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Hard to hold urine: Urinary incontinence | Office on Women’s Health

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Urinary Incontinence in Men | HealthLink BC

Topic Overview

What is urinary incontinence in men?

Urinary incontinence is the accidental release of urine. It’s not a disease. It’s a symptom of a problem with a man’s urinary tract.

Urine is made by the kidneys and stored in a sac made of muscle, called the urinary bladder. A tube called the urethra leads from the bladder through the prostate and penis to the outside of the body. Around this tube is a ring of muscles called the urinary sphincter. As the bladder fills with urine, nerve signals tell the sphincter to stay squeezed shut while the bladder stays relaxed. The nerves and muscles work together to prevent urine from leaking out of the body.

When you have to urinate, the nerve signals tell the muscles in the walls of the bladder to squeeze. This forces urine out of the bladder and into the urethra. At the same time the bladder squeezes, the urethra relaxes. This allows urine to pass through the urethra and out of the body.

Incontinence can happen for many reasons:

  • If your bladder squeezes at the wrong time, or if it squeezes too hard, urine may leak out.
  • If the muscles around the urethra are damaged or weak, urine can leak out even if you don’t have a problem with your bladder squeezing at the wrong time.
  • You can also have incontinence if your bladder doesn’t empty when it should. This leaves too much urine in the bladder. If the bladder gets too full, urine will leak out when you don’t want it to.
  • If something is blocking your urethra, urine can build up in the bladder and cause leaking.

Urinary incontinence happens more often in older men than in young men, but it’s not just a normal part of aging.

What are the different types of urinary incontinence?

Urinary incontinence can be short-term or long-lasting (chronic). Short-term incontinence is often caused by other health problems or treatments. This topic is about the different types of chronic urinary incontinence:

  • Stress incontinence happens when you sneeze, cough, laugh, lift objects, or do something that puts stress or strain on your bladder and you leak urine.
  • Urge incontinence is an urge to urinate that’s so strong that you can’t make it to the toilet in time. It also happens when your bladder squeezes when it shouldn’t. This can happen even when you have only a small amount of urine in your bladder. Overactive bladder is a kind of urge incontinence. But not everyone with an overactive bladder leaks urine.
  • Overflow incontinence happens when your bladder doesn’t empty as it should and then leaks urine later. This happens when bladder muscles are weak or the urethra gets blocked. These blockages can be related to an enlarged prostate or a narrow urethra.
  • Total incontinence happens when you are always leaking urine. It happens when the sphincter muscle no longer works.
  • Functional incontinence is rare. It happens when you can’t make it to the bathroom in time to urinate. This is usually because something got in your way or you were not able to walk there on your own.

What causes urinary incontinence in men?

Different types of incontinence have different causes.

  • Stress incontinence can happen when the prostate gland is removed. If there has been damage to the nerves or to the sphincter, the lower part of the bladder may not have enough support. Keeping urine in the bladder is then up to the sphincter alone. The sphincter may be too weak to hold back the urine. And any extra pressure from sneezing, coughing, or straining can cause urine to leak.
  • Urge incontinence is caused by bladder muscles that squeeze so hard that the sphincter can’t hold back the urine. This causes a very strong urge to urinate. Doctors don’t know why this happens. But sometimes it can be caused by other urinary problems.
  • Overflow incontinence can be caused by something blocking the urethra, which leads to urine building up in the bladder. This is often caused by an enlarged prostate gland or a narrow urethra. Over time, the bladder gets so full that pressure builds up and forces the extra urine to move past the blockage and out of the bladder. Overflow incontinence may also happen because of weak bladder muscles.

In men, incontinence is often related to prostate problems or treatments.

Drinking alcohol can make urinary incontinence worse. Taking prescription or over-the-counter drugs such as diuretics, antidepressants, sedatives, opioids, or non-prescription cold and diet medicines can also affect your symptoms.

What are the symptoms?

The most common sign of urinary incontinence is leaking urine from the bladder. Other signs will depend on the type of urinary incontinence you have.

  • Stress incontinence: You release a small amount of urine when you cough, strain, lift something, or change position.
  • Urge incontinence: The need to urinate is so strong that you can’t reach the toilet in time.
  • Overflow incontinence: You have the urge to urinate, but you can only release a small amount. And you can’t control the constant dribbling of urine.

How is the cause of urinary incontinence in men diagnosed?

Your doctor will do a physical examination, ask questions about your symptoms and past health, and test your urine. Often this is enough to help the doctor find the cause of the incontinence. You may need other tests if the incontinence is caused by more than one problem or if the cause is unclear.

How is it treated?

Treatments are different for each person. They depend on the type of incontinence you have and how much it affects your life. After your doctor knows what has caused the incontinence, your treatment may include medicines, simple exercises, or both. A few men need surgery, but most do not.

There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.

  • Cut back on caffeine drinks, such as coffee and tea. Also cut back on fizzy drinks like soda pop. And don’t drink more than one alcoholic drink a day.
  • Eat foods high in fibre to help avoid constipation.
  • Don’t smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Stay at a healthy weight.
  • Try simple pelvic-floor exercises like Kegels.
  • Go to the bathroom at several set times each day, and wear clothes that you can remove easily. Make your path to the bathroom as clear and quick as you can.
  • When you urinate, practice double voiding. This means going as much as you can, relaxing for a moment, and then going again.
  • Keep track of your symptoms and any leaking of urine with a bladder diary. This can help you and your doctor find the best treatment for you.

If you have symptoms of urinary incontinence, don’t be embarrassed to tell your doctor. Most people with incontinence can be helped or cured.

Cause

Urinary incontinence occurs when the muscle (sphincter) that holds your bladder’s outlet closed is not strong enough to hold back the urine. This may happen if the sphincter is too weak, if the bladder muscles contract too strongly, or if the bladder is overfull.

A man may have one or more types of incontinence, and each type may have a different cause.

  • Stress incontinence occurs when the muscle (sphincter) surrounding the urethra opens at an inappropriate time. This can happen when you laugh, sneeze, cough, lift something, or change posture. Stress incontinence can be caused by surgery to treat an enlarged prostate or prostate cancer, radiation therapy to treat prostate cancer, or removal of the prostate.
  • Urge incontinence is caused by bladder contractions that are too strong to be stopped by the sphincter. Often the urge is a response to something that makes you anticipate urination, such as waiting to use a toilet, unlocking the door when returning home, or even turning on a faucet. The bladder contractions can be caused by many conditions, including: Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine. For more information, see the topic Overactive Bladder.
  • Overflow incontinence usually is caused by obstruction of the urethra from BPH or prostate cancer or when the bladder muscles contract weakly or don’t contract when they should. Other causes include:
    • Narrowing of the urethra (stricture).
    • Medicines, such as antihistamines and decongestants.
    • Nerve conditions, such as diabetes or multiple sclerosis.
  • Functional incontinence is a rare form of incontinence caused by physical or mental limitations that restrict a man’s ability to reach the toilet in time.

Symptoms

Your symptoms will depend on the type of urinary incontinence you have.

The main symptom of stress incontinence is the loss of urine while coughing, laughing, lifting, straining, or changing posture.

Symptoms of urge incontinence may include:

  • A sudden, urgent need to urinate.
  • Sudden accidents in which you lose a large amount of urine.
  • The need to urinate frequently, often at night.

Symptoms of overflow incontinence may include:

  • A urine stream that starts and stops during urination.
  • An accidental release of a small amount of urine.
  • A weak urine stream.
  • A need to strain while urinating and a sense that the bladder is not empty.
  • An urgent need to urinate, often at night.
  • Loss of urine while asleep.

What Happens

Urinary incontinence in men is often related to prostate problems. As men age, the prostate gland grows larger, squeezing the urethra and pushing the neck of the bladder out of position. These changes can lead to incontinence. In most cases, incontinence due to prostate enlargement can be cured by medicine or prostate surgery.

But prostate surgery is also a major cause of urinary incontinence in men.

  • Short-term (acute) incontinence following prostate surgery may go away with time, especially for younger men. In some cases, the incontinence may last up to a year.
  • Stress incontinence is a common complication following prostate removal (radical prostatectomy) or radiation treatment for prostate cancer, though it is becoming less common with improving surgical techniques.
  • Some treatments for an enlarged prostate (benign prostatic hyperplasia, or BPH) can also cause incontinence, but this is uncommon.

If your incontinence is not related to prostate surgery and it appears suddenly, it will usually clear up after you have received treatment for whatever is causing the incontinence. For example, incontinence related to a urinary tract infection, prostatitis, or constipation will most likely disappear when the infection or condition is cured.

For some men, incontinence may have more than one cause.

What Increases Your Risk

Many things have been associated with an increased risk of urinary incontinence in men. Incontinence may be the result of various health conditions or medical treatments, or it could be caused by family history or lifestyle. In some men, things from more than one of the lists below can combine to cause incontinence.

Physical conditions or lifestyle factors that may make urinary incontinence more likely include:

  • Age-related changes, including decreased bladder capacity and physical frailty.
  • Smoking tobacco.
  • Injury to the bladder or urethra, such as from radiation therapy or prostate surgery.
  • Bladder infection or prostatitis.
  • Obesity.
  • Structural abnormalities of the urinary tract.

Medicines and foods that may make urinary incontinence worse include:

  • Caffeinated and carbonated drinks, such as coffee, tea, and soda pop.
  • Alcohol beverages.
  • Prescription medicines that increase urine production, such as diuretics, or relax the bladder, such as anticholinergics and antidepressants.
  • Other prescription medicines, such as sedatives, opioids, and calcium channel blockers.
  • Non-prescription medicines, such as diet, allergy, and cold medicines.

Several diseases or conditions may increase your risk of urinary incontinence, including:

  • Neurological conditions such as Alzheimer’s disease, Parkinson’s disease, stroke, diabetes, spinal injury, and multiple sclerosis.
  • Bladder cancer.
  • Chronic bronchitis.
  • Interstitial cystitis.
  • Anxiety and depression.

When should you call your doctor?

