What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of urine control, or the inability to hold your urine until you can reach a restroom. More than 12 million people in the United States experience incontinence - male and female (women over age 50 are the most likely to develop UI), young and old. Urinary incontinence may be a temporary condition, resulting from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.

What causes urinary incontinence?

Incontinence is not an inevitable result of aging, but is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications, and/or the onset of an illness. Sometimes, it is the first and only symptom of a urinary tract infection.

What are some of the different types of urinary incontinence?

The following are some of the different types of urinary incontinence:

• urge incontinence - the inability to hold urine long enough to reach a restroom. It is often found in people who have conditions such as diabetes, stroke, dementia, Parkinson's disease, and multiple sclerosis, but may be an indication of other diseases or conditions that would also warrant medical attention.
• stress incontinence - the most common type of incontinence that involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.
• functional incontinence - leakage due to a difficulty reaching a restroom in time because of physical conditions such as arthritis.
• overflow incontinence - leakage that occurs when the quantity of urine produced exceeds the bladder's capacity to hold it.

What are the symptoms of urinary incontinence?

The following are the most common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:

• inability to urinate pain related to filling the bladder and/or pain related to urination without a proven bladder infection
• progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying
• an increased rate of urination without a proven bladder infection
• needing to rush to the restroom and/or losing urine if you do not get to restroom in time
• abnormal urination or changes in urination related to a nervous system abnormality such as stroke, spinal cord injury, multiple sclerosis
• leakage of urine that prevents activities
• leakage of urine that began or continued after surgery
• leakage of urine that causes embarrassment
• frequent bladder infections

The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

How is urinary incontinence diagnosed?

For people with urinary incontinence, it is important to consult a physician for a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. In many cases, patients will then be referred to a urologist, a physician who specializes in diseases of the urinary tract.

Treatment for urinary incontinence:

Specific treatment for urinary incontinence will be determined by your physician based on:

• your age, overall health, and medical history 
  
• extent of the disease 
  
• your tolerance for specific medications, procedures, or therapies 
• expectations for the course of the disease 
  
• your opinion or preference

Treatment may include:

• certain behavioral techniques (including pelvic muscle exercises, biofeedback, and bladder training)
• medications
• surgery (if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage)
• diet modifications (including eliminating caffeine in coffee, soda, and tea, and/or eliminating alcohol)

Managing urinary incontinence:

Specifically designed absorbent underclothing is available - which is no more bulky than normal underwear and can be worn easily under everyday clothing. Also, incontinence may be managed by inserting a catheter into the urethra and collecting the urine into a container. Consult your physician with your questions regarding the management and treatment of urinary incontinence.

Loss of urinary control is called urinary incontinence. If you have incontinence, you are not alone. Many other people have this problem, too. Being incontinent can affect you are only physically, but emotionally and socially as well. That is why you should get help. There are ways to treat incontinence. If you have been treated for prostate cancer, your incontinence may result from the treatment. Your leakage may be temporary. It may just take time before the muscles are strong enough to control urination. Or your incontinence may be a chronic possible long-term effect of our cancer treatment.

The UAB Continence Program has many options for patients who experience urinary incontinence after prostate surgery. The nurse practitioner and physician will assist patients in selecting a therapy that is ideal for each patient. As a comprehensive clinic, the UAB Continence Program has numerous treatments available. Many of the treatments are conservative and do not require surgery. An individualized program will be based on a thorough evaluation and may include one or more of the following treatments:

• Lifestyle Changes: Many bladder problems can be significantly improved by changes to the patient’s lifestyle or home environment. These might include changes in diet, voiding schedules or prompting from a family member or caretaker to make it easier for a patient to get to the bathroom.

• Pelvic Muscle Exercises: These exercises are designed to strengthen the pelvic floor muscles to help prevent urine loss and also to help calm an overactive bladder. A home program, which includes bladder strategies, is designed for each individual patient.

• Biofeedback: Biofeedback training is commonly used to teach patients how to locate, learning to exercise, and control their pelvic floor muscles. After a short training session in the clinic, most patients feel comfortable about doing their pelvic muscle exercises at home.

• Electrical Stimulation: This is a battery-powered device that stimulates the muscles around the urethra, making them stronger and tighter. The unit is pre-set for each individual and the patient uses it either at home or in the clinic.

• Medications: There are several medications that can help urinary incontinence, including those that calm overactive bladders and those that tighten the bladder outlet.

Other therapies include the use of collagen material injected surgically to tighten the valve responsible to prevent leakage. There are devices such as an artificial urinary sphincter. If your incontinence cannot be completely corrected, it can still be helped. You can manage how to live with your incontinence. Available products are present to be worn under the clothing and can provide protection as well. Bed pads can also be used to protect bed linens and mattresses.

Stress Incontinence – Urinary leakage associated with coughing, sneezing, or laughing is called stress incontinence. It is caused by a weakness of the muscles that surround the urethra (sphincter muscles). You may sleep through the night, but leak when you get up in the morning. To avoid accidents, you may use the bathroom more often than normal.

Overflow Incontinence – Happens when the bladder is too full. You take a long time to urinate and have a weak, interrupted steam when urinating. You void low amounts and do not feel completely empty. Sometimes you may feel the urge to urinate, but cannot. You may leak urine throughout the day.

Urge Incontinence – Occurs when the bladder contracts too often. You will wet yourself if you do not get to the bathroom in time. It is a feeling of lower abdominal pressure, and is caused by a spasm of the bladder muscle.

Kegel Exercises – These are exercises specifically designed to strengthen the urinary muscles. To do them, tighten your muscles as if you are trying to stop urination or trying not to pass gas. Doing twenty repetitions of this exercise morning and night can help to control incontinence.