- Urinary Incontinence in Older Adults
- Causes of Urinary Incontinence
- Diagnosis of Urinary Incontinence
- Types of Urinary Incontinence
- Treatment for Urinary Incontinence
- Incontinence and Alzheimer’s Disease
- Managing Urinary Incontinence
- For More Information on Urinary Incontinence
- 8 Causes of Urinary Leaks and 8 Ways to Stop Them
- What Causes Urinary Incontinence?
- What Are the Treatments for Urinary Incontinence?
- The 6 Types of Urinary Incontinence
- Learn about different types of urinary incontinence
- Browse articles related to
- What is Urinary Incontinence?
- Indwelling Catheters
- External Collecting Systems
- Urine Drainage Bags
- Catheters for Intermittent Catheterization (IC)
- Absorbent Products
- Toilet Substitutes
- Skin Care Products
- Types of urinary incontinence
- Stress incontinence
- Overactive bladder (urge incontinence)
- Mixed incontinence
- Overflow incontinence
- Functional incontinence
- Reflex incontinence
- Solutions for a Leaky Bladder
- What Causes Bladder Leaks?
- Stress incontinence
- Urge incontinence
- Watch your diet
- Shed extra pounds
- Train your bladder
- Know your options
Urinary Incontinence in Older Adults
Urinary incontinence means a person leaks urine by accident. While it may happen to anyone, urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled. Talk to your healthcare provider about what you can do.
What happens in the body to cause bladder control problems? The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra.
At the same time, the muscles around the urethra relax and let the urine pass the body. When the muscles in and around the bladder don’t work the way they should, urine can leak.
Incontinence typically occurs if the muscles relax without warning.
Causes of Urinary Incontinence
Incontinence can happen for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation. Some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:
- Weak bladder muscles
- Overactive bladder muscles
- Weak pelvic floor muscles
- Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson’s disease
- Blockage from an enlarged prostate in men
- Diseases such as arthritis that may make it difficult to get to the bathroom in time
- Pelvic organ prolapse, which is when pelvic organs (such as the bladder, rectum, or uterus) shift their normal place into the vagina. When pelvic organs are place, the bladder and urethra are not able to work normally, which may cause urine to leak.
Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:
- Prostatitis—a painful inflammation of the prostate gland
- Injury, or damage to nerves or muscles from surgery
- An enlarged prostate gland, which can lead to Benign Prostate Hyperplasia (BPH), a condition where the prostate grows as men age.
Diagnosis of Urinary Incontinence
The first step in treating incontinence is to see a doctor. He or she will give you a physical exam and take your medical history. The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests. These might include:
- Urine and blood tests
- Tests that measure how well you empty your bladder
In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine. Your family doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.
Types of Urinary Incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-age women. It may begin around the time of menopause.
- Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
- Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
Treatment for Urinary Incontinence
Today, there are more treatments for urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.
Bladder control training may help you get better control of your bladder. Your doctor may suggest you try the following:
- Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating. Making these muscles stronger helps you hold urine in your bladder longer. Learn more about pelvic floor exercises and how to do them.
- Biofeedback uses sensors to make you aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra. Biofeedback can be helpful when learning pelvic muscle exercises.
- Timed voiding may help you control your bladder. In timed voiding, you urinate on a set schedule, for example, every hour. You can slowly extend the time between bathroom trips. When timed voiding is combined with biofeedback and pelvic muscle exercises, you may find it easier to control urge and overflow incontinence.
- Lifestyle changes may help with incontinence. Losing weight, quitting smoking, saying “no” to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation and avoiding lifting heavy objects may help with incontinence. Choosing water instead of other drinks and limiting drinks before bedtime may also help.
For more tips to keep your bladder healthy, visit 13 Tips to Keep Your Bladder Healthy.
Incontinence and Alzheimer’s Disease
People in the later stages of Alzheimer’s disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. To minimize the chance of accidents, the caregiver can:
- Avoid giving drinks caffeinated coffee, tea, and sodas, which may increase urination. But don’t limit water.