See your doctor immediately if your urinary incontinence does not go away or is accompanied by:

  • Weakness or numbness in your buttocks, legs, and feet.
  • Fever, chills, and abdominal (belly) or flank pain.
  • Blood in your urine or burning with urination.
  • A change in your bowel habits.

Call your doctor if:

  • You have a problem with urinary incontinence that is getting worse.
  • Uncontrolled loss of urine is enough of a problem that you need to wear an absorbent pad.
  • Incontinence interferes with your life in any way.

Do not be embarrassed to discuss incontinence with your doctor. Incontinence is not an inevitable result of aging. Most people with incontinence can be helped or cured.

Watchful waiting

If home treatment does not control your problem, or if incontinence interferes with your lifestyle, ask your doctor to recommend a treatment.

If you have urinary incontinence that begins suddenly (acute), call your doctor. Acute incontinence is often caused by urinary tract problems or medicines and can be easily corrected.

Who to see

Your family doctor or general practitioner can diagnose and treat some causes of urinary incontinence. You may also be referred to a specialist, such as an internal medicine doctor, a urologist, or a geriatrician.

If you need surgery to treat your incontinence, it is important to find a surgeon who is experienced in the type of surgery you need, usually a urologist.

Examinations and Tests

The first steps your doctor will take to learn the cause of your urinary incontinence are a medical history and a physical examination. The physical examination will include examination of the penis, the prostate, and the nervous system. The history and examination, along with routine diagnostic tests such as a urinalysis, often provide enough information to determine the cause of the incontinence and enable your doctor to start treatment.

Your doctor may ask you to keep a voiding log, which is a record of the amount of liquids you drink and how much and how often you urinate.

Tests that may be done to determine the type and cause of your urinary incontinence include:

  • Urinalysis and urine culture, which may be done to learn whether a urinary tract infection (UTI) or prostatitis is present or whether there is blood or sugar in your urine.
  • Cough test to check for urine leakage while coughing.
  • Urodynamic tests, which could include:
    • Uroflowmetry. The uroflowmetry test measures the rate of urine flow during urination. During the test, a flow curve will be charted to determine the peak flow rate. A low peak flow rate may be suggestive of an obstruction or a weak bladder causing the incontinence.
    • Pressure flow studies, which measure pressures produced in the bladder as the flow changes. Pressure studies may help distinguish between urinary symptoms caused by obstruction and those caused by a problem affecting the bladder muscles or nerves. This test is often used when the cause of a man’s symptoms is uncertain.
    • Residual urine determination. Your doctor may measure your post-void residual volume by inserting a thin tube (catheter) into your bladder or by using a bladder ultrasound scan immediately after you have urinated.
  • Cystometrogram (CMG). This test evaluates your bladder’s ability to store and release urine.
  • Electromyogram (EMG), which is used to record the electrical activity of muscles.

Your doctor may conduct a cystoscopic examination (a test that allows your doctor to see inside the urinary tract) to rule out other causes of incontinence.

Further tests may be required if the first treatment for incontinence has failed. Other tests may also be needed if you have had previous prostate surgery, radiation therapy, or frequent urinary tract infections, or if a catheter cannot be easily placed into your bladder.

Tests such as cystourethrogram, an X-ray taken of your bladder and urethra while you are urinating, are not often used to evaluate incontinence, but they may be helpful. If your doctor wants to do one of these tests, ask whether the test is needed to diagnose your type of incontinence.

Treatment Overview

The treatment you and your doctor choose will depend upon what type of urinary incontinence you have and how much you are bothered by your symptoms.

If there is no infection or cancer or other cause that could only be cured by surgery, treatment for incontinence proceeds in stages.

  • Behavioural strategies are tried first for all types of incontinence. These include reducing the amount of liquids you drink, eliminating caffeinated and carbonated drinks, and setting a schedule for urinating. See Home Treatment for more information.
  • Exercise on a regular basis is important for physical and emotional health. Some men with urinary incontinence stop exercising because they fear that it will cause leakage. But regular exercise is important and can help you manage stress and keep your muscles in tone.
  • Continence products such as absorbent pads or diapers, incontinence clamps, and pressure cuffs may be used if you are progressing through a different treatment and are waiting to see whether your incontinence goes away or if other methods of treatment have failed. But these products should only be used along with a more specific treatment, since they can hide a more serious condition that may be curable.
  • Medicines may be prescribed, depending on the cause of your incontinence.
    • Antispasmodics and anticholinergics may be prescribed to relax the bladder (for urge incontinence).
    • Antibiotics may be prescribed for incontinence caused by infection.
  • Self-catheterization may be tried if you have overflow incontinence from a weak bladder or blockage or if surgery is not the best option for you.
  • Surgery is usually considered when it is the only treatment that can cure the incontinence, such as when the condition is caused by a bladder obstruction.

What to think about

Many men who have urge incontinence or overflow incontinence also have an enlarged prostate gland (benign prostatic hyperplasia). They may want to talk to a doctor about medicine, surgery, or other treatment to relieve their symptoms. For more information, see the topic Benign Prostatic Hyperplasia (BPH).

Urinary incontinence can be a problem following treatment for prostate cancer, including radiation therapy and removal of the prostate.

Treatment will be different for men who have total incontinence or who cannot comply with or tolerate specific treatments because of a serious illness or disease.

Prevention

You may reduce your chances of developing urinary incontinence by:

  • Limiting caffeine and alcohol.
  • Getting to and staying at a healthy weight.
  • Quitting smoking.
  • Avoiding constipation by eating a healthy, high-fibre diet.
  • Doing Kegel exercises to strengthen the muscles that control the flow of urine.

Home Treatment

In many cases, behavioural changes, including changes to your diet, lifestyle, and urinary habits, can be enough to control urinary incontinence.

The following changes to diet and lifestyle may help reduce incontinence:

  • Reduce or eliminate caffeinated and carbonated drinks—such as coffee, tea, and soda pop—from your diet.
  • Do not drink more than one alcohol drink a day.
  • Try to identify any foods that might irritate your bladder—including citrus fruits, chocolate, tomatoes, vinegars, spicy foods, dairy products, and aspartame—and eat less of those foods.
  • If you smoke, quit.
  • Avoid constipation:
    • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre.
    • Drink enough fluids. Don’t avoid drinking fluid because you are worried about leaking urine.
    • Get some exercise every day. Try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It’s fine to be active in blocks of 10 minutes or more throughout your day and week.footnote 1
    • Take a fibre supplement with psyllium (such as Metamucil). Read and follow all instructions on the label.
    • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
  • If you are overweight, try to lose some weight. Remember that effective weight-loss programs depend on a combination of diet and exercise.
  • Try pelvic floor (Kegel) exercises to strengthen your pelvic muscles.

The following changes to urinary habits may help reduce incontinence:

  • Set a schedule for urinating every 2 to 4 hours, regardless of whether you feel the need.
  • Practice “double voiding” by urinating as much as possible, relaxing for a few moments, and then urinating again.
  • If you have trouble reaching the bathroom before you urinate, consider making a clearer, quicker path to the bathroom and wearing clothes that are easily removed (such as those with elastic waistbands or Velcro closures). Or keep a urinal close to your bed or chair.

Talk with your doctor about all the medicines you take, including non-prescription medicines, to see whether any of them may be making your incontinence worse. Medicines that may cause urinary incontinence in men include certain antidepressants, sedatives, and even some allergy and cold medicines.

Medications

Although some types of long-term (chronic) incontinence may be treated with medicine, the likelihood that medicines will improve your incontinence depends on the severity and cause of the problem. Some medicines that are used to treat incontinence may actually make the condition worse in men whose incontinence is caused by an enlarged prostate gland (benign prostatic hyperplasia, or BPH). So consulting with a urologist is an important part of incontinence care.

Medication choices

  • For overflow incontinence: If incontinence is caused by an enlarged prostate, medicines to treat benign prostatic hyperplasia may be prescribed. But these medicines don’t always improve incontinence. For more information, see the topic Benign Prostatic Hyperplasia (BPH).
  • For urge incontinence:
    • Anticholinergic and antispasmodic medicines, such as oxybutynin and tolterodine, calm the nerves that control bladder muscles and increase bladder capacity.
    • Alpha-blocker medicines, such as alfuzosin and tamsulosin, relax the muscles in the prostate and bladder.
    • The antidepressant medicine duloxetine may help with bladder control.
    • Botox (botulinum toxin) may be an option when other medicines don’t work. A Botox shot helps relax the bladder muscles.
  • For stress incontinence: The antidepressant medicine duloxetine may help with bladder control.

What to think about

For men with stress incontinence or urge incontinence, behavioural methods of treatment such as bladder training techniques are used in combination with medicine.

Surgery

If your urinary incontinence has not improved after you have tried behavioural methods and medicine, and if your doctor thinks surgery will be an effective treatment, you may choose to have surgery rather than live with your symptoms. In some cases, such as when a bladder outlet obstruction is affecting kidney function, surgery may be the only way to treat the problem that is causing the incontinence.

Surgery may be appropriate for men who:

  • Have ongoing (chronic) incontinence.
  • Have severe symptoms and total incontinence.
  • Are extremely bothered by their symptoms.
  • Have problems with urinary retention.
  • Have moderate to severe blood in the urine (hematuria) that is recurrent (keeps coming back).
  • Have recurrent urinary tract infections.

Overflow incontinence caused by enlargement of the prostate (benign prostatic hyperplasia, or BPH) is the form of incontinence most often treated with surgery.

Stress incontinence caused by removal of the prostate gland because of prostate cancer or an enlarged prostate may also be treated with surgery, if the incontinence isn’t cured after a period of watchful waiting.

Surgery choices

If overflow incontinence is caused by benign prostatic hyperplasia (BPH), prostate surgery may relieve the incontinence. For more information about surgery options and treatment for BPH, see the topic Benign Prostatic Hyperplasia (BPH).

