What is Urinary Incontinence?
Urinary incontinence is leaking of urine that you can't control. Many American men and women suffer from urinary incontinence. We don't know for sure exactly how many. That's because many people do not tell anyone about their symptoms. They may be embarrassed, or they may think nothing can be done. So they suffer in silence.
Urinary incontinence is not just a medical problem. It can affect emotional, psychological and social life. Many people who have urinary incontinence are afraid to do normal daily activities. They don't want to be too far from a toilet. Urinary incontinence can keep people from enjoying life.
Many people think urinary incontinence is just part of getting older. But it's not. And it can be managed or treated. Learn more here. Talk to your doctor. Find out what treatment is best for you.
A quarter to a third of men and women in the U.S. suffer from urinary incontinence. That means millions of Americans. About 33 million have overactive bladder (also known as OAB) representing symptoms of urgency, frequency and with or without urge incontinence.
Studies show that many things increase risk. For example, aging is linked to urinary incontinence. Pregnancy, delivery, and number of children increase the risk in women. Women who have had a baby have higher rates of urinary incontinence. The risk increases with the number of children. This is true for cesarean section (c-section) and vaginal delivery.
Women who develop urinary incontinence while pregnant are more likely to have it afterward. Women after menopause (whose periods have stopped) may develop urinary incontinence. This may be due to the drop in estrogen (the female sex hormone). Taking estrogen, however, has not been shown to help urinary incontinence.
Men who have prostate problems are also at increased risk. Some medications are linked to urinary incontinence and some medicines make it worse. Statistics show that poor overall health also increases risk. Diabetes, stroke, high blood pressure and smoking are also linked.
Obesity increases the risk of urinary incontinence. Losing weight can improve bladder function and lessen urinary incontinence symptoms.
What happens normally?
The brain and the bladder control urinary function. The bladder stores urine until you are ready to empty it. The muscles in the lower part of the pelvis hold the bladder in place. Normally, the smooth muscle of the bladder is relaxed. This holds the urine in the bladder. The neck (end) of the bladder is closed. The sphincter muscles are closed around the urethra. The urethra is the tube that carries urine out of the body. When the sphincter muscles keep the urethra closed, urine doesn't leak.
Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract. This forces the urine out through the urethra, the tube that carries urine from the body. The sphincters open up when the bladder contracts.
What are the types of urinary incontinence?
Urinary incontinence is not a disease. It is a symptom of many conditions. Causes may differ for men and women. But it is not hereditary. And it is not just a normal part of aging. These are the four types of urinary incontinence:
1. Stress Urinary Incontinence (SUI)
With SUI, weak pelvic muscles let urine escape. It is one of the most common types of urinary incontinence. It is common in older women. It is less common in men.
SUI happens when the pelvic floor muscles have stretched. Physical activity puts pressure on the bladder. Then the bladder leaks. Leaking my happen with exercise, walking, bending, lifting, or even sneezing and coughing. It can be a few drops of urine to a tablespoon or more. SUI can be mild, moderate or severe.
There are no FDA approved medicines to treat SUI yet, but there are things you can do. Ways to manage SUI include "Kegel" exercises to strengthen the pelvic floor. Lifestyle changes, vaginal and urethral devices, pads, and even surgery (Bulkamid) are other ways to manage SUI.
2. Overactive Bladder (OAB)
OAB is another common type of urinary incontinence. It is also called "urgency" incontinence. OAB affects more than 30% of men and 40% of women in the U.S. It affects people's lives. They may restrict activities. They may fear they will suddenly have to urinate when they aren't near a bathroom. They may not even be able to get a good night's sleep. Some people have both SUI and OAB and this is known as mixed incontinence.
With OAB, your brain tells your bladder to empty - even when it isn't full. Or the bladder muscles are too active. They contract (squeeze) to pass urine before your bladder is full. This causes the urge (need) to urinate.
The main symptom of OAB is the sudden urge to urinate. You can't control or ignore this "gotta go" feeling. Another symptom is having to urinate many times during the day and night.
OAB is more likely in men with prostate problems and in women after menopause. It is caused by many things. Even diet can affect OAB. There are a number of treatments. They include life style changes, drugs that relax the bladder muscle, or surgery (Axonics Therapy). Some people have both SUI and OAB.
To learn more about OAB risk factors, causes and treatments visit our OAB page.
3. Mixed Incontinence (SUI and OAB)
Some people leak urine with activity (SUI) and often feel the urge to urinate (OAB). This is mixed incontinence. The person has both SUI and OAB.
4. Overflow Incontinence
With overflow incontinence, the body makes more urine than the bladder can hold or the bladder is full and cannot empty thereby causing it to leak urine. In addition, there may be something blocking the flow or the bladder muscle may not contract (squeeze) as it should.
One symptom is frequent urinating of a small amount. Another symptom is a constant drip, called "dribbling."
This type of urinary incontinences is rare in women. It is more common in men who have prostate problems or have had prostate surgery.
The symptoms tell you what kind of urinary incontinence you have.
Not all incontinence is long term. Some causes are temporary so that the incontinence ends when the cause goes away. Vaginal infections can cause temporary incontinence. Irritation, medications, constipation and restricted mobility can cause it. Urinary tract infections (UTIs) are a common cause of temporary incontinence and should be addressed.
It remains important that if the cause isn't temporary or easily treated, the leakage is probably one of the four types described above. With SUI, the pelvis or sphincter muscles (or both) aren't strong enough to hold the urine by closing the bladder and urethra. With OAB, the bladder muscles contract too much, pushing urine out even when you are not ready to release it. Mixed incontinence is usually both SUI and OAB. With overflow incontinence, the bladder gets too full without releasing.
These are the symptoms for each:
The key symptom of SUI is leaking when you are active. The activity and amount of leaking depends on how severe the SUI is.
The main symptom of OAB is a sudden, strong urge to urinate that you can't control. The urge may or may not cause your bladder to leak urine.
Mixed incontinence (SUI and OAB)
The symptoms of mixed incontinence include leaking and a sudden, strong urge to urinate. Mixed incontinence is when you have more than one type of incontinence. Most often, people with mixed incontinence have SUI and OAB.
Frequent small urinations and constant dribbling are the main symptoms of overflow incontinence. The bladder is unable to empty. Symptoms happen when the bladder is full. This type is less often in women however, dropped bladders, prior bladder surgeries or diabetes may affect this. It is more common in men with a history of prostate problems or surgery.