- Keep pathways clear and the bathroom clutter-free, with a light on at all times.
- Make sure you provide regular bathroom breaks.
- Supply underwear that is easy to get on and off.
- Use absorbent underclothes for trips away from home.
For more ways to deal with incontinence and other common medical problems in someone with Alzheimer’s, visit Alzheimer’s Disease: Common Medical Problems.
Managing Urinary Incontinence
Besides bladder control training, you may want to talk with your doctor about other ways to help manage incontinence:
- Medicines can help the bladder empty more fully during urination. Other drugs tighten muscles and can lessen leakage.
- Some women find that using an estrogen vaginal cream may help relieve stress or urge incontinence. A low dose of estrogen cream is applied directly to the vaginal walls and urethral tissue.
- A doctor may inject a substance that thickens the area around the urethra to help close the bladder opening. This can reduce stress incontinence in women. This treatment may need to be repeated.
- Some women may be able to use a medical device, such as a urethral insert, a small disposable device inserted into the urethra. A pessary, a stiff ring inserted into the vagina, may help prevent leaking if you have a prolapsed bladder or vagina.
- Nerve stimulation, which sends mild electric current to the nerves around the bladder that help control urination, may be another option.
- Surgery can sometimes improve or cure incontinence if it’s caused by a change in the position of the bladder or blockage due to an enlarged prostate.
Even after treatment, some people still leak urine from time to time. There are bladder control products and other solutions, including adult diapers, furniture pads, urine deodorizing pills, and special skin cleansers that may make leaking urine bother you a little less.
Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on urinary incontinence in men and urinary incontinence in women.
Read about this topic in Spanish. Lea sobre este tema en español.
For More Information on Urinary Incontinence
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This content is provided by the National Institute on Aging (NIA), part of the National Institutes of Health. NIA scientists and other experts review this content to ensure that it is accurate, authoritative, and up to date.
Content reviewed: May 16, 2017
8 Causes of Urinary Leaks and 8 Ways to Stop Them
Living Well, Women's Health
By Jamie H. Chao, MD , May 16, 2017
Ever have a little “oops” leak down there? That’s how it usually starts. We’re talking about urinary incontinence.
Some people with this medical condition may have frequent or sudden urges to urinate. For other people, the disorder results in an inability to control the bladder. This can lead to leaks.
Both men and women can have urinary incontinence (UI). Women experience this condition about twice as often. Up to 45 percent of women have UI to some degree.
Incidents of UI tend to increase with age. Among women age 20 to 39, up to 37 percent report some degree of UI. Among women older than 60, up to 39 percent report daily UI.
What Causes Urinary Incontinence?
There are many causes of UI, including:
- Pregnancy, childbirth, menopause and the structure of the female urinary tract are reasons the condition is more common in women.
- Diseases diabetes, Parkinson’s and multiple sclerosis (MS) can damage the nerves that control your bladder.
- Urinary tract diseases, infections, strokes, surgeries and treatments for pelvic cancers can also cause UI.
- Tumors or obstructions.
- Poor kidney function.
- Certain medications.
- Certain foods or beverages.
- High fluid intake
What Are the Treatments for Urinary Incontinence?
Here’s good news: A number of treatment options are available. You can take a number of steps yourself to remedy UI. If self-care doesn’t help, your health care provider can discuss approaches that may work for you and your lifestyle. Here are some of the common medical treatments.
- Behavioral modification therapy — Your provider can suggest techniques for you to adopt. These can include limiting the amount of fluid you drink, eliminating caffeine (which can irritate your bladder) or teaching yourself to hold your urine longer.
- Physical therapy or exercises — These strengthen your pelvic floor, which is the group of muscles that help to control urine flow.
- Vaginal insert (pessary) — Meant to support the urethra, these removable vaginal inserts can help prevent stress incontinence.
- Medications — Some block chemical messages in the nerves around the bladder, which relax the bladder muscles to increase your bladder capacity.