Surgery for severe stress incontinence that does not improve with behavioural methods includes:

  • Artificial sphincter, which is a device made of silicone rubber that fits around the urethra (the tube that carries urine from your bladder to the outside of your body) and can be inflated or deflated to control urination.
  • Urethral bulking, which involves injecting material around the urethra to control urination by either closing a hole in the urethra or building up the thickness of the wall of the urethra.
  • Bulbourethral sling, which may be considered as a treatment for severe urinary incontinence that results from prostate surgery. In this procedure, a sling is placed beneath the urethra to support it and is attached to either muscle tissue or the pubic bone. The sling compresses and elevates the urethra, giving the urethra greater resistance to pressure from the abdomen.
  • Sacral nerve stimulation (SNS). In SNS, the doctor puts an electrical stimulator under your skin above your buttocks. This stimulator looks like a pacemaker. It is attached to electrodes that send pulses to a nerve in your lower back (sacrum). The sacral nerve plays a role in bladder storage and emptying.

Severe urge incontinence may be treated with surgery to make the bladder bigger (augmentation cystoplasty) or to make another way to store and pass urine (urinary diversion).

What to think about

Surgery usually isn’t considered for urinary incontinence unless it is the only reasonable way to cure it or after attempts to treat the problem with conservative measures or other treatment have failed. The decision to have surgery must always be based on an accurate diagnosis and realistic expectations for the surgery.

Factors that increase the chances that surgical treatment will fail to correct incontinence include obesity, long-term (chronic) cough, radiation therapy, age, poor nutrition, and strenuous physical activity.

Other Treatment

Treatment other than surgery or medicine may be used to treat urinary incontinence.

  • For stress incontinence, biofeedback, a technique that helps you learn to control a specific body function, may be an option for some men who have stress incontinence or urge incontinence.
  • For urge incontinence, behavioural therapies such as biofeedback and bladder training can be used to treat urge incontinence.
  • For overflow incontinence, some men may require intermittent self-catheterization. During this procedure, a catheter is inserted into the bladder, usually 3 or 4 times a day.

Other treatment choices

  • Catheterization may be used to treat severe incontinence that cannot be managed with medicines or surgery. Catheters don’t cure incontinence but rather allow you or a caregiver to manage incontinence.
    • Intermittent self-catheterization is done with a thin, flexible, hollow tube (catheter) that is inserted through the urethra into the bladder, allowing the urine to drain out.
    • Indwelling catheterization uses a catheter that remains in place continuously. For more information, see the topic Care for an Indwelling Urinary Catheter.
    • Condom or Texas catheter uses a special condom that can be attached to a tube for short-term use. The condom, placed over the penis, keeps the tube in place. The tube allows the urine to drain out.
  • Behavioural therapies, including biofeedback and pelvic muscle exercises, are used to treat urge and stress incontinence.
  • Continence products such as absorbent pads or diapers, incontinence clamps, or pressure cuffs may be used to manage any form of incontinence. Some of these products absorb leaked urine and some put pressure on the urethra to help prevent urine from leaking.

What to think about

Men often use absorbent products, such as pads or diapers, when other methods of treating incontinence have failed or cannot be used. Some men may prefer to use absorbent products rather than taking medicines or having surgery. They may also use absorbent products after surgery for prostate cancer, while they are waiting to see if their incontinence goes away. This method doesn’t treat the incontinence but instead manages the problem. In general, absorbent products should only be used along with a more specific treatment, because use of absorbent products can hide a more serious condition that may be curable.

References

Citations

  1. Canadian Society for Exercise Physiology (2011). Canadian Physical Activity Guidelines For Adults. Available online: http://www.csep.ca/CMFiles/Guidelines/CSEP_PAGuidelines_adults_en.pdf. Accessed October 28, 2014.

Other Works Consulted

  • Chapple CR, Milson I (2012). Urinary incontinence and pelvic prolapse: Epidemiology and pathophysiology. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 1871–1895. Philadelphia: Saunders.
  • Herschorn S (2012). Injection therapy for urinary incontinence. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2168–2185. Philadelphia: Saunders.
  • Naumann M, et al. (2008). Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70(19): 1707–1714.
  • Resnick, NM (2012). Incontinence. In L Goldman, A Shafer, eds., Goldman’s Cecil Medicine, 24th ed., pp. 110–114. Philadelphia: Saunders.
  • Silva LA, et al. (2011). Surgery for stress urinary incontinence due to presumed sphincter deficiency after prostate surgery. Cochrane Database of Systematic Reviews (4).
  • Wadie BS (2010). Retropubic bulbourethral sling for post-prostatectomy male incontinence: 2-year followup. Journal of Urology, 184(6): 2446–2451.

Credits

Adaptation Date: 7/17/2020

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Bladder control problems in women: Seek treatment

Bladder control problems in women: Seek treatment

Recognize the warning signs and symptoms of a bladder control problem. Understand when to seek a doctor’s help and how to get the most out of your visit.

By Mayo Clinic Staff

If you experience bladder control problems, don’t let embarrassment keep you from getting the help you need. Leaking urine, having to urinate frequently and experiencing other symptoms of urinary incontinence aren’t trivial consequences of childbirth or a natural part of aging.

Not all doctors routinely ask about urinary function during an exam. It’s up to you to take the first step. Tell your doctor about any bladder control problems and ask for help.

Why to seek help

Bladder control problems require medical attention for several reasons. Reduced bladder control may:

  • Cause you to restrict your physical activities
  • Lead you to withdraw from social interactions
  • Increase risk of falling if you have balance problems and rush to the bathroom to avoid leaking urine

Sometimes having a bladder control problem means you may have a serious underlying medical condition, such as diabetes or kidney disease.

When to seek help

A few isolated incidents of urinary incontinence don’t necessarily require medical attention. And most people, as they age, have to get up to urinate at night. But if the problem affects your quality of life, consider having your symptoms evaluated.

Make an appointment with your primary care provider if:

  • You’re embarrassed by urine leakage, and you avoid important activities because of it
  • You often feel urgency to urinate and rush to a bathroom, but sometimes don’t make it in time
  • You often feel the need to urinate, but you’re unable to pass urine
  • You notice that your urine stream is getting progressively weaker, or you feel as if you can’t empty your bladder well

Most of the time, symptoms can be improved.

When to seek a specialist

Many health care providers can evaluate bladder control problems without referring you to a specialist. In spite of better understanding and treatment of urinary incontinence, some providers may consider it an inevitable consequence of childbearing, menopause or aging. Others may lack the time, training or experience that make them likely to consider you for evaluation or treatment.

If your doctor dismisses symptoms that have an impact on your quality of life, or if the treatments he or she prescribes fail, ask for referral to a specialist. Doctors who specialize in urinary disorders include:

  • Geriatrician. This medical doctor specializes in the care of older adults, often with emphasis on problems related to common quality-of-life issues, such as urinary incontinence.
  • Urogynecologist. This is an obstetrician-gynecologist with additional training in problems that affect the pelvic floor — the network of muscles, ligaments, connective tissue and nerves that helps support and control the bladder and other pelvic organs.
  • Urologist. A urologist specializes in male and female urinary disorders, as well as the male reproductive system.

Bladder diary: A detailed symptom record

Before your visit, ask your doctor’s office for a bladder diary and how to use it so that you can track information for several days in a row.

A bladder diary is a detailed, day-to-day record of your symptoms and other information related to your urinary habits. It can help you and your doctor determine the causes of bladder control problems and the most effective treatments.

To figure out how much urine you pass, you can use any collection device that allows you to measure ounces or milliliters.

Medical history review

Your visit will be more productive if you provide a good medical history. Make a list of:

  • Any surgeries, childbirths, illnesses, injuries and medical procedures, along with approximate dates
  • Current health problems, such as diabetes or any condition that affects your ability to walk or rise rapidly to a standing position
  • Past and current problems with your urinary system
  • Medications you’re taking, including each drug’s brand or generic name, dosage, when you take it, and what you take it for

Medications can be associated with bladder control problems, so list everything — prescriptions, over-the-counter drugs, vitamins, minerals, herbs and other supplements. If you’re not sure whether something counts as a medication, put it on the list.

What to expect from treatment

As a first step, your doctor may recommend lifestyle changes to “train” your bladder, such as performing pelvic-strengthening exercises (Kegel exercises) and following a schedule for when you drink fluids and use the bathroom.

For some women, medications help. For others, surgery provides effective treatment. But, both medications and surgery have side effects you’ll want to discuss with your doctor before deciding on these treatment options. What’s best for you depends on the type and severity of your bladder control problem.

Your bladder control problems may significantly improve after treatment. Any improvement, however, counts as a success, as long as it helps you to do what you like and enhances your quality of life.

May 01, 2021

Show references

  1. Duralde ER, et al. Bridging the gap: Determinants of undiagnosed or untreated urinary incontinence in women. American Journal of Obstetrics and Gynecology. 2016;214:266e1.
  2. Lukacz ES. Evaluation of women with urinary incontinence. https://www.uptodate.com/contents/search. Accessed Jan. 30, 2019.
  3. Bladder control problems (urinary incontinence). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/all-content. Accessed Jan. 30, 2019.
  4. Qaseem A, et al. Nonsurgical management of urinary incontinence in women: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2014;161:429.
  5. Lukacz ES. Treatment of urinary incontinence in women. https://www.uptodate.com/contents/search. Accessed Jan. 30, 2019.
  6. Urinary incontinence. U.S. Department of Health and Human Services, Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/urinary-incontinence. Accessed Jan. 30, 2019.
  7. Wood LN, et al. Urinary incontinence in women. The BMJ. 2014;349:g4531.
  8. Wein AJ, et al., eds. Evaluation and Management of Women with Urinary Incontinence and Pelvic Prolapse. Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Jan. 16, 2016.
  9. Lightner DL (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 20, 2016.

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Urinary Incontinence in Men – Causes & Classifications

If you have a hard time controlling when urine comes out of your body, it’s called urinary incontinence. It means your body has lost some control over your bladder.

It can be frustrating and embarrassing, but figuring out what’s causing your pee to leak can help you find ways to treat and cope with the problem.     

How Urine Leaks

Normally, urine moves from your kidneys to your bladder through tubes called ureters. Your bladder stores your urine until a signal tells your brain that your bladder is full. Then urine leaves your body through a tube in your penis called the urethra. Urinary incontinence happens either because the signal to your brain gets scrambled or doesn’t happen, or because of a problem somewhere in your urinary tract.

