Urinary incontinence is the loss of voluntary bladder control that can lead to urine leakage. Incontinence can be temporary or long-lasting. It is a symptom, not a condition.
The causes may vary with the type of incontinence.
The leakage may be caused by:
This is also known as overactive bladder. It may be caused by:
This occurs when the bladder will not empty. The urine builds up and overflows. This leads to leaking of urine. It may be caused by:
This is when you have normal bladder control, but you are unable to reach the toilet in time. It may be a result of a condition like severe arthritis. Drugs that cause confusion or sedation can also lead to functional incontinence.
There may be several different causes for incontinence. In some cases, the cause may also be unclear.
Factors that may increase your risk of incontinence include:
Urinary incontinence is a symptom of other conditions. Any loss of bladder control can be considered incontinence.
With stress incontinence, leakage may happen when there is extra pressure on your bladder. This can happen when you laugh, sneeze, lift heavy objects, or exercise.
With urge incontinence, you may have a loss of bladder control following a strong urge to urinate. You may not be able to hold urine long enough to make it to a toilet.
Your doctor will ask about your symptoms and medical history. You will be asked about your urine leakage and how often you empty your bladder. A physical exam will be done to look for any physical causes. These include blockages or nerve problems. Your doctor may ask you to keep a diary of your urinary habits.
You may be referred to a specialist. Urologists are doctors who focus on urinary issues.
Tests to help find the cause of the incontinence may include:
Treatments may include:
Behavioral therapy includes:
Losing weight may help reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a weight loss program that is right for you.
Medicines may be prescribed to relax the bladder muscles. These types of medicines are called anticholinergics. They are often used in treating urge incontinence. Examples include:
Absorbent diapers are often used by men with incontinence.
Catheters are sometimes used to treat more severe cases. External (condom) or internal (Foley) catheters may be used.
Another option is a penile clamp. These clamps are padded and have a sleeve to absorb leakage.
Devices like Urgent PC and Inter-Stim may be used to stimulate the nerves. This may involve implanting a thin lead wire with a small electrode tip. This electronic stimulation therapy can be done as a series of treatments in your doctor's office.
National Institute of Diabetes and Digestive and Kidney Diseases
Urology Care Foundation
Canadian Nurse Continence Advisors
Corcos J, Gajewski J, et al. Canadian Urological Association guidelines on urinary incontinence. Can J Urol. 2006;13:3127-3138.
Incontinence. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143. Updated January 2011. Accessed September 14, 2012.
Occhino J, Siegel S. Sacral nerve modulation in overactive bladder. Curr Urol Rep. 2010;11(5):348-352.
Prevention of incontinence. Continence Foundation website. Available at: http://www.continence-foundation.org.uk. Accessed September 14, 2012.
Subak L, Wing R, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.
Urinary incontinence in men. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 29, 2012. Accessed September 14, 2012.
Urinary incontinence in men. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/uimen/#treated. Published June 29, 2012. Accessed September 14, 2012.
Wein A, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management. J Urol. 2006;175:S5-10.
Yang C, Schwartz S, et al. A new, simple device to manage male urinary incontinence. International Continence Society website. Available at: http://www.icsoffice.org/publications/2005/pdf/0464.pdf. Accessed September 14, 2012.
12/3/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int. 2010;106(6):816-821.
Last reviewed September 2012 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.