- Injections of medications — Certain substances can thicken your urethra wall so it seals more tightly to stop urine from leaking.
- Botox — For women who haven’t been helped by other injections, Botox injections can relax overactive bladder muscles. Benefits can last several months. Repeat injections may be needed once or twice each year.
- InterStim® therapy — A small device – about the size of a stopwatch – is implanted under the skin of your hip. It sends mild electric impulses to the nerve that controls your bladder muscles.
- Sling procedures — During this minimally invasive surgery, your provider puts a sling made of synthetic or natural material around your urethra to support it, which helps prevent stress incontinence.
Your health care provider can review the benefits of each treatment and how they might work for you. If you’re thinking about a surgical solution, consider getting a second opinion.
If you’re coping with urinary incontinence, take heart. Help is available.
If you’d more everyday health help, visit the Aurora Health Care page!
The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.
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The 6 Types of Urinary Incontinence
There are different types of urinary incontinence, each with distinct symptoms and causes. Explore six types of urinary incontinence, including those related to neurogenic bladder.
Learn about different types of urinary incontinence
As you learn more about your neurogenic bladder dysfunction or bladder disorder, you probably know that one of the symptoms is incontinence. What you may not know is that there are different types of incontinence, each having different causes.
What is incontinence?
If bladder control is lost and urine leakage occurs, it is called incontinence. Urinary incontinence can occur in people of all ages, and for a variety of reasons. Some, but not all, people with neurogenic bladder experience incontinence.
Types of incontinence
The main types of urinary incontinence are stress, urge, mixed, overflow, and functional. Reflex incontinence is another type caused by an injury to the spinal cord.
|Incontinence Type||Common Symptoms||Common Causes|
|Stress||Urine loss during activities such as coughing, sneezing, laughing, jumping, or lifting||Pregnancy, childbirth, menopause, pelvic radiation, surgical trauma|
|Urge||An occasional sudden need to urinate with large volume urine loss; can also exist without incontinence||May be associated with pregnancy, childbirth, menopause, pelvic trauma, and neurologic diseases such as Parkinson’s disease and multiple sclerosis|
|Mixed||Combination of stress and urge incontinence||A combination of any of the stress or urge incontinence common causes listed above|
|Overflow||A frequent dribble of urine due to inefficient bladder emptying; symptoms are similar to stress incontinence||Many causes, such as spinal cord injury, diabetes, neurological damage, Parkinson’s disease, multiple sclerosis, or an enlarged prostate|
|Functional||Urine loss not associated with any pathology or problem in the urinary system||Associated with physical or cognitive impairment such as immobility, Alzheimer’s disease, or head injury|
|Reflex||Reflex (spastic bladder) incontinence happens when the bladder fills with urine and an involuntary reflex causes it to contract in an effort to empty||Usually occurs when the spinal cord is injured above the area medically labeled as the “T12” level|
Your type of incontinence
If you’re experiencing incontinence, see your doctor. He or she can perform tests to diagnose your bladder condition and determine whether you may have neurogenic bladder dysfunction.
Browse articles related to
- If you’re experiencing bladder-related symptoms, your healthcare provider can run several tests to diagnose the problem. Explore common tests and exams used to diagnose a bladder disorder. Read More
- A spinal cord injury can make you susceptible to certain medical complications. Learn about these conditions so you can seek medical attention promptly. Read More
- If you've been diagnosed with a neurogenic bladder disorder, it helps to learn some basic information about how your body works. Learn about your urinary system here. Read More
What is Urinary Incontinence?
There are many devices and products that collect and hold urine. They help manage urinary retention and urinary incontinence. With urinary retention, your bladder does not completely empty. With urinary incontinence (UI), you have urine leakage that you cannot control.
Products and devices can help men and women of all ages. For some people, they are the only way to manage bladder problems. These devices can also give older and disabled persons more freedom.
A catheter is a flexible tube placed in your bladder. An “indwelling” catheter stays in your bladder all day and night. There are two types of indwelling catheters.