You may leak urine because:       

  • Your bladder squeezes too hard or at the wrong time
  • The muscles around your urethra don’t work the way they should
  • Your bladder doesn’t empty when it needs to, and gets too full
  • Something is blocking your urethra
  • Your urinary tract didn’t form correctly     

There are several reasons these things might be happening. There might be a medical condition behind it, or you may have had surgery recently that affects your bladder control.     

Conditions That Cause Urinary Incontinence

There are several health and lifestyle issues that can make you start to leak urine. They can include:

Problems with your prostate. It’s common for prostate issues to cause urinary incontinence. Your prostate may be larger due to a non-cancerous condition called benign prostatic hyperplasia (BPH). Your prostate may also be bigger than usual because of cancer. An enlarged prostate can block your urethra. When your urethra is blocked, your bladder has to work harder to squeeze pee out. This makes its walls thicker and weaker. That makes it hard for your bladder to empty all the urine in it.

You can also struggle with urinary incontinence with prostate cancer or after having certain treatments for it — such as radiation treatment or surgery to remove your prostate. The surgery may cause problems with the nerves that control your bladder.

Certain diseases. Multiple sclerosis is a disease that can damage the nerves that tell the bladder when to empty and can also lead to bladder spasms. Some other conditions that can damage your nerves and keep your bladder from sending or receiving the signals it needs to work correctly are:

Surgery. Major bowel surgery, lower back surgery, and prostate surgery can all cause problems with your bladder. This is usually because some of the nerves in your urinary tract have been damaged during surgery.

Old age. Just like other muscles in your body, your bladder loses some of its tone and strength as you age and this can cause leaks.

Obesity or lack of exercise. When you don’t get enough activity, you may start carrying extra weight. When you add pounds to your body, your bladder feels more pressure. This can make you go to the bathroom more often, because you have a harder time holding your urine for a long time.

Chronic coughing. If sickness, allergies, or other problems keep you in coughing fits, it can put stress on your bladder and pelvic floor muscles. If they’re weak, they may struggle to keep pee inside.

Urinary tract infection. Bacteria can sometimes infect part of your urinary tract. The infection can irritate your bladder and cause incontinence.

Constipation. When your stool is hard or backed up, it can press on the nerves to your urinary system. This can cause leaks.

Also good to know: drinking alcohol or taking certain medications like diuretics, antidepressants, sedatives, narcotics, or over-the-counter cold and diet medicines can make urinary incontinence worse. So, though they don’t cause the problem, they can worsen your symptoms.     

When to See Your Doctor

It’s time to get things checked out if:

  • You have to go to the bathroom a lot more than usual, and often can’t hold in your urine until you get to the toilet
  • You leak when you sneeze, cough, or even stand up
  • You leak at random times, even if you didn’t cough or sneeze
  • You feel like your bladder still has urine in it, even after you go
  • Your stream of urine is weak
  • You have to strain when you urinate
  • It hurts to urinate
  • You feel pressure in your lower abdomen    

Urinary incontinence – NHS

Urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people.

There are several types of urinary incontinence, including:

  • stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
  • urge incontinence – when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards
  • overflow incontinence (chronic urinary retention) – when you’re unable to fully empty your bladder, which causes frequent leaking
  • total incontinence – when your bladder cannot store any urine at all, which causes you to pass urine constantly or have frequent leaking

It’s also possible to have a mixture of both stress and urge urinary incontinence.

Find out more about the symptoms of urinary incontinence.

When to seek medical advice

See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.

This can also be the first step towards finding a way to effectively manage the problem.

Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis.

The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.

Find out about diagnosing urinary incontinence.

Causes of urinary incontinence

Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.

Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.

Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.

Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area (fistula).

Certain things can increase the chances of urinary incontinence, including:

  • pregnancy and vaginal birth
  • obesity
  • a family history of incontinence
  • increasing age – although incontinence is not an inevitable part of ageing

Find out more about the causes of urinary incontinence.

Treating urinary incontinence

Non-surgical treatments

Initially, a GP may suggest some simple measures to see if they help improve your symptoms.

These may include:

  • lifestyle changes such as losing weight and cutting down on caffeine and alcohol
  • pelvic floor exercises, where you strengthen your pelvic floor muscles by squeezing them
  • bladder training, where you learn ways to wait longer between needing to urinate and passing urine

You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.

Medicine may be recommended if you’re still unable to manage your symptoms.

Find out more about non-surgical treatments for urinary incontinence.

Surgical treatments

Surgery may also be considered. The procedures that are suitable for you will depend on the type of incontinence you have.

Surgical treatment for stress incontinence, such as a sling procedure, is used to reduce pressure on the bladder or strengthen the muscles that control urination.

Surgery to treat urge incontinence includes enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Find out more about surgery and procedures for urinary incontinence.

Preventing urinary incontinence

It’s not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it happening.

These include:

  • maintaining a healthy weight
  • avoiding or cutting down on alcohol
  • staying active – in particular, ensuring that your pelvic floor muscles are strong

Healthy weight

Being obese can increase your risk of urinary incontinence. You may be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating.

Use the healthy weight calculator to see if you are a healthy weight for your height.

Get more information and advice about losing weight.

Drinking habits

Depending on your particular bladder problem, a GP can advise you about the amount of fluids you should drink.

If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder.

The recommended weekly limit for alcohol consumption is 14 units.

A unit of alcohol is roughly half a pint of normal strength lager or a single measure (25ml) of spirits.

Find out more about alcohol units.

If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day.

Pelvic floor exercises

Being pregnant and giving birth can weaken the muscles that control the flow of urine from your bladder. If you’re pregnant, strengthening your pelvic floor muscles may help prevent urinary incontinence.

Find out more about exercise during pregnancy.

Everyone may benefit from strengthening their pelvic floor muscles with pelvic floor exercises.

Find out more about pelvic floor exercises.

Information:

Social care and support guide

If you:

  • need help with day to day living because of illness or disability
  • care for someone regularly because they’re ill, elderly or disabled (including family members)

Our guide to social care and support explains your options and where you can get support.

Page last reviewed: 07 November 2019
Next review due: 07 November 2022

Symptoms & Causes of Bladder Control Problems (Urinary Incontinence)

In this section:

What are the symptoms of bladder control problems?

Signs and symptoms of urinary incontinence can include

  • leaking urine during everyday activities, such as lifting, bending, coughing, or exercising
  • feeling a sudden, strong urge to urinate right away
  • leaking urine without any warning or urge
  • being unable to reach a toilet in time
  • wetting your bed during sleep

You may have bladder control problems if you limit your activities in fear of not making it to a bathroom in time.

When should I see a health care professional?

See a health care professional if you have symptoms of a bladder problem, such as trouble urinating, a loss of bladder control, waking to use the bathroom, pelvic pain, or leaking urine.

Bladder problems can affect your quality of life and cause other health problems. Your doctor may be able to help you treat your UI by recommending a lifestyle change or a change in how much medicine you normally take.

See a health care professional if you

  • can’t pass urine or empty your bladder
  • urinate too often—8 or more bathroom visits a day—also called frequency
  • see blood in the urine, also called hematuria
  • have bladder infection symptoms, including painful urination

These symptoms can signal a serious health problem, including inflammation of the bladder, also called cystitis, or even bladder cancer.

What causes bladder control problems in women?

Certain life events and health problems can lead to stress incontinence in women by weakening the pelvic floor muscles

Weak pelvic floor muscles can make it hard for your bladder to keep urine in during stress incontinence. Stress incontinence occurs when some of your movements—coughing, sneezing, laughing, or physical activity—put pressure on your bladder and cause urine to leak. A weak pelvic floor can also cause fecal incontinence, or bowel control problems.

Weak pelvic floors can cause your bladder to move downward and push slightly out of the bottom of your pelvis, causing urinary incontinence.

What causes bladder control problems in men?

Men sometimes develop UI along with prostate problems.

Prostate problems

Men have a prostate gland that surrounds the opening of the bladder. The prostate gets bigger as a man ages. When the prostate gets too big but isn’t cancerous, a man has a condition called prostate enlargement, or benign prostatic hyperplasia (BPH). Men with an enlarged prostate may have

  • problems with starting to urinate
  • a slow urine stream
  • problems fully emptying the bladder

Men who have a history of prostate cancer may have short-term or long-term UI. The cancer can damage or block the urinary tract. Or, the surgery, radiation, or other prostate cancer treatments can lead to nerve damage, bladder spasms, or stress incontinence. Bladder control problems after prostate cancer can get better over time.

When the prostate gets too big, it can squeeze the ureter, making it hard to start urinating. You also may have a slow urine stream or be unable to completely empty your bladder.

What else causes bladder control problems in women and men?

Other health problems, including those with your nervous system, and lifestyle factors can cause or contribute to urinary incontinence (UI) in women and men.

Health changes and problems

Certain health changes and problems can lead to urinary incontinence

Some health problems can be short-term, like coughing or constipation, and can cause temporary incontinence. When a disability or a problem speaking or thinking keeps you from reaching a toilet in time, you have functional incontinence.

Problems with your nervous system are common causes of UI. UI can occur when your brain doesn’t tell the right part of your urinary tract—usually the bladder, the sphincters, or both—to do its job.

Bladder nerves and muscles can be damaged or affected by

Triggers of urinary incontinence can include drinking or touching water, hearing running water, or being in a cold environment, such as reaching into the freezer at the grocery store.

Lifestyle factors

Lifestyle factors that make women and men more likely to develop UI include

  • eating habits, such as eating foods that cause constipation
  • drinking habits, such as drinking alcohol or caffeinated or carbonated beverages
  • certain medicines
  • physical inactivity
  • smoking

Temporary incontinence is usually a side effect of a medicine or short-term health condition. Temporary incontinence can also be a result of eating habits, including alcohol or caffeine use.

Urinary incontinence: when you can’t hold back or control leakage

Stress incontinence

This is loss of urine when you exert pressure – stress – on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Stress incontinence occurs when the sphincter muscle and/or the pelvic floor of the bladder is weakened. In women, this could be due to physical changes resulting from pregnancy, childbirth and menopause. In men, removal of the prostate gland can lead to this type of incontinence. Treatment depends on the severity of your symptoms, and ranges from behavior advice and physical therapy to pharmaceuticals and surgery.

