior, and/or emotions.

Get medical care without delay. If symptoms are life threatening go to the ER or call 9-1-1. Don’t call 9-1-1 or use the ER if symptoms do not threaten life. Ask your doctor ahead of time where you should go for a problem that needs prompt care, but not emergency care.

Question 2

Does loss of bladder control come with symptoms of a kidney infection?

Question 3

With loss of bladder control, are any of these problems present?

• Recent surgery or injury to the abdomen.

• It burns when you pass urine or you pass urine often.

• Urine is cloudy or has blood in it.

• Pain in the abdomen or mid back.

• Fever and/or chills.

• Diabetes or signs and symptoms of diabetes

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 4

For men, are signs and symptoms of prostate problems present?

Call your doctor or health care provider and state the problem. He or she can decide what you should do.

Question 5

Do you leak urine when you cough, sneeze, laugh, jump, run, or lift heavy objects?

Call your doctor or health care provider and state the problem. He or she can decide what you should do.

Question 6

Did you lose bladder control after you took a new medicine or took a higher dose of one you were already taking?

Call your doctor or health care provider and state the problem. He or she can decide what you should do.

Use Self-Care / Prevention:

You can probably take care of the problem yourself if you answered NO to all the questions. Use the “Self-Care” measures that are listed. Call your doctor if you don’t feel better soon, though. You may have some other problem.

Self-Care / Prevention

• Don’t have caffeine. Limit or avoid fluids 2 to 3 hours before bedtime.

• Limit carbonated drinks, alcohol, citrus juices, greasy and spicy foods, and items with artificial sweeteners.

• Empty your bladder before you leave the house, take a nap, or go to bed.

• Go to the bathroom often, even if you don’t feel the urge. When you pass urine, empty the bladder as much as you can. Relax for 1 to 2 minutes. Then try to pass urine again.

• Keep a diary of when you leak urine. If you find that you have accidents every 3 hours, empty your bladder every 2 hours. Use an alarm clock or wristwatch with an alarm to remind you.

• Wear clothes you can pull down easily when you use the bathroom. Wear elastic-waist bottoms. Wear items with velcro closures or snaps instead of buttons and zippers.

• Wear absorbent pads or briefs, if needed.

• Keep the pathway to your bathroom free of clutter and well lit. Leave the bathroom door open until you use it. Use a night light in the bathroom when it is dark.

• Use an elevated toilet seat and grab bars if these will make it easier for you to get on and off the toilet.

• Keep a bedpan, plastic urinal (for men), or portable commode chair near your bed.

• Ask your doctor if your type of incontinence could be managed by using self-catheters. These help to empty your bladder all the way. A doctor needs to prescribe self-catheters.

Kegel Exercises

• Kegel exercises are pelvic floor exercises. These help treat or cure stress incontinence. Persons who have leaked urine for years can benefit greatly from these exercises. How do you do them?

• First, start to urinate, then hold back and try to stop. If you can slow the stream of urine, you are using the right muscles. You should feel muscles squeeze around the urethra and the anus. The urethra is the tube through which urine is passed. The anus is the opening through which stool is passed.

• Next, relax your body, and close your eyes. Imagine that you are going to pass urine, but hold back from doing so. You should feel the muscles squeeze like you did in the step before this one.

• Squeeze the muscles for 3 seconds. Then relax them for 3 seconds. When you squeeze and relax, count slowly. Start out doing this 3 times a day. Gradually work up to 3 sets of 10 contractions. Hold each one for 10 seconds at a time. You can do them when you lie down, and/or stand.

• When you do these exercises, do not tense the muscles in your belly or buttocks. Do not hold your breath, clench your fists or teeth, or make a face.

• Squeeze your pelvic floor muscles right before and during whatever it is (coughing, sneezing, jumping, etc.) that causes you to lose urine. Relax the muscles once the activity is over.

• Women can also use pelvic weights prescribed by their doctor. A women inserts a weighted cone into the vagina and squeezes the correct muscles to keep the weight from falling out.

It may take several months to benefit from pelvic floor exercises. They should be done daily.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.

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