Indwelling “Foley” catheters are placed in your urethra. Indwelling “suprapubic” catheters go above your pubic bone through a small surgical cut in the belly. With both types, a balloon holds the tube in your bladder.
They both also drain urine into a bag outside the body.
A health care provider will place the Foley catheter in your urethra. The catheter can be managed by home care nurses when used long term. A urologist places the suprapubic catheter with minor surgery.
A Foley catheter should only be used for less than 2 years. If you need an indwelling catheter for a longer period of time, you should consider a suprapubic catheter. Because the suprapubic catheter is only in the bladder, there is less risk of bacteria growing (because it is away from the vagina and rectum). That means less risk of urinary tract infections, especially in women.
Both Foley and suprapubic catheters need to be replaced with a new catheter at least once every month. This also lowers the risk of infection. Both catheters can cause complications if used for a long time. Bladder, testicle (males), and kidney infections, bladder stones and bladder cancer can occur. Foley catheters can cause permanent damage to the urethra.
Foley and suprapubic catheters should be taped or strapped to the upper thigh or lower belly. This lowers the chance of injury if the catheter is tugged accidentally.
Catheters are made from latex with Teflon coating or silicone. The choice depends on a person's allergies and the health care provider's preference. Some catheters are coated with antibiotics to prevent infection. There is debate about whether this works.
Indwelling catheters vary in shape, tube size and tip. They are sized using the French (Fr) scale. Size 14 Fr is the most common size. A balloon is inflated once the catheter is inserted. This keeps the catheter from falling out. The balloon is usually filled with about 2 teaspoons of sterile water.
External Collecting Systems
For men, there are external collecting systems called condom or Texas catheters. These special condoms are rolled over the penis. They are kept in place by adhesive or straps. The condoms have holes at the tip. A tube goes from the hole to a drainage bag. Urine from incontinence collects in the drainage bag. Newer condoms are usually silicone. They come in sizes, with a sizing guide.
This device may be hard to use if you have problems with finger dexterity. A caregiver or family member would need to apply the condom catheter. Adhesive pouches may be better for men whose penis has retracted (drawn back).
An external collection device for women funnels urine from a pouch through a tube to a collecting device. These must be stuck to the outside of the labia. They are rarely used as the labia do not form a good water tight seal, so urine leaks.
Urine Drainage Bags
Both indwelling and external collecting devices are connected to drainage bags. They collect urine coming the bladder. Drainage bags come in different sizes. Overnight bags hold 1500 to 2000 milliliters (1.5 to 2.0 liters) of urine. These are large and cannot be hidden.
A leg bag is a smaller drainage bag. It holds 500 to 800 milliliters. It allows more freedom of movement. It can be hidden under clothing. It can be strapped to the thigh or calf. A new type, called the Belly Bag, is strapped to the belly. Drainage bags work by gravity. So they should be strapped somewhere below the bladder.
When choosing a bag, make sure the strap is not too restrictive or tight. The valve that drains urine from the bag should be easy to open.
Drainage bags can be cleaned and deodorized. Soak 20 minutes in a solution of two parts vinegar and three parts water.
Catheters for Intermittent Catheterization (IC)
Intermittent catheterization is also called “in and out” catheterization. It is also called “clean intermittent catheterization” (CIC). Because it is clean you don't need gloves and sterile preparation.
A catheter is inserted in the urethra 3 to 5 times a day. After you empty your bladder, you remove the catheter and throw it away. You or a caretaker can insert the catheter. You don't have to wear it all the time. This lowers the chance of infection. And these devices don't have a balloon the indwelling catheter.
Older men and women can perform CIC and should be on a routine schedule. The amount of urine in the bladder should be 15 ounces or less. Catheterization may be needed four to five times a day. Most healthcare insurances and Medicare will pay for 4 catheters a day (120 a month).
Most IC catheters are straight. Some (called Coudé catheters) have a curved tip. It may be easier for a man to advance a curved tip past the prostate gland. Catheter lengths are 6 inches for women and 12 inches for men.
