What is incontinence

The involuntary loss of bladder or bowel control and the inability to control the timing and frequency of urination.

Many people confuse urinary incontinence with a loss of bladder control. Urinary incontinence is not when someone loses bladder control but rather when they cannot sense that their bladder is full. This is an unfortunate misconception because it can add another layer of embarrassment for those already struggling with urinary incontinence.

Urinary incontinence is sometimes referred to as bladder control issues. If you are one of the estimated 30 million people in the United States who are struggling with urinary incontinence, you know it's not something that can be hidden or ignored. You may be reluctant to discuss it with anyone, including your doctor. But if it becomes a severe problem, especially if you have trouble getting out of bed at night to use the bathroom, your quality of life can deteriorate quickly.

Some medications can contribute to urinary incontinence. There are steps that you can take to limit the effects of these medications and improve bladder control at the same time.

What causes urinary incontinence?

The first step to treating urinary incontinence is to understand the underlying cause. The most common cause of both types of incontinence—incontinence due to a weak bladder muscle and incontinence due to a full bladder—is an overactive bladder. Overactive bladder is an underlying condition that can lead to symptoms of urinary incontinence that are sometimes misdiagnosed as other conditions, such as overactive bowel or overactive thyroid. If your doctor suspects you have an overactive bladder, you may be prescribed drugs that can help treat this condition.

Other causes of urinary incontinence include the following:

Cancer treatments, such as chemotherapy or radiation therapy may weaken the muscles in the bladder. This effect may last for many years after treatment ends.

Stress incontinence—sudden urine leakage when the pressure created by straining, sneezing, coughing, or even laughing increases pressure within your abdomen and pelvic area—can result from childbirth or weight gain. Over time pelvic floor muscles that support the bladder can weaken. The most common cause of stress incontinence is pregnancy. It occurs in about half of women who have had a baby. The pressure of childbirth and the pressure of monthly periods can weaken pelvic floor muscles. Pregnancy causes the body to produce extra fluids throughout the body to support the baby during development, and the excess fluid puts additional pressure on bladder walls.

Overflow incontinence—the loss of bladder control that occurs when your bladder pushes its contents into your urethra before you can make it to the bathroom—is often caused by other factors, including ageing, dementia, diarrhoea, stroke, multiple sclerosis (MS), Parkinson's disease (PD), or other medical conditions.

Frequency and urge incontinence—the repeated loss of small amounts of urine due to a sudden and uncontrollable increase in the need to urinate—can be caused by bladder problems, such as bladder stones, benign prostate hypertrophy (BPH), or bladder tumours. Urge incontinence can also result from an overactive bladder. Sometimes it is caused by a medical condition that affects the nerves that control urine flow, such as multiple sclerosis (MS).

What are the symptoms of urinary incontinence?

The symptoms of urinary incontinence can vary depending on the underlying cause. Some people may have only one symptom, while others may have more than one symptom. Symptoms can also change over time.

What causes urinary incontinence? How can stress incontinence be treated?

Overactive bladder, a common cause of urinary incontinence, is an underlying condition that can lead to incontinence symptoms. You can take steps to limit the effects of this condition and improve your ability to control your bladder as you age. If you have BPH, your doctor may recommend medications that help reduce symptoms of incontinence caused by an enlarged prostate. If you have MS, your doctor may recommend medications that help reduce the urge to urinate at night. Overactive urinary bladder can be treated with drugs known as alpha-receptor blockers, which help reduce bladder contractions. You may be prescribed these medications if you have an overactive bladder due to BPH, but your doctor may recommend other types of medications to treat this type of incontinence.

See your doctor if you are not sure whether an overactive bladder or another condition causes your urinary incontinence. If your doctor suspects this is the problem, he or she will refer you to a urologist for further testing and evaluation. Treatment for overactive bladder may include medications that help control the problem, such as alpha-receptor blockers. Your doctor will also recommend surgery or other medicines that may help improve symptoms of incontinence.

How are urinary incontinence symptoms treated?

The symptoms of urinary incontinence can be treated with various methods. These include:

Pelvic floor muscle exercises. These exercises are performed with the guidance of a physical therapist who specializes in treating muscle weakness or pelvic floor disorders, such as urinary incontinence. However, over time these exercises alone may not be sufficient to improve incontinence.

These exercises are performed with the guidance of a physical therapist who specializes in treating muscle weakness or pelvic floor disorders, such as urinary incontinence. However, over time these exercises alone m may not be sufficient to improve incontinence medications, including anticholinergics and alpha-receptor blockers. The latter help relax the bladder muscles by decreasing nerve impulses that trigger bladder contractions. A medication called mirabegron may also help promote better bladder control. It works on a specific type of calcium channel found on nerves in the brain and spinal cord that control urine flow from the bladder to the urethra (the tube through which urine leaves your body).ay not be enough to prevent the symptoms of urinary incontinence, especially in people with severe symptoms.