What is incontinence?

Urinary incontinence is a condition that impacts many people’s lives. When you have incontinence, you may experience bladder control issues and leak urine. This leakage is often uncontrollable and can negatively impact your life.

Your urinary system is made up of the kidneys, ureters, bladder and urethra. These parts do several jobs. They filter, store and remove waste from your body. Your kidneys are the filters of your body. Waste products are removed from your blood by the kidneys, creating urine. The urine then moves down through two thin tubes called the ureters. The ureters connect to the bladder, where the urine will collect until it’s time to leave the body. Your bladder is like a storage tank — once the bladder is full, the brain sends a signal that it’s time to urinate. Urine then leaves the bladder when a muscle opens up (sphincter), allowing the urine to flow freely out of the body through the urethra.

When this system is working smoothly, you usually have time to get to a bathroom before needing to urinate and you don’t experience any leakage of urine. Urinary incontinence can happen when these parts don’t operate as they should. This can happen for many different reasons throughout your life.

Many people think that incontinence is a normal part of aging that can’t be helped. While it is true that your risk of incontinence increases as you get older, there are also treatments available to help you manage this condition. Incontinence doesn’t have to disrupt your life and keep you from being active.

What are the different types of incontinence?

There are several different types of incontinence. These types have different causes, characteristics and triggers for urine leakage. Knowing the type of incontinence is often an important part of the diagnosis and treatment plan for incontinence.

The types of incontinence include:

  • Urge incontinence: This type of incontinence is characterized by an intense need to urinate right away. Often, this happens too quickly for you to make it to a toilet and you end up leaking urine. Urge incontinence can be caused by a condition called overactive bladder (OAB). You could have OAB for a variety of reasons like having weak pelvic muscles, nerve damage, an infection, low levels of estrogen after menopause or a heavier body weight. Some medications and beverages like alcohol and caffeine can also cause OAB.
  • Stress incontinence: When you leak urine during activities, this is often stress incontinence. In this type of incontinence, your pelvic floor muscles are weak and no longer support your pelvic organs as they should. This muscle weakness means that you’re more likely to accidently leak urine when you move around. For many people, leakage issues happen when they laugh, cough, sneeze, run, jump or lift things. These actions all place pressure on your bladder. Without the support of strong pelvic muscles, you’re more likely to leak urine. Women who have given birth are at a higher risk of having stress incontinence. Men who have had prostate surgery may develop stress incontinence.
  • Overflow incontinence: If your bladder doesn’t empty completely each time you urinate, you could have overflow incontinence. Think of the bladder as a juice jug. If you only pour some of the juice out of the jug, but not all of it, there’s still a risk that you could spill when you move around. People with overflow incontinence never completely empty the bladder — placing them at risk for a spill. Usually, this results in small amounts of urine dripping out over time instead of one big gush of urine. This type of incontinence is more common in people with chronic conditions like multiple sclerosis (MS), stroke or diabetes. This may also occur in men with a large prostate.
  • Mixed incontinence: This type of incontinence is a combination of several problems that all lead to leakage issues. When you have mixed incontinence, you might be dealing with stress incontinence and an overactive bladder. It’s often important to pay attention to what you’re doing when you have leakage issues with this type of incontinence. Identifying what triggers mixed incontinence is usually the best way to manage it.

Who gets incontinence?

Incontinence can happen to anyone. However, it’s more common in certain groups and at certain times in your life. Incontinence is much more common in women than in men. This is often related to pregnancy, childbirth and menopause. Each of these experiences can cause a woman’s pelvic support muscles to weaken over time.

You’re also more likely to experience incontinence as you get older. The muscles that support your pelvic organs can become weaker over time, causing you to experience leakage issues.

Am I at a higher risk of incontinence at an older age?

Your body constantly changes throughout your life. As you age, the muscles that support your pelvic organs can weaken. This means that your bladder and urethra have less support — often leading to urine leakage. Your risk for developing incontinence as you age might be higher if you have a chronic health condition, have given birth to children, went through menopause, have an enlarged prostate or have had prostate cancer surgery. It’s important to talk to your healthcare provider over time about the risks of incontinence and ways you can manage it without interference to your daily life.

Is incontinence more common in women?

Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a woman’s life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, you’re more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones (estrogen in particular) change during menopause and this can alter your bladder control.

Men can also experience incontinence, but it isn’t as common as it is in women.

What causes incontinence?

There are many different reasons that you could experience incontinence. These causes can vary depending on if you’re a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term (chronic) medical conditions. When you experience leakage issues because of a chronic condition, it’s usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually don’t go away. Incontinence may have to be managed over time as a symptom of your chronic condition.

Temporary or short-term causes of incontinence can include:

  • Urinary tract infections (UTIs): An infection inside your urinary tract (urethra, ureters, bladder and kidneys) can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
  • Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
  • Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
  • Beverages: There are certain drinks — like coffee and alcohol — that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
  • Constipation: Chronic constipation (stool that’s hard and dry) can cause you to have bladder control issues.

Chronic or long-term causes of incontinence can include:

  • Pelvic floor disorders: When you have an issue with your pelvic floor muscles, it can impact the way your organs function, including your bladder.
  • Stroke: A stroke can cause you to experience issues with muscle control. This can include the muscles that control your urinary system.
  • Diabetes: When you have diabetes, your body produces more urine. This increase in the amount of urine can cause leakage issues. In addition, peripheral neuropathy can affect the bladder’s function.
  • Menopause: Menopause is another time of change in a woman’s body when hormone levels change rapidly and pelvic floor muscles can also become weaker — something that also can happen as you get older.
  • Multiple sclerosis (MS): If you have MS, you may experience a loss of control with your bladder, leading to leakage issues.
  • Enlarged prostate: When the prostate is larger than normal, it can cause several bladder control issues. You might also hear this condition called benign prostatic hyperplasia, or BPH.
  • After prostate cancer surgery: During prostate cancer surgery the sphincter muscle can sometimes be damaged leading to stress incontinence.

Why does pregnancy cause incontinence?

During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.

Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.

What are the symptoms of incontinence?

The main symptom of incontinence is a leakage of urine. This could be a constant dripping of urine or an occasional experience of leakage. If you have incontinence, you might have large amounts or small amounts of leaked urine. You might experience leakage for a wide variety of reasons — often depending on the type of incontinence you have.

You might leak urine when you:

  • Exercise.
  • Cough.
  • Laugh.
  • Sneeze.
  • Have an urge to urinate, but can’t make it to the toilet on time.
  • Have to get up in the middle of night to urinate (nocturia).

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