You can get catheters and other supplies, such as lubricant, packaged together. These packages are helpful if you need to use the catheter at work. Catheter supply companies deliver catheters and other supplies by mail.
Absorbent products such as pads and adult diapers are available for incontinence. There are many designs. Some pads or panty liners have adhesive strips that attach to underwear. There are also undergarments, adult briefs and protective underwear. There are guards and drip collection pouches for men.
These products all absorb urine leakage and they help protect the skin from urine accordingly, they keep urine from wetting clothing. Pads can be disposable or reusable.
Absorbent incontinence products are designed to absorb and hold urine. Feminine hygiene pads are designed to absorb blood, not urine.
The advantage of using incontinence products is that the surface area is closest to the urethral opening, which is above the vaginal opening. The pads are super absorbent and they cause less skin irritation and fewer rashes.
Reusable pads are made of cloth with a rayon or polyester core and helps urine absorb.
When choosing a product, consider ease of use. Consider whether you need to remove outer clothing to change the device. Also consider absorbency, the liner, and the materials. For example, outside coverings made of plastic may irritate skin. Cost is also a concern for many people.
Portable devices can be very helpful if you cannot get to a regular toilet. These devices include commode seats or bedside commodes. There are also bedpans and urinals.
A bedside commode is placed close to the bed. It is easy to use at night or on a floor of the house with no bathroom. When choosing a commode you should consider its height and weight, how easy it is to empty, seat type, and cost. A soft surface may be more comfortable.
There are also raised seats (toilet raisers) that can help you get up and down from a regular toilet on your own.
Bedpans are usually not very effective or comfortable. Special fracture pans can help if you are recovering from surgery and can't get bed.
Urinals (plastic jug-type devices) are useful if you cannot move easily. You urinate into these devices directly. They can help when restrooms are not accessible. They are also useful when traveling. And they are an option if you are confined to a bed or chair. Most urinals, such as the newer spill proof ones, are easier for men to use. Urinals for women are not as easy to use.
Skin Care Products
If you are using incontinence devices or products, you may need skin care. Over time, urine leakage can cause skin breakdown, rash and redness. Urine on your skin can lead to bacteria growth and infection.
Soaps, skin products, topical antimicrobials, cleansers and skin barrier products can all help if used properly. Frequent washing with soap and water can dry out your skin. Rinses or cleansers made to remove urine may be better for washing the skin around the urethra.
Disposable wipes or wash clothes rather than toilet tissue may help keep your skin healthy. Moisturizing creams, lotions or pastes keep the skin moist. They seal in or add moisture. Barrier products protect the skin from contact with moisture. They lower friction from absorbent incontinence products.
Types of urinary incontinence
Many things can go wrong with the complex system that allows us to control urination. Incontinence is categorized by the type of problem and, to a lesser extent, by differences in symptoms.
If urine leaks out when you jump, cough, or laugh, you may have stress incontinence. Any physical exertion that increases abdominal pressure also puts pressure on the bladder. The word “stress” actually refers to the physical strain associated with leakage.
Although it can be emotionally distressing, the condition has nothing to do with emotion. Often only a small amount of urine leaks out. In more severe cases, the pressure of a full bladder overcomes the body's ability to hold in urine.
The leakage occurs even though the bladder muscles are not contracting and you don't feel the urge to urinate.
Stress incontinence occurs when the urethral sphincter, the pelvic floor muscles, or both these structures have been weakened or damaged and cannot dependably hold in urine. Stress incontinence is divided into two subtypes.
In urethral hypermobility, the bladder and urethra shift downward when abdominal pressure rises, and there is no hammock- support for the urethra to be compressed against to keep it closed.
In intrinsic sphincter deficiency, problems in the urinary sphincter interfere with full closure or allow the sphincter to pop open under pressure.
Many experts believe that women who have delivered vaginally are most ly to develop stress incontinence because giving birth has stretched and possibly damaged the pelvic floor muscles and nerves. Generally, the larger the baby, the longer the labor, the older the mother, and the greater the number of births, the more ly that incontinence will result.
