Urinary incontinence is the loss of bladder control, which can range from minor leakage to a complete inability to control urination. There are two main types of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence primarily affects women, while urge incontinence can affect both men and women.

Stress incontinence occurs when urine leaks due to pressure on the bladder from activities like laughing, coughing, sneezing, or exercising. Urge incontinence involves a sudden, intense urge to urinate, leading to involuntary urination.

Several factors can contribute to urinary incontinence, including age, underlying health conditions, and various risk factors. Treatment options may involve behavioral techniques, exercises, medications, and in some cases, surgery.

At Golden Gate Urology, we treat our patients with care and respect. While discussing urinary incontinence can be uncomfortable, it is important to address it if it is impacting your quality of life. Please don’t hesitate to talk to your doctor about your concerns.

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Causes

Urinary incontinence can manifest as either stress incontinence or urge incontinence. Stress incontinence occurs when urine leaks due to pressure on the bladder from activities such as coughing, sneezing, laughing, or exercising. Urge incontinence involves a sudden, intense urge to urinate, leading to involuntary urine loss.

While occasional urine leakage is common, incontinence itself is a symptom rather than a standalone condition. It often results from an underlying issue or everyday habits.

Common causes of urinary incontinence include:

  • Daily habits like consuming alcohol, caffeine, or artificial sweeteners
  • Medications such as blood pressure drugs, sedatives, or muscle relaxants
  • Urinary tract infections
  • Constipation
  • Pregnancy
  • Menopause and aging
  • Hysterectomy
  • Prostatectomy
  • Enlarged prostate or prostate cancer
  • Neurological conditions such as Parkinson’s, multiple sclerosis, stroke, or spinal injury

Urinary incontinence can sometimes be temporary, especially if it is related to an underlying condition that can be treated. Risk factors for developing urinary incontinence include:

  • Gender: Women are more likely to experience stress incontinence due to their anatomy, while men with prostate issues are at higher risk for urge incontinence.
  • Age: Aging can weaken the muscles of the bladder and ureters.
  • Obesity: Excess weight can place additional pressure on the bladder, leading to leakage.
  • Smoking: Tobacco use can contribute to urinary incontinence.

If urinary incontinence is affecting your quality of life, it’s important to discuss your symptoms with your doctor.

Diagnosis

Your doctor will first identify whether you have stress incontinence or urge incontinence, as the treatment plan will depend on the type you are experiencing.

The evaluation begins with a medical history review and physical exam. For stress incontinence, your doctor may ask you to cough to observe if this triggers leakage. Additionally, a urine sample will be tested to identify any urinary conditions that might be contributing to the incontinence.

If the cause remains unclear, further testing such as imaging of the bladder and urinary muscles may be conducted. Urge incontinence, which can be related to an overactive bladder, might be managed with medication if necessary.

Treatment

If your urinary incontinence is due to a treatable underlying condition, addressing that condition will be the primary approach. If treating the underlying condition does not alleviate the incontinence, your doctor will recommend the least invasive treatments first.

Treatment options for urinary incontinence include:

  • Behavioral Techniques: Your doctor may suggest bladder training to enhance muscle control, which can involve scheduled bathroom breaks and fluid management.
  • Pelvic Floor Exercises: Exercises like Kegels can strengthen the pelvic muscles to help manage incontinence.
  • Medication: If you have an overactive bladder, your doctor might prescribe medication to relax the bladder muscles.
  • Surgery: In some cases, surgical options may be considered to help keep the urethra closed and reduce leakage.

FAQs

Who is at risk for urinary incontinence?

Urinary incontinence is more common with age, due to risk factors such as menopause and enlarged prostate. Incontinence is also more common in pregnant women, those with prior hysterectomy or prostatectomy, those with neurologic conditions, and some medications.

How often should I urinate?

You should urinate every 2-3 hours if you are regularly consuming liquid. This will prevent developing infections such as urinary tract infections that may cause incontinence.

What causes urinary incontinence?

Urinary incontinence can be caused by daily habits such as consuming excess alcohol, caffeine, or artificial sweeteners, medication. Incontinence can also be caused by urinary tract infections, constipation, pregnancy, menopause, hysterectomy, prostatectomy, or neurological conditions.

How is urinary incontinence diagnosed?

Your urologist will get a medical history and conduct a physical exam. If needed, urine analysis and further imaging tests of your urinary muscles may be required.

How is urinary incontinence treated?

Treatment options can vary based on the severity of incontinence. Treatments can include behavioral techniques such as bladder training and fluid management, pelvic floor muscle exercises, medication, or surgery.