Urge incontinence

This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Your bladder muscle contracts and may give you a warning of only a few seconds to a minute to reach a toilet. With urge incontinence, you may need to urinate often, including throughout the night. Urge incontinence may be caused by urinary tract infections, bladder irritants (pharmaceuticals, foodstuff etc.), urinary retention, bowel problems, Parkinson’s disease, Alzheimer’s disease, stroke, injury or nervous system damage associated with multiple sclerosis. If there’s no known cause, urge incontinence is also called overactive bladder. Treatment depends on the severity of your symptoms, and ranges from behavior advice and physical therapy to pharmaceuticals, catheterization and surgery, often a combination of treatment is mostly effective.

Overflow incontinence

If you frequently or constantly dribble urine, you may have overflow incontinence, which is an inability to empty your bladder. Sometimes you may feel as if you never completely empty your bladder. When you try to urinate, you may produce only a weak stream of urine. This type of incontinence may occur in people with a damaged bladder, blocked urethra or nerve damage from diabetes and in men with prostate gland problems. Treatment depends on the severity of your symptoms and ranges from catheterization, behavior advice and physical therapy to pharmaceuticals and surgery, often a combination of treatment is mostly effective.

Mixed incontinence

If you experience symptoms of more than one type of urinary incontinence, such as stress incontinence and urge incontinence, you have mixed incontinence.

Other, less common types of incontinence include:

  • Functional incontinence: Older adults or disabled people may experience incontinence simply because a physical or mental impairment keeps them from making it to the toilet in time. For example, a person with severe arthritis may not be able to unbutton his or her pants quickly enough. 
  • Gross total incontinence: This term is sometimes used to describe continuous leaking of urine, day and night, or the periodic uncontrollable leaking of large volumes of urine. In such cases, the bladder has no storage capacity. Some people have this type of incontinence because they were born with an anatomical defect. It can be caused by injuries to the spinal cord or urinary system, or by an abnormal opening (fistula) between the bladder and an adjacent structure, such as the vagina. Treatment depends on the severity of your symptoms and ranges from catheterization, behavior advice and physical therapy to pharmaceuticals and surgery, often in combination. 

How to Solve Bladder Control Problems

This Week’s Question: This is embarrassing to discuss with anyone so I thought I’d write to you about it. I’m having bladder-control problems. What can I do?

About 10 percent of men and women over the age of 65 have trouble with bladder control, also know officially as urinary incontinence. Women suffer from this more than men.

During urination, muscles in the bladder contract, forcing urine into the urethra, a tube that carries urine out of the body. At the same time, muscles surrounding the urethra relax and let the urine pass. If the bladder muscles contract or the muscles surrounding the urethra relax without warning, the result is incontinence.

Short-term incontinence is caused by infections, constipation, and some medicines. If the problem persists, it might be caused by weak bladder muscles, overactive bladder muscles, blockage from an enlarged prostate, damage to nerves that control the bladder from diseases such as multiple sclerosis or Parkinson’s.

Treatable condition

In most cases urinary incontinence can be treated and controlled, if not cured. If you are having bladder control problems, go to your doctor. Doctors see this problem all the time, so there is no need to be embarrassed.

Your doctor may do a number of tests on your urine, blood and bladder. You may be asked to keep a daily chart about your urination.

There are several different types of urinary incontinence:

  • If urine leaks when you sneeze, cough, laugh or put pressure on the bladder in other ways, you have “stress incontinence.”
  • When you can’t hold urine, you have “urge incontinence.”
  • When small amounts of urine leak from a bladder that is always full, you have “overflow incontinence.
  • Many older people who have normal bladder control but have difficulty getting to the bathroom in time, have “functional incontinence.”

There are many ways to treat urinary incontinence. The method depends upon the type of problem.

You can train your bladder with exercises and biofeedback. You can also chart your urination and then empty your bladder before you might leak.

Plugs, medicines and surgery

Your doctor has other tools he can use. There are urethral plugs and vaginal inserts for women with stress incontinence. There are medicines that relax muscles, helping the bladder to empty more fully during urination. Others tighten muscles in the bladder and urethra to cut down leakage.

Surgery can improve or cure incontinence if it is caused by a problem such as a change in the position of the bladder or blockage due to an enlarged prostate. Common surgery for stress incontinence involves pulling the bladder up and securing it. When stress incontinence is serious, the surgeon may use a wide sling. This holds up the bladder and narrows the urethra to prevent leakage.

Even if treatment is not fully successful, management of incontinence can help you feel more relaxed and comfortable about the problem.

The Healthy Geezer column publishes each Wednesday on LiveScience. If you would like to ask a question, please write [email protected] © 2009 by Fred Cicetti.

90,000 Physiological causes of loss of urinary control in men and women

Temporary incontinence.

Functional incontinence – when the normal regulation of urination is impeded by mental or physical (inability to quickly reach the toilet) problems, while the excretory system itself is in order. Parkinson’s disease, Alzheimer’s disease and other forms of dementia lead to functional incontinence.

Urgent incontinence .People who leak urine after a sudden, intense urge to urinate have urge incontinence. This is due to an increase in the tone of the muscles of the bladder, which can be due to a large number of reasons, such as: mental stress, nerve damage (with diabetes, stroke), infection, stones in the bladder, swelling. In this situation, a complete examination is necessary to identify the root cause and prescribe adequate treatment. Acute incontinence most often begins with an acute urge to urinate if it is impossible to carry it out.This condition progresses to the point where it becomes impossible to control the process of urination. For urge incontinence, drug therapy is indicated to help regulate bladder tone, as well as Kegel exercises to strengthen the pelvic floor muscles and “accustom” the bladder to work at regular intervals.

Stress incontinence. Every fifth woman over the age of 40 knows what stress incontinence is. This is when a small portion of urine is released during coughing, laughing, sneezing, physical exertion (especially those that increase intra-abdominal pressure). In the vast majority of cases, stress urinary incontinence is characteristic of women, but does not depend on age – both young women and professional athletes are familiar with this. We are not talking about emotional stress, but about weakened muscles of the sphincter and pelvic floor, which leads to the fact that a stressful effect, whether it be a sudden movement or an increase in intra-abdominal pressure, leads to the squeezing of a portion of urine from the bladder into the urethra. In this situation, exercises to strengthen the muscles of the pelvic floor and Kegel exercises can help.

Overfill incontinence. This type of incontinence is common among older men. The cause in most cases is a benign overgrowth of prostate tissue, which compresses the urethra and affects urine flow. Symptoms of this pathology are rare in men under 40, but by 60 more than half of the strong half of humanity will become familiar with the symptoms of overflow incontinence, and by the age of 80 their number will increase to 90%. Due to the blockage of the urethra, urine constantly accumulates in the bladder, stretching its walls.Symptoms vary, but the most common ones are difficulty urinating (inability to urinate, poor flow), urinary leakage, and frequent urge to urinate, especially at night. Problems with urination are not necessarily caused by an enlarged prostate. Treatment is most often surgery or bladder catheterization.

Mixed incontinence. It is a combination of stress and urge incontinence symptoms. It occurs in a significant number of patients.A complete examination is necessary to identify the causes.

90,000 It is not customary to talk about him: urinary incontinence in women

Some topics related to intimate health are tacitly prohibited. They are embarrassed to talk about them even with close people. When a problem is not discussed, it seems that it is not. Often a woman with urinary incontinence thinks she is the only one “wrong” and is very ashamed of her disorder. In fact, this is not the case. Let’s see what the statistics say.

According to experts from the Cleveland Clinic, USA, 10% of women suffer from urinary incontinence. After age 65, the prevalence of this condition increases to 35%. Often the problem is completely solvable, there are effective methods of treatment. But many women are embarrassed to see a doctor.

In Russia, the situation is no better. In our country, it is generally accepted to go to doctors “when everything is already really bad.” Especially when it comes to such delicate issues.

There is no need to be afraid, shy and endure. If you are faced with this unpleasant problem, the doctors of the SOVA clinic will definitely help you. And you can be sure that nobody but our doctor will know about your disorder.

Types of urinary incontinence

Depending on the manifestations, there are several types of urinary incontinence:

  • Stress urinary incontinence is the most common. Leaks happen when the pressure in the abdomen rises: during laughing, sneezing, coughing, exercising, or lifting heavy objects. The most common cause of this condition is weakening of the pelvic floor muscles, prolapse of the vagina and uterus.
  • Urgent incontinence. When the urge to urinate arises, the woman does not have time to reach the toilet. This is due to the overactivity of the muscles in the bladder wall.
  • Continuous urine leakage . It is caused by a violation of the nervous regulation of the bladder, the work of the sphincter muscles, which normally should hold urine.
  • Reflex urinary incontinence is the result of nerve impulses from the brain not reaching the bladder. For example, this condition develops after serious damage to the spinal cord.
  • Leakage of urine after urination . Due to muscle dysfunction after using the toilet, there is still some urine in the bladder, which then flows out under the influence of gravity.
  • Bedtime incontinence (enuresis) is diagnosed in women and girls over 5 years of age if involuntary urination occurs during sleep.

Why is urinary incontinence more common in women, and what causes it?

The prevalence of the problem among men is only 1.5% – almost ten times less than among women. This is due to some of the features of female anatomy and physiology.

During pregnancy 4 out of 10 women suffer from urinary incontinence, especially in the third trimester. As the fetus grows, it puts more and more pressure on the bladder, urethra, and pelvic floor.The muscles that support the pelvic organs are stretched, and as a result, urinary retention is impaired.

During labor , the pelvic floor muscles are even more stressed. They stretch, the nerves are compressed. Muscles usually recover within 6 weeks and no more urine leaks. If the disorder persists, see a doctor.

Women have a shorter urethra compared to men. Because of this, with an increase in intra-abdominal pressure, urine leaves the bladder more easily.

During menopause and as a result of age-related changes in the body, the pelvic floor muscles continue to weaken and stretch, changes occur in the mucous membranes.