Age is wise a factor in stress incontinence. As a woman gets older, the muscles in her pelvic floor and urethra weaken, and it takes less pressure for the urethra to open and allow leakage. Estrogen can also play some role, although it is not clear how much. Many women do not experience symptoms until after menopause.
In men, the most frequent cause of stress incontinence is urinary sphincter damage sustained through prostate surgery or a pelvic fracture.
Lung conditions that cause frequent coughing, such as emphysema and cystic fibrosis, can also contribute to stress incontinence in both men and women.
Overactive bladder (urge incontinence)
If you feel a strong urge to urinate even when your bladder isn't full, your incontinence might be related to overactive bladder, sometimes called urge incontinence.
This condition occurs in both men and women and involves an overwhelming urge to urinate immediately, frequently followed by loss of urine before you can reach a bathroom.
Even if you never have an accident, urgency and urinary frequency can interfere with work and a social life because of the need to keep running to the bathroom.
Urgency is caused when the bladder muscle, the detrusor, begins to contract and signals a need to urinate, even when the bladder is not full. Another name for this phenomenon is detrusor overactivity.
Overactive bladder can result from physical problems that keep your body from halting involuntary bladder muscle contractions.
Such problems include damage to the brain, the spine, or the nerves extending from the spine to the bladder — for example, from an accident, diabetes, or neurological disease.
Irritating substances within the bladder, such as those produced during an infection, might also cause the bladder muscle to contract.
Often there is no identifiable cause for overactive bladder, but people are more ly to develop the problem as they age.
Postmenopausal women, in particular, tend to develop this condition, perhaps because of age-related changes in the bladder lining and muscle.
African American women with incontinence are more ly to report symptoms of overactive bladder than stress incontinence, while the reverse is true in white women.
A condition called myofascial pelvic pain syndrome has been identified with symptoms that include overactive bladder accompanied by pain in the pelvic area or a sense of aching, heaviness, or burning.
In addition, infections of the urinary tract, bladder, or prostate can cause temporary urgency.
Partial blockage of the urinary tract by a bladder stone, a tumor (rarely), or, in men, an enlarged prostate (a condition known as benign prostatic hyperplasia, or BPH) can cause urgency, frequency, and sometimes urge incontinence.
Surgery for prostate cancer or BPH can trigger symptoms of overactive bladder, as can freezing (cryotherapy) and radiation seed treatment (brachytherapy) for prostate cancer.
Neurological diseases (such as Parkinson's disease and multiple sclerosis) can also result in urge incontinence, as can a stroke. When hospitalized following a stroke, 40% to 60% of patients have incontinence; by the time they are discharged, 25% still have it, and one year later, 15% do.
If you have symptoms of both overactive bladder and stress incontinence, you ly have mixed incontinence, a combination of both types. Most women with incontinence have both stress and urge symptoms — a challenging situation. Mixed incontinence also occurs in men who have had prostate removal or surgery for an enlarged prostate, and in frail older people of either gender.
If your bladder never completely empties, you might experience urine leakage, with or without feeling a need to go. Overflow incontinence occurs when something blocks urine from flowing normally the bladder, as in the case of prostate enlargement that partially closes off the urethra.
It can also occur in both men and women if the bladder muscle becomes underactive (the opposite of an overactive bladder) so you don't feel an urge to urinate. Eventually the bladder becomes overfilled, or distended, pulling the urethra open and allowing urine to leak out. The bladder might also spasm at random times, causing leakage.
This condition is sometimes related to diabetes or cardiovascular disease.
Men are much more frequently diagnosed with overflow incontinence than women because it is often caused by prostate-related conditions.
In addition to enlarged prostate, other possible causes of urine blockage include tumors, bladder stones, or scar tissue.
If a woman has severe prolapse of her uterus or bladder (meaning that the organ has dropped its proper position), her urethra can become kinked a bent garden hose, interfering with the flow of urine.
