Urinary Incontinence, also known as, bladder incontinence is signified by the involuntary loss of urine when there is an urge to urinate. This may be an occasional issue, such as when you sneeze, cough or laugh. This may be an ongoing urgency issue that doesn’t give you enough time to reach the restroom. This may be characterized by dribbling following urine. The inability to control urine may be a combination of these examples. Regardless, urinary incontinence is an issue that requires further exploration for many.   

 How It Works

Normally, the bladder fills with urine from the kidneys to up to 2 cups by expanding the bladder wall muscle. The function of the sphincter (circular muscles around the bladder opening) is vital to prevent urine from leaking. The sphincter’s function involves both holding the urine and releasing it in a timely fashion (less than 1 cup) after the bladder contracts to force urine into the ureters. All the while the bladder keeps filling. Your nervous system also plays a role in the expulsion of your urine, such as the ability to feel the sensation and respond to the need to urinate properly.

Children may have accidents or wet the bed up to age 6 and young girls may leak on occasion for some time thereafter. This is not incontinence. Instead, incontinence tends to affect more women and the elderly when compared to men.  Select medications are associated with incontinence.

An Emergent Condition

Urinary incontinence may be an emergent condition if your instincts tell you so or if the condition is accompanied by the following.

• Sudden weakness, numbness, or tingling in an arm or leg

• Difficulty talking, walking, or speaking

• Vision loss

• Loss of consciousness or confusion

• Loss of bowel control

Your Physician Contact

The decision to contact you physician, gynecologist or urologist is yours. Still, common reasons physicians recommend calling include, but may not be limited to the following.

• Constipated for over a week

• Cloudy or bloody urine

• Dribbling

• Frequent or urgent need to urinate

• Pain or burning during urination

• Difficulty urinating

• Only passing a small amount of urine

• Bladder feels full following urination

• Incontinence over 2 weeks, despite Kegel exercises to strengthen your pelvic muscles

Your Physician Consultation

Your physician will want to perform a comprehensive intake and examination to help identify the cause of your concern. You may be referred to a gynecologist and urologist, if you didn’t start there. Tests that may be performed include:

• Urinalysis

• Urine Culture to check for infection

• Cystoscopy (viewing the inside of the bladder)

• Post Void Residual (PVR) to measure the amount of urine left after you urinate

• Urodynamic studies (to measure pressure and urine flow)

• Uroflow (to measure the pattern of urine flow)

The intake examination and testing may be relate to any one or more of the following conditions.

Functional Bladder Pressure, such as Pregnancy, Urinary System Blockage, Stool Obstruction or Stool Impaction

Overactive Bladder

Neurological or Nerve Health Issues, which may or may not be linked to muscle issues or following radiation treatment to the pelvis

Mental Health Issues, such as Dementia or confusion  

Lifestyle Issues, such as, too much bed rest, sedentary lifestyle, weight gain

Medication Side Effects, such as select antihistamines, antidepressants, cold remedies, diuretics, and tranquilizers   

 Prostate Infection or Inflammation

 Urinary Tract Infection (UTI) or Inflammation

Special Considerations: Ongoing Incontinence

Ongoing Incontinence may be linked to the following.

• Alzheimer’s Disease

• Bladder Cancer

• Bladder Spasms

• Depression

• Large Prostate

• Nervous System Medical Conditions, such as Multiple Sclerosis or Stroke.

• Nerve or Muscle Damage after Pelvic Prolapse in women – lowering of the bladder, urethra, or rectum into the vagina, which is more commonly caused by pregnancy and delivery.

• Spinal Cord Injuries

• Sphincter Weakness which may more commonly be caused by vaginal surgery or prostate surgery.

Urinary Incontinence Treatment  

Once identified, your physician will propose treatment options that relate to the root of to your concern. You may be referred to a gynecologist and urologist for treatment. For many,   the initial approach may involve learning how to  control urination by strengthening pelvic floor muscles with the aid of Kegel exercises three times a day (to strengthen muscles that start and stop urine); Biofeedback to help identify appropriate muscles to strengthen; or electrical stimulation. You may be advised to wear absorbent pads or “diapers” for more excessive leakage. Other initial adjuncts to treatment may include, but may not be limited to:

• Avoid constipation, more fiber in the diet may assist.      

• If you smoke, quit to reduce coughing, bladder irritation and the risk of cancer.

• Avoid food and drinks that stimulate or irritate the bladder, such as, alcohol, caffeinated drinks, citrus fruits and spicy foods.

• If you are overweight, lose weight.

• If you have diabetes, keep your blood sugar (glucose) level under control.

Medical Treatment

Depending upon the root cause, there may be medical treatment options available. For example, there are a variety of treatments for an overactive bladder.

If you cannot empty your bladder completely, you may need to use a catheter, such as indwelling catheter care and self-catheterization. If you require a catheter and experience discomfort, tell your physician. Adjustments may need to be made to identify the appropriate size or the insertion protocol may need to be improved. There is a shortage of select sizes of catheters as of 2013. Thus, you may need to check with other resources for an appropriate fit.   

It is important to recognize that medications and medical procedures are associated with benefits and risks that should be discussed with your physician. It is important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition.