Urinary Incontinence

by Dr. Karen Leggett

General Information

Urinary incontinence is often part of the aging process. After age 65, about 10% of men and 20% of women have some incontinence. Incontinence is a severe problem in less than 5%. Often incontinence is temporary. Listed below are seven general causes of incontinence.

  1. Infection. Sometimes bladder infection alone may cause sufficient discomfort that loss of bladder control results. At other times, infection is just one problem among others that together result in incontinence.
  2. Weakening of the muscle that supports the bladder (stress incontinence). Weakening of the muscle supporting the bladder results in stress incontinence, which is the loss of small amounts of urine on coughing or sneezing. It usually occurs in women. Mild stress incontinence responds to regular exercises that strengthen the muscles supporting the bladder. Severe stress incontinence requires surgery to correct the supporting muscles.
  3. Weakening of the muscle of the bladder itself. Partial obstruction of the bladder outlet causes weakening of the bladder muscle itself. This muscle change in the bladder most often occurs in men who have an enlarged prostate. It also occurs with nervous system problems, such as stroke, Parkinson’s disease, and dementia.
  4. Nerve disorder. Nerve disorders may cause loss of sensation in the bladder or control of the bladder. When bladder tightening cannot be controlled, bladder emptying can occur at any time.
  5. Delirium. The confusion and disorientation associated with delirium may cause the patient to experience urinary incontinence.
  6. Drugs. Incontinence may be the side effect of a drug, or it may result as a secondary effect of the desirable result of a drug’s action. The administration of diuretics (water pills) to a patient with fluid retention and edema may produce such a copious output of urine that the patient becomes incontinent.
  7. Other diseases. Additional causes of incontinence may be other illnesses, such as heart disease or diabetes, which, if not well controlled, will cause a copious outflow of urine.

Important Points in Treatment
When you are experiencing incontinence, one way to limit dribbling or uncontrolled release of urine at nighttime is to adjust when you drink fluids. This does not mean to stop fluid intake, for that would cause dehydration and be dangerous; it simply means to drink fluids at certain times and to limit them at others. For instance, to minimize incontinence at night or before going on a trip, do not drink large quantities for 2 hours before bedtime or before an outing. You can drink small amounts to keep your mouth moist or if you have to take medication at a specific time (before bed, for instance).

If you are experiencing incontinence, make sure you have a clear path to the bathroom so that you can get there in a hurry from your bed at night. Alternatively, place a portable commode next to your bed so that it is right there when you need it.

Garments are available to protect you during incontinence (called continence garments), and pads are available to protect your furniture and bedding (called incontinence pads). If you carefully select garments that fit your needs, you will ensure that you can continue to lead an active social life without embarrassment or odor.

For men, a number of urine collection (drainage) appliances are available to control incontinence. Your physician may occasionally insert a catheter to aid in emptying the bladder. Catheters carry a risk of infection, however, and a catheter by itself is not proper treatment of incontinence.

Notify Our Office If

  • You have any evidence of infection. Patients with incontinence are susceptible to infection of the urinary tract. This infection can cause fever, chills, a burning sensation on urination, frequent urination, cloudy urine, or bloody urine. Sometimes with incontinence, you may have an infection of the urinary tract but may not have any of these symptoms.
  • You have any change in your urinary habits. A change indicates that something is wrong, whether it is an infection, another illness, or a side effect of your medication.
  • You have any evidence of blood in your urine.
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