Stress urinary incontinence is a very common condition among women today. You can and should fight with it. Self-medication using folk methods will not help here. See a doctor.

This is serious

Stress urinary incontinence is not just an unpleasant symptom, it can greatly affect all areas of life.The psycho-emotional state of a woman suffers, she has complexes, anxiety, she tries not to be outside the house for a long time, because “this” can happen at the most unexpected moment. Relationships with the opposite sex, work suffer, you have to limit yourself in many things.

The risk of genitourinary infections increases. Due to the constant exposure to urine, irritation, rash, itching appear on the skin.

How is urinary incontinence treated?

Before starting treatment, you need to understand the causes of the disorder.This often requires a thorough examination. Gynecologists and urologists are involved in the diagnosis and treatment of urinary incontinence in women. After the examination, the doctor may prescribe a general and bacteriological analysis of urine, measurement of residual urine (which remained in the bladder after urination) using an ultrasound scan. The patient is asked to keep a notebook in which she should record the volume of fluid and urine excreted, the number and time of urges, incontinence episodes.

When the cause is clearly and unambiguously established, you can begin treatment.There are many techniques.

Temporary urinary incontinence can be caused by an infection of the genitourinary organs. Usually, the problem disappears as soon as the underlying disease is eliminated. Doctors of the SOVA clinic successfully treat cystitis and other infectious and inflammatory pathologies. Do not wait for complications, make an appointment with a specialist.

There are special methods of “training” the bladder and pelvic floor muscles:

  • Kegel exercises, named after the American gynecologist who developed them, strengthen the pelvic floor.You need to tense, as if you are trying to hold back the flow of urine, and try to keep the muscles in this state for 10 seconds. It is recommended to do the exercise 3 times a day for 10 approaches.
  • Retention of urination: when the urge to urinate arises, you need to be patient for a few more minutes.
  • Double urination: a few minutes after using the toilet, you need to urinate again.
  • “Urination on a schedule”: you need to visit the toilet in advance at a certain time (every 2-4 hours), and not when you really want to.

When lowering the vagina and uterus, pessaries are used – rings made of a special material that are inserted into the vagina. To strengthen the muscles, electrical stimulation is used with electrodes inserted into the vagina or rectum. Sometimes a device resembling a pacemaker is implanted under the skin – it sends impulses to the muscles. The doctor may prescribe various medications, correction with fillers that reduce the lumen of the urethra. With an overactive bladder, botulinum toxin injections help.

Modern manufacturers offer a huge selection of pelvic muscle trainers. These devices can be of different shapes and are inserted into the vagina. Some devices just need to be held inside, straining the muscles, while others have the function of vibration, electrical stimulation. They can be connected to a smartphone and set training programs. These machines can be helpful, but you should consult your doctor before using them.

In case conservative treatment does not help, there are different types of surgical interventions.

As you can see, modern doctors have a wide arsenal of tools to combat urinary incontinence. You do not need to limit yourself in different areas of life, wear urological pads all the time and constantly sniff, worrying about whether an unpleasant smell is coming from you. See your doctor. Experienced doctors at the SOVA clinic will understand the causes of your problem and help you cope with it.

90,000 Urinary incontinence: open conversation with the doctor

Photo from the archive of the Center

“Jumping with the child on a trampoline, I felt that there was an“ accident ”, – such a story of the patient about her problem was heard by the obstetrician-gynecologist of the Medical Center for Diagnostics and Treatment Irena Kirilova, with whom we are talking today about a delicate the problem of urinary incontinence.

– The issue of incontinence is being talked about more and more loudly. The story of a young woman is far from a special case when patients of this age group complain of urinary incontinence. Is this another female “epidemic” caused by the modern lifestyle?

– Urinary incontinence or incontinence at all times tormented both women and men. We are used to talking only about female incontinence. This is probably due to the fact that a myth has taken root in our minds that all women who gave birth naturally, with age, to one degree or another, face this problem, and nothing can be done about it, alas.We, gynecologists, today confidently declare that this condition can be effectively treated and return a woman to a full life at any age. Whether you are thirty or eighty-five years old – if you suffer from urinary incontinence, seek help. Older people, of course, are much more likely to face such a problem in connection with the changes that the whole body undergoes as a whole, but one should not think that young people are bypassed by this problem, and even episodic “accidents” should lead a woman to a doctor.

– If only a drop of urine is released when you sneeze, is it worth worrying?

– Any involuntary leakage of urine, regardless of the amount excreted, already serves as a signal that the system is “leaking”.

People sometimes take incontinence lightly, as a variation of the norm, which, however, they are ashamed to talk about. Yes, indeed, because incontinence does not lead to death, does not affect the state of health, therefore patients often try to “solve” this problem on their own.Nowadays, there are a great variety of items for proper personal hygiene. Unfortunately, over time, the disease, as it progresses, forces a person who does not want to suddenly find himself in an awkward position to lead a reclusive lifestyle – to refuse travel, meetings, going to the theater, playing sports. This can affect the psyche, causing feelings of inferiority and even lead to depression. If during coughing, sneezing, vomiting, urine is involuntarily released, the urge to urinate becomes frequent, you have to get up at night, and when urinating you experience pain, burning, cloudy sediment or blood impurities appear in the urine, be sure to consult a doctor.Only a doctor will be able to assess whether you have, among other things, more formidable diseases of the genitourinary system and will prescribe an effective treatment.

– What causes urinary incontinence?

– Urinary incontinence more often worries elderly people, and due to anatomical features, women more often than men. Dementia, multiple sclerosis, Parkinson’s disease, stroke, endocrine disorders, and sometimes the use of certain medications can also provoke the development of this ailment.

In young women and middle-aged women after childbirth, especially after complicated ones, or if the child was large, stretching and tearing of the muscles of the pelvic floor, perineum and urogenital diaphragm occur, which in turn can provoke the problem we are talking about today. All expectant mothers before and after childbirth are advised to strengthen their pelvic floor muscles daily with the Kegel exercise. This gymnastics is very simple but very effective. Training the muscles of the vagina and the pubic-coccygeal muscle, among other things, protects against prolapse of organs, in addition, gives a new color to intimate life.

The causes of this disease can be of all kinds, and, therefore, a detailed examination should be carried out to identify them, and the correct treatment tactics should be chosen – drug therapy, surgery, or a simple lifestyle change – diet, gymnastics to strengthen the pelvic floor muscles , especially in young patients. Such a restructuring is not easy, but it is so necessary to return to a fulfilling life without drastic measures.

– Do different reasons for the development of incontinence lead to the same result?

– Basically, there are three types of urinary incontinence: stressful (with exertion, for example, when coughing), imperative (irritable bladder syndrome) associated with an uncontrollable urge to urinate and mixed.The result is the same – the bladder “does not obey”, but the mechanism of “disobedience” is different.

Stress urinary incontinence – involuntary leakage of urine during coughing, laughing, running and other physical activities, leading to an increase in intra-abdominal and, therefore, intravesical pressure. A characteristic feature of stress urinary incontinence is the absence of the urge to urinate.

The main reason for the development of stress urinary incontinence in women is a decrease in the tone of the pelvic floor, leading to prolapse of the pelvic organs (uterus, vagina, bladder, urethra), damage to the connective tissue structures of the pelvic floor, impaired coordination of various muscle groups.Emotional stress can also serve as a trigger.

Women who suffer from irritable bladder syndrome complain that they cannot reach the toilet when they have an irresistible urge. This urge is called “imperative” or “imperative”. External stimuli can provoke incontinence in this condition: pouring water, bright light, or others. Its main cause is an overactive bladder, which reacts instantly to even slight irritation.

– How to treat urinary incontinence?

– Today the incontinence can be treated very well. First of all, the doctor determines the cause of urinary incontinence – checks for prolapse of organs, conducts diagnostic tests and determines the type of incontinence. Sometimes it is difficult to immediately establish the cause, research and observation are needed, which take a certain amount of time, consultation of other specialists, for example, a urologist. The patient should come to the gynecologist’s appointment with a full bladder.

If diagnosed with irritable bladder syndrome, medication is most often prescribed, which reduces the sensitivity of the bladder receptors. Patients should also follow a specific diet to reduce excess weight and strengthen their pelvic floor muscles.

Stress urinary incontinence is effectively treated with minimally invasive vaginal surgery. During the operation, which lasts about 10 minutes under full anesthesia, a supportive synthetic loop is placed around the middle part of the urethra.This method is 95 percent effective. After five to ten years, the efficiency remains at the level of 80-70%.

– It happens that people suffering from urinary incontinence begin to restrict their fluid intake.

– This is tantamount to a disservice, especially if the person is suffering from irritable bladder syndrome. Concentrated urine further irritates the bladder, which has the opposite effect. It is necessary to drink water! Experts strongly recommend giving up coffee, carbonated drinks, concentrated juices, alcohol, as well as hobbies for spices, but in no case from water.Patients, regardless of the type of origin of the disease, are advised to lose weight, strengthen the pelvic floor muscles with Kegel exercises, take care of themselves, and do not lift weights. These measures will not only protect against the progression of urinary incontinence, but also prevent the prolapse of the pelvic organs.

Regular visits to an obstetrician-gynecologist, an open conversation with him will help to notice changes in the body in time, prevent illness and manage the consequences caused by the natural aging process.

90,000 Why is it dangerous to endure | Domestos

Author: Anna Gorbunova – pediatrician, infectious disease specialist

A delay in urination for an hour or two does not pose any threat to health. But still, it can harm the body if it happens regularly.

The bladder is an expandable organ. The process of emptying the bladder is not much different from the contraction of other muscles in our body. Filtered urine by the kidneys is collected in the bladder by two tubes called ureters.The volume of the bladder fluid in an adult can be about 400-600 ml. A child is 0-12 months old. – 30-60 ml, in children 1-3 years old – 90-150, in children 4-12 years old – 200-400 ml. It takes time to fill it, which depends on age.

For children under one year old, this time is approximately one hour, for children under 3 years old – 2 hours, 6 years old – 3 hours, 12 years old – up to 4 hours, for an adult – 6-8 hours.

