Types of Urinary Incontinence

Urinary incontinence affects about 12 million Americans -- more women than men. It happens when you lose urine by accident. There are several different types of urinary incontinence.

Stress Incontinence
Stress incontinence may happen when there is an increase in abdominal pressure -- such as when you exercise, laugh, sneeze, or cough. Urine leaks due to weakened pelvic floor muscles and tissues.

Causes of stress incontinence include:

Multiple pregnancies and childbirths, which cause stretching and damage
Being overweight
Genetic weaknesses
Radiation therapy
Other chronic conditions
Urge Incontinence

Urge incontinence is often called "overactive bladder": You have an urgent need to go to the bathroom, and may not get there in time, leaking urine.

Causes of overactive bladder include:

Damage to the bladder's nerves
Damage to the nervous system
Damage to muscles
Conditions such as multiple sclerosis, Parkinson's disease, Alzheimer's disease, and stroke can harm muscles or nerves, leading to urge incontinence.

Some women have both of these types of urinary incontinence -- "stress" and "urge." Doctors call this mixed urinary incontinence.

Overflow Incontinence
You may have overflow incontinence if you are not able to completely empty your bladder when you urinate. As a result, you have a constant or frequent dribble of urine. This is the type of urinary incontinence that most often strikes men.

Causes of overflow incontinence include:

Weak bladder muscles
Blockage of the urethra, such as by prostate enlargement
Medical conditions such as tumors

Functional Incontinence

With functional incontinence, physical problems such as arthritis or cognitive problems such as dementia prevent you from getting to the bathroom in time.

Treatment for Different Types of Urinary Incontinence
To improve or eliminate urinary incontinence, you can make lifestyle changes and get treatment depending on which type you have.

For stress incontinence, treatment options include:

Pelvic floor exercises. If you've had a baby, chances are you've been told to do Kegel exercises. These help to strengthen the pelvic floor after childbirth. It is wise to keep doing the Kegels to keep your pelvic muscles and tissues strong, which can help prevent stress incontinence. Best of all, Kegels can be done anytime, anywhere.

To do Kegels:
Pretend you are trying to stop the flow of urine.
Hold the squeeze for 10 seconds, then rest for 10 seconds.
Do 3 or 4 sets daily.

Biofeedback. Using monitors, the biofeedback instructor feeds you information about bodily processes, including when your bladder and urethral muscles contract. This helps you gain control. It's also often used in combination with Kegel exercises.

Medications or surgery. Medications for stress incontinence can help tighten muscles at the bladder neck, preventing leakage. Or, in more extreme cases, surgery can help. One procedure pulls the bladder back up to a more normal position, relieving the pressure and leakage. Another surgery involves securing the bladder with a "sling," a piece of tissue or other material that holds up the bladder to prevent leakage.

For urge incontinence, treatment options include:

Timed voiding and bladder training. First, you complete a chart of the times you urinate and the times you leak. You observe patterns and then plan to empty your bladder before an "accident" would likely occur. You can also "retrain" your bladder, gradually increasing the time between bathroom visits.
Medications or surgery. Doctors sometimes prescribe medicines designed to inhibit the contractions of an overactive bladder. Surgery is reserved for severe cases. It aims to increase the storage capacity of the bladder.
Talking About Urinary Incontinence

All types of urinary incontinence can be embarrassing to talk about, but overcoming your reluctance is worth it. Treatment can reduce or eliminate the problem.

Here are some tips that may help you overcome your embarrassment and be open about urinary incontinence:

Be straightforward. Just tell the physician or the nurse you are having problems. Keep it simple: "I'm having bladder problems."
Expect your doctor to ask many questions about your situation: how long the leakage has been happening, how bad it is, how much it upsets your life. If this doesn't happen, it may be time to switch doctors or at least to ask for a referral to another doctor with expertise in this kind of problem.

PT Hawaii Reference from WebMD Medical Reference (June 24, 2009)

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