Nerve damage (from injuries, childbirth, past surgeries, or diseases such as diabetes, multiple sclerosis, or shingles) and aging often prevent the bladder muscle from contracting normally. Medications that prevent bladder muscle contraction or that make you unaware of the urge to urinate can also result in overflow incontinence.
If your urinary tract is functioning properly but other illnesses or disabilities are preventing you from staying dry, you might have what is known as functional incontinence.
For example, if an illness rendered you unaware or unconcerned about the need to find a toilet, you would become incontinent. Medications, dementia, or mental illness can decrease awareness of the need to find a toilet.
Even if your urinary system is fine, it can be extremely difficult for you to avoid accidents if you have trouble getting to a toilet. This problem can affect anyone with a condition that makes it excessively difficult to move to the bathroom and undress in time. This includes problems as diverse as having arthritis, being hospitalized or restrained, or having a toilet located too far away.
If a medication (such as a diuretic used to treat high blood pressure or heart failure) causes you to produce abnormally large amounts of urine, you could develop incontinence that requires a change in treatment. If you make most of your urine at night, the result might be nocturnal incontinence, or bedwetting.
Reflex incontinence occurs when the bladder muscle contracts and urine leaks (often in large amounts) without any warning or urge.
This can happen as a result of damage to the nerves that normally warn the brain that the bladder is filling.
Reflex incontinence usually appears in people with serious neurological impairment from multiple sclerosis, spinal cord injury, other injuries, or damage from surgery or radiation treatment
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Solutions for a Leaky Bladder
Research has found that at least half of people with urinary incontinence don’t discuss the condition with a health care provider. But there’s no need to feel embarrassed. If you have a leaky bladder, you’re definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.
And it’s definitely worth discussing, because of the many ways it can interfere with enjoying daily life—from exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.
What Causes Bladder Leaks?
There are two main types of urinary incontinence:
If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.
Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, it’s often due to prostate cancer treatment, such as radiation or surgery.
With this type, your brain, spinal cord and bladder don’t work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel you need to urinate frequently, a problem called overactive bladder.
Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors don’t know what causes urge incontinence.
It is possible to have both types of incontinence at the same time.
Your doctor will want to know as much as possible about your bladder leaks—when they occur, how much urine comes out, and what you’re doing when leaks happen. Consider keeping a diary of when you urinate and when you have leaks, recommends Wright.
No matter what’s causing your bladder leakage, Wright offers good news: “The vast majority of cases can either be cured or significantly improved.” Some strategies that can help:
Watch your diet
You may be able to cut down on bladder leaks by avoiding certain foods, drinks and ingredients, including:
- Artificial sweeteners
- Carbonated beverages
- Citrus fruits and tomatoes
- Corn syrup
- Spicy foods
Shed extra pounds
Research has found that overweight and obese women who lose weight report fewer episodes of bladder leakage.
Train your bladder
Certain exercises can help you keep your bladder under better control:
- Kegel exercises. During Kegels, you regularly tighten certain muscles in your pelvis to strengthen them, which helps you become more leak-proof.
- The Knack. With this method, you do a Kegel just as you cough, sneeze or do another activity that tends to trigger a leak.
These require practice, Wright says. You may need a professional—your doctor or a physical therapist—to show you how to do them properly.
Know your options
Depending on the type of incontinence you have, your doctor may recommend one of the following treatments, Wright says:
- Medications that can help your bladder hold more, reduce urgency and improve your ability to empty your bladder. (There is even a recently approved over-the-counter patch for women with overactive bladder that helps relax the bladder muscle; the patch is available for men by prescription.)
- An injection of Botox into the lining of your bladder to block the release of a chemical that prompts muscle contractions.
- An injection of a thick substance around your urethra (the tube that carries urine your body) to help it hold back urine.
- Surgery to insert a strip of mesh to press against your urethra and prevent leaks.
“Many solutions are available, but you can only get help for what you’re willing to talk about and explain,” Wright says.