Research shows that the bladder is directly connected to your brain, i.e. it is full of receptors that tell the brain how full it is.Essentially, there is an invisible “fill line” in the bladder. When urine reaches this point, the brain receives a signal that indicates the need to urinate. This usually happens when the bladder is only a quarter full. Therefore, when we feel the urge to urinate, we still have time before the bladder is fully filled. When it is full, its muscles work to keep urine from leaking until the moment is right.

A single retention of urine for several hours can rarely be harmful in the long term.The danger of urinary retention has a cumulative effect. That is, if this happens all the time, if a habit is formed to ignore the urge to urinate, then complications may develop.

This complication can be a urinary tract infection. Urine is usually sterile, and bacteria usually do not become infected with the normal flow of urine. But with urinary retention, the urethra can open up and there is a possibility of bacteria penetrating ascending into the bladder, causing cystitis, and even into the kidneys, causing pyelonephritis.

Plus, in some people, high intravesical urine pressure leads to disruption of the closure of the vesicoureteral segment and causes urine to flow back into the kidneys.

This backflow, called reflux, can damage the kidneys.

In the same way, the habit of “tolerating” can damage the bladder itself.

If the bladder stretches too much, for a long time and regularly, then its muscles can be damaged (atrophy) and lose the ability to contract.Subsequently, urinary incontinence may occur.

With prolonged “patience”, for 10 or more hours, on the contrary, urinary retention may develop, due to the fact that the muscles of the bladder cannot relax, even when we want to. In very rare cases, prolonged urinary retention can rupture the bladder. The habit of “enduring”, especially if it is formed from early childhood, can extremely unfavorably affect the development of the urinary organs.

Therefore, it is necessary to empty the bladder whenever this desire arises.In this case, it is necessary to empty it completely and not to rush this process.

Here it is interesting that, after conducting a study among Russians, the Domestos brand found that 45% of parents say that their children try not to go to school toilets. Therefore, it is very important for yourself and your children to form the habit of going to the toilet on time so that there are no undesirable consequences.

A timely trip to the potty in kindergarten is often given enough time, but with schoolchildren it is more difficult.It is necessary to start teaching the use of public toilets and conduct explanatory conversations from early childhood. Young children may find public toilets noisy, uncomfortable, but we must try to explain that it is dangerous to “endure” in this situation and gradually teach the child to use public toilets, for example, when you go to cafes, children’s clubs. Then, at an older age, in school years, the skill will be developed – to control yourself during recess and go to the toilet before the lesson, so that later you will not endure during the lesson.

Yes, our public toilets are often lacking in appeal. They are often not cleaned, they have worn out plumbing, the doors of the booths in them often do not close or are completely absent, as in the bathrooms of many schools, they also often lack hygiene products and dryers are broken. Therefore, the feeling of awkwardness and disgust often overpowers the natural need of our children. And this is understandable. After all, it is ideal when you can choose a clean toilet, which will undoubtedly have a cleaning schedule on the door, it will have soap and toilet paper, towels or a working hand dryer.Then we will have no obstacles to go to the toilet.

First of all, all public organizations in which there are public toilets, especially in children’s institutions, are supposed to follow the rules for their maintenance. Then nothing will hinder this important need and we, and especially our children, will not have to restrain ourselves to our detriment.

Therefore, the Domestos brand launched the project “You Can’t Endure Learning”, where we have to put the comma ourselves. The project focuses on the low level of sanitary maintenance of school bathrooms and how this can affect the health of the child.As part of the project, the brand helped schools by renovating toilets, and also launched an educational campaign for parents, schoolchildren and teachers across the country to help them immerse themselves in the problem and urge them to pay more attention to the topic of hygiene by collecting expert materials on the topic on the website. link.

the main causes of the disease and hygiene products that help in solving the problem

Official statistics show that 16% of the adult population, half of whom are men of different ages, in one way or another, meet with such ailments as incontinence or urinary incontinence.This condition is characterized by unconscious reflex urination. Moreover, the older the representative of the stronger sex, the more likely it is that he, sooner or later, will develop a similar disease. Particularly vulnerable are those male citizens whose age exceeds 60 years .

In fact, urinary incontinence in men is not a separate disease. Often it is the result of a series of sequential pathological changes that disrupt the usual course of life.However, the main problem for a man suffering from incontinence is not a deterioration in his physical condition, but psychological discomfort. After all, such an ailment complicates family life, reduces social activity and hinders professional growth.

Urinary incontinence in men: the main factors provoking the disease

The main reasons for spontaneous emptying of the bladder include the following:

  • incontinence, as the result of previous operations on the pelvic organs: removal of part or all of the prostate gland (prostate), radiation therapy, etc.NS.;
  • diseases of the nervous system : due to the fact that the nervous system provides the conduction of nerve impulses from the brain to the genitourinary system and vice versa, exercising control and regulation of the urination process, in the event of a violation of any transmission mechanisms of such signals, the connection is terminated, provoking male urinary incontinence varying degrees of severity. Such NS diseases include: stroke, multiple sclerosis, brain or spinal cord injury, Parkinson’s or Alzheimer’s disease, etc.;
  • Narrowing of the urethra : This happens due to an enlargement of the prostate gland, which most often occurs due to age-related changes in the male body. And as a result – intermittent urination or, conversely, an increase in the frequency of the urge to urinate, which in most cases develop into an inability to maintain urine;
  • urinary incontinence in men with alcohol intoxication : alcohol abuse causes brain damage, which, in turn, leads to disturbances in the functioning of the urinary system;
  • other reasons: age-related and hormonal changes in the male body; congenital and acquired diseases of the genitourinary system.

Urinary incontinence in men at any age is a delicate problem that, once it occurs, can certainly return again. What to do if urine does not hold in men? Any representative of the stronger sex who is faced with a similar ailment, in order not to aggravate it, is simply obliged to seek advice from a specialist. The doctor will conduct a comprehensive examination, based on the results of which he will conclude what type of disease the patient has encountered and what therapy is indicated for him.

Urinary incontinence in young men and in older men: the main forms of the disease

Today, problems with the bladder are observed in both young guys and men in old age. Modern specialists distinguish the following forms of male incontinence:

  • stress urinary incontinence : This is an involuntary drip in men, characterized by periodicity. It is associated with extreme stress or intense physical exertion.Often observed at the time of coughing, sneezing, laughing, etc.;
  • Urgent (imperative) incontinence : profuse excretion of urine, which is previously accompanied by a strong urge to use the toilet;
  • functional incontinence in men : involuntary leakage of urine in men after urination. Such an ailment may be caused by a state of health or other factors, due to which a representative of the stronger sex cannot get to the bathroom in time;
  • total incontinence : systematic uncontrolled urination in men.This form of the disease is usually seen in older men when there is a weakening of the muscles in the bladder;
  • enuresis: bedwetting in men. Most often, this disease is the result of untreated childhood diseases.

In turn, enuresis that occurs in both adults and older men during sleep is classified (depending on the duration of the disease) into the following types:

  • persistent nocturnal incontinence in men: a small amount of urine is excreted every night;
  • Recurrent incontinence: In this form of the disease, exacerbation occurs periodically and alternates with a period of remission.As a rule, this type of enuresis is observed in men who abuse alcohol;
  • complete absence of urine in men.

If at least one of the above signs is found, a man should immediately seek the advice of a doctor. After all, the earlier the treatment begins, the more chances you have to defeat the disease.

Hygiene products that help to discreetly solve the problem of male urinary incontinence

As you can see, male urinary incontinence is a fairly common problem, which in most cases forces a man of any age to change his usual way of life, to give up his favorite activities and activities.All this cannot but undermine the psychological health of the stronger sex. Therefore, to prevent this from happening, every man looks for methods of dealing with the consequences of incontinence during treatment. It is hygiene products, such as pads (liners), absorbent underpants, and diapers (diapers) for adults, that will help imperceptibly solve the problem of urinary incontinence in both young and elderly men. However, before purchasing them, it is important to understand their purpose and species diversity.Today, modern manufacturers offer the following types of male inconspicuous hygiene products:

  • urological pads (inserts) for men Tena: due to the fact that such hygiene products ideally retain not only urine, but also prevent the appearance of an unpleasant odor, they have become a panacea for those of the stronger sex who wish to avoid social maladjustment;
  • Seni sanitary pads (liners) for men: they are characterized not only by a high ability to retain urine and unpleasant odors, but also by structural features.All this guarantees a man suffering from spontaneous urination, freedom of movement and maximum comfort. And this means that he will not have to give up his favorite things and long-term communication with loved ones;
  • Tena and Seni Adult Absorbent Briefs: With these hygiene products, men don’t have to give up their active lifestyle. Indeed, in addition to the fact that the panties are endowed with good absorbency, in appearance they resemble ordinary men’s underwear with a wide elastic belt and are absolutely invisible under clothes.

Which hygiene product to choose depends on the personal preference of the consumer and the degree of urinary incontinence. But, giving preference to Tena sanitary pads, or purchasing Seni men’s urological pads, pay attention to the fact that their price depends on several factors: size, shape, amount of absorbent substances, as well as the number of units in the package.

90,000 causes, treatment and hygiene products

Urinary incontinence in women at a young age usually occurs after a complicated birth.But more often than not, incontinence is a problem for older women. During menopause, the production of female hormones estrogens, which are responsible for the elasticity of tissues in a woman’s body, as well as for the ligamentous and muscular apparatus of the pelvic floor, is reduced. Because of this, the tone of the urethra worsens, which leads to involuntary leakage of urine at the slightest exertion, for example, when sneezing or coughing, not to mention lifting weights. What to do?

Types of incontinence and their features

Urinary incontinence, or incontinence, as doctors call this condition, is divided into three types according to symptoms:

  • Stress urinary incontinence: incontinence occurs only when intra-abdominal pressure increases, which can cause elevation heavy lifting, playing sports, intercourse, and even minor stresses such as sneezing, coughing or laughing.
  • Urgent urinary incontinence: characterized by an intolerable urge to urinate, sometimes a woman may not have time to react. The strangest thing is that the bladder can be very slightly filled.
  • A mixed form of incontinence, which combines the symptoms of the first and second forms of incontinence.

