Urinary Incontinence

Urinary incontinence is the leakage of urine. A number of women leak small amounts of urine, while others may have leakage that is more frequent or severe.

There are many types of urinary incontinence:

  • Urge incontinence - Leakage of urine due to overactive bladder muscles which contract too frequently or difficulties with the nerves that transmit signals to the bladder.
  • Stress urinary incontinence - Loss of urine when a woman sneezes, laughs or coughs. Leaks could also occur when running, walking or exercising. This is the result of weakening tissues which support the bladder or the urethra muscles.
  • Overflow incontinence - Steady loss of urine in small amounts when the bladder does not fully empty during voiding. The cause can be attributed to a blockage of the urethra or an under active bladder muscle.
  • Mixed incontinence - A combination of both urge and stress incontinence conditions

Other symptoms besides leaking urine can accompany incontinence:

  • Frequency - Voiding more frequently than she believes normal
  • Urgency - A strong urge to urinate regardless of whether the bladder is full, usually with pelvic pressure
  • Dysuria - Painful voiding
  • Nocturia - The need to void during hours of sleep
  • Enuresis - leaking  during sleep (bed-wetting)

Urinary incontinence may have both short and long-term causes. Short-term factors are easier to treat. Short term causes include:

  • Urinary tract infection - very common in women and treated with antibiotics
  • Medications - Commonly caused from some diuretic.
  • Abnormal growths - Polyps, bladder stones, or less commonly, bladder cancer, can cause urinary incontinence

Long-term causes can include the following:

  • Pelvic support issues - The pelvic organs are held in place by supportive tissues and muscles. When these supporting tissues become torn, stretched, or weakened from aging, organs may drop down and cause leakage or make it difficult to pass urine.
  • Abnormalities in the urinary tract - An irregular opening in the urinary tract that leads into another area of the body, like the vagina, is called a fistula. It can allow urine to leak out through the vagina.
  • Neuromuscular problems - These disorders can disrupt the transmission of alerts from the brain and spinal cord to the bladder and urethra.

A variety of steps may be required to discover the cause of urinary incontinence. In certain cases, there could be more than one cause. You could be required to keep a voiding diary for several days where you would record the time and amount of urine leakage. Additionally you should record the amount of liquid you consumed and what your activity was at the time the leak occurred.

A pelvic exam will also be performed to identify physical conditions which may be connected to the issue. Lab tests may also be completed to diagnose a urinary tract infection.

Other tests to examine the way your bladder functions include the following:

  • Urodynamic tests
  • Postvoid residual volume test
  • Stress test
  • Cystoscopy
  • Dye test

There are several methods of treatment. Quite often treatments are more effective when done in combination. Treatment methods include bladder training, lifestyle changes, physical therapy, medications, devices, bulking agents and surgical procedures.
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