Urinary Incontinence

You are sitting in a theater enjoying the newest blockbuster when the scene abruptly changes to a rushing river. The sound of moving water engulfs the auditorium and seems to have pushed a button attached directly to your bladder. Suddenly, you have an overwhelming urge to urinate, and if you don't get to a bathroom immediately, there could be a problem. This incident describes a type of urinary incontinence that can cause a great deal of anxiety and disrupt everyday activities.

Urinary incontinence is the inability to control the flow of urine or involuntary leakage of urine. There are different causes of urinary incontinence depending on the location of the problem along the urinary tract. The various types of urinary incontinence include urge, stress and overflow incontinence.

Normally, urine is made by the kidneys and then travels through small tubes called ureters to the bladder. The urethra connects the bladder to the outside of the body. When the bladder is filling with urine, sphincter muscles that surround the urethra tighten preventing urine leakage. When the bladder is full and ready to empty it begins to contract. The sphincter muscles will relax allowing the urine to flow.

When the bladder contracts prematurely, before an individual is ready to urinate, it is called urge incontinence. Urge incontinence, also known as overactive bladder, is the most frequent form of urinary incontinence. An individual will have an overwhelming compulsion to urinate followed by a small or large amount of urinary leakage.

Stress incontinence occurs when the urethral sphincter muscles do not close properly, and ordinary abdominal pressure from a sneeze or a cough causes urine leakage. Stress incontinence is common among women who have had children.

Overflow incontinence is uncommon and occurs when the bladder is too weak to completely empty or when the urethra is blocked by an enlarged prostate, leaving a large amount of urine in the bladder. This type of incontinence typically affects older men and very rarely women.

Diagnosis requires a visit to your health care provider. During your visit a history and physical examination will be performed. Questions that may be asked include when the symptoms started, the exact nature of the symptoms, what makes the symptoms worse or better, and what previous treatments have you had, if any. They will also want to know what medications you are taking and what other conditions you may have, for instance, hypertension or diabetes. Laboratory tests may also be ordered to check the urine for infection and kidney function. Other specialized tests, such as a cough test, post void residual or urodynamic test, are usually completed by an urologist.

Treatment options include lifestyle modifications, medication or surgery depending on the type of urinary incontinence that an individual has. Treatment goals should be discussed with your health care provider, who will be able to provide the best choices for you. For further information please visit the National Association for Continence at www.nafc.org.