Whatever type of incontinence is observed, it is always an additional experience for a woman, and stress is one of the main causes of pathology. You can walk along this vicious circle for a very long time.

Causes of urinary incontinence in women

Although urinary incontinence in women can develop for many reasons, a significant proportion of them are associated with nervous tension and fatigue:

  • Severe, traumatic childbirth – one of the causes of stress incontinence. Childbirth traumatism consists not only in tears of the soft tissues of the perineum, but also in overstretching of the muscles of the pelvic floor.
  • Overweight is also indicated as one of the provoking factors in the development of stress incontinence.
  • Gynecological procedures – such as removing cysts or tumors on the uterus or ovaries, can also lead to incontinence as a consequence.
  • Hormonal changes due to menopause . The sphincter is weakened due to insufficient elasticity of the muscles, which weaken with age due to hormonal changes.
  • Features of the female anatomy . Stress incontinence is known to be more common in women than in men.This is due to the peculiarities of the female anatomy: the urethra in women is only 3-4 cm long, while in men it can reach 24-30 cm. In women, the urethra is 6-10 mm wide, while in men it is from 4 to 7 mm. That is why women need very strong pelvic floor muscles, otherwise urine will easily pour out of the bladder through the short and wide urinary canal.
  • Urgent urinary incontinence . This condition may be associated with overactive bladder syndrome or neurogenic bladder syndrome.An unforeseen situation can occur even when a woman, knowing her peculiarity, deliberately limits the amount of fluid consumed. This type of urinary incontinence forces a woman to be in the immediate vicinity of the toilet (she is afraid to move away, because the urge happens with enviable regularity – at least once every one and a half to two hours). This type of incontinence can be caused by a neurological problem: a head injury or spinal injury, or it can also be a consequence of a stroke.Also, the reason may be hidden in a genitourinary infection, having cured which, a woman forever forgets about this problem.
  • Mixed incontinence . It is a combination of urgent and stressful incontinence.

Methods and methods of treating incontinence

Treatment of incontinence should be carried out after the exact establishment of its causes – it can be not only hormonal disruptions or complications after childbirth, but also banal infections of the urinary tract or tumor diseases.It is clear that in this case, exercise for the pelvic floor muscles will not give a special effect.

Non-surgical non-drug methods

Non-drug treatments for incontinence include:

  • bladder training;
  • exercises to strengthen the pelvic floor;
  • physiotherapy.

Training consists in creating and implementing a urination plan. You still need to learn how to implement the plan and train better under the guidance of a doctor.The intervals between urination should be gradually increased. The fact is that women suffering from incontinence, over time, develop a certain stereotype of going to the toilet: they tend to go there, even if the urge is weak, as if for “prevention” or “in reserve”, so that in no case there would be embarrassment … In carrying out the plan, the woman must restrain the urge. The interval between urination should be increased by half an hour every week until it reaches its duration of 3-3.5 hours. Thus, a woman changes the old stereotype of behavior and develops a new one.Usually, the training is supported by drug therapy, which is designed for 3 months, as well as the training program.

Also, no less attention should be paid to training the muscles of the pelvic floor. For most women, trained pelvic floor muscles are the key to success in the treatment and prevention of urinary incontinence. However, only a few consciously work on the pelvic muscles, and in vain. This is the best prevention of female incontinence. For example, “Kegel exercises” are included in the list of exercise therapy exercises for incontinence.

In addition to these exercises and training, physiotherapy should not be forgotten. It can strengthen muscles and make ligaments more elastic by improving blood flow to the pelvis. For this purpose, physiotherapeutic methods are usually used, such as:

  • microcurrents,
  • warming up,
  • electromagnetic pulses.
Medicinal methods

Medicines have proven themselves especially effective in the case of an urgent type of incontinence.For the treatment of this type of urinary incontinence, women are primarily prescribed antispasmodics and antidepressants. The drug Driptan has proved to be excellent for the treatment of urgent urinary incontinence in women, which:

  • has a relaxing effect on the muscles of the bladder;
  • dampens urge impulses from the nervous system.

Thus, under the influence of Driptan, the bladder relaxes and increases in volume, the imperative urges that the woman could not cope with disappear, respectively, she begins to go to the toilet less often.The full effect of taking Driptan is felt one month after the start of treatment. However, in each case, the dose of Driptan must be selected by the doctor, do not try to take Driptan on your own.

Surgical intervention

Usually, surgery is used for stress incontinence, but sometimes surgery is indicated for urgent incontinence. However, young patients can be helped by conservative methods. At the present stage of the development of surgery, doctors use about 250 different methods of surgical interventions in order to eliminate stress urinary incontinence in women.Many of these methods are also used in our country, including minimally invasive methods, such as putting on loops made of synthetic fabric. After such operations, a woman can go home the next day after the operation. 85% of women who have undergone such an operation live a full life, the only risk factor for them is cystitis due to hypothermia.

Hygiene for female incontinence

Urological pads facilitate socialization and improve the quality of life of women with urinary incontinence.There is a large selection of quality urological pads that reliably absorb liquid and neutralize unpleasant odors.

Basic requirements for urological pads:

  • the ability to absorb and retain secretions;
  • Keeping the surface dry to avoid skin irritation;
  • anatomical compliance;
  • bacterial safety.

Many women are ashamed of their problem and postpone the visit to the doctor, “quietly” using urological pads.This attitude towards your health is unreasonable, you should be examined.

Every fourth woman suffers from incontinence

– Igor Viktorovich, why do most patients come to the doctor when the situation has reached the point where they no longer have the strength to live with pads?

– I don’t even want to admit to myself: what should be under control no longer obeys you. Shyness is the main reason why almost everyone with urinary incontinence continues to “live” with this ailment, overcoming difficulties and discomfort.The reluctance to publicize their problem is also explained by the fact that for a long time urinary incontinence in adults, firstly, was not recognized as a significant medical problem, and secondly, doctors had nothing to offer their patients – there were no effective methods of treatment.

Most people have never been treated for this problem. They did not mention its existence to doctors, and doctors did not think to ask a direct question on this topic. Research data show that people wait an average of about 5-9 years for it to “pass by itself” before seeking help, while trying to stay close to the toilet.Today the situation has changed. Urinary incontinence is considered one of the most serious problems affecting quality of life and health.

– How dangerous is urinary incontinence from a medical point of view?

– Urinary incontinence is any involuntary loss of urine. It does not pose a danger to life, but it can destroy it, limiting a person in communication, choosing a profession, depriving him of mobility and causing constant discomfort. Solving this problem with the help of specialists allows you to improve the quality of life, return patients to active activity.

– Does it appear the same for everyone?

– Incontinence can be urgent, stressful and mixed. Urgent is characterized by the presence of an imperative urge to urinate with the inability to maintain urine (about 20% of all cases). The causes of this type of urinary incontinence are associated with a violation of the nervous regulation of the lower urinary tract or with an increase in the sensitivity of the bladder to accumulation.

The second type of urinary incontinence is stressful (takes up to 50% of all types of urinary incontinence), which manifests itself during any physical activity, be it coughing, laughing, sneezing or running, in the form of involuntary urinary leakage.This type of incontinence is associated with an insufficiency of the sphincter apparatus that keeps urine in the bladder.

The mixed form (about 30%) is characterized by the presence of symptoms of both urgent and stress urinary incontinence.

– It is believed that incontinence occurs primarily in women. Why?

– Firstly, the very anatomy of the woman’s pelvic region predisposes to the fact that the load on the pelvic floor is higher, and pregnancy and childbirth lead to the fact that the bladder neck and the initial sections of the urethra are displaced to the bottom.

Secondly, the aging process affects all tissues of the body, including the lower urinary tract (bladder, urethra, as well as the ligamentous apparatus and pelvic floor muscles that support them). The blood supply and innervation of these structures deteriorate. The walls of the bladder and urethra become less elastic, and the tone of the retaining sphincter apparatus decreases.

Thirdly, the condition of both the bladder and the urethra in women depends on the level of female sex hormones (estrogens).The closer to menopause, the less estrogen, and a decrease in their level leads to a change in the state of the muscles and walls of the bladder and urethra, which further reduces the ability to retain urine. A change in the hormonal background also contributes to the more frequent development of inflammatory diseases of the lower urinary tract, that is, cystitis, which also leads to a violation of the accumulative function of the bladder.

– Are there real statistics on this incidence?

– Determining the prevalence of urinary incontinence is difficult.Most people think that this is a “pattern” that does not respond to treatment, and therefore do not seek help. According to various sources, in developed countries, from 11 to 72% of women are faced with the problem of urinary incontinence. It is believed that the number of women suffering from this pathology is on average 25%, which is one in four. In Russia, this is about 38-39% of urban dwellers, although in the country as a whole, the figure may be higher. Of these, only 4% seek medical help.

In men, the prevalence of urinary incontinence is about 5%.As a rule, it is associated with urological (adenoma, prostate cancer, urethral stricture) and neurological diseases, can occur after surgery on the prostate gland.

– For which age groups is this or that form of urinary incontinence typical?

– Our patients are mostly women from 20 to 80 years old. At the same time, different age groups are characterized by their own form of urinary incontinence. As a rule, at the age of 20-55, stress is more often observed – up to 60%, urgent in 10-15%, mixed in 30%.After 55 years, mixed occurs more often – 50%, stressful – 30%, urgent – 25%. The most common age at which to see a doctor is 45-55 years.

– What to do if a problem occurs?

– For a start – do not close in yourself, staying with her one on one, but turn to specialists. This is one of the main ingredients for successful treatment. The doctor will determine the nature of the problem, assess the type and degree of urinary incontinence, and prescribe the necessary examination. The meaning of treatment is to target the causes that led to urinary incontinence in a particular patient.

– How?

– For this, there are medication, non-medication and surgical methods of treatment. If this is an urgent incontinence, then the priority is given to drug and non-drug therapy, during which we try to reduce the pathological activity of the bladder, to achieve an increase in its capacity and stability. For stress incontinence, surgical treatment is used, the purpose of which is to eliminate the failure of the mechanisms that hold urine under stress.