1. Shultz, Jean M. BSN, RN, CWOCN

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What is it?

Urinary incontinence (also called bladder control problems) is an involuntary loss of urine. Although urinary incontinence is more common in older people, it's not a normal part of aging. But it may be a sign of another problem that can be cured or made better with treatment.


There are four types of urinary incontinence:


Stress incontinence is the loss or leaking of urine during exercise, sneezing, laughing, coughing, or when lifting something heavy. You may need to make many trips to the bathroom to avoid accidents. This type of urinary incontinence is more common in women than in men.


Urge incontinence (also called overactive bladder) is the loss of urine as soon as you feel the urge to urinate. You may not be able to get to the bathroom fast enough to avoid an accident.


Overflow incontinence occurs when you often feel the need to urinate, but you can't completely empty your bladder. You may have trouble urinating, producing only a dribble or weak stream, and you may lose or leak small amounts of urine throughout the day. This type of incontinence is more common in men, especially those who have an enlarged prostate.


Functional incontinence is caused by problems that prevent you from getting to the bathroom in time to avoid an accident. For example, some people have trouble walking quickly enough because of arthritis.


A combination of urge and stress incontinence, called mixed incontinence, is also common.


How will my healthcare provider know what type I have?

Your healthcare provider will ask you how often you go to the bathroom, how many times a day you're incontinent, what you were doing when it happened, what types of fluids you drink, when you drink them, and how much. You'll be asked whether your problems occur during the day or at night (or both) and what you've done to cope with the problem. You'll also be asked questions about your home and bathrooms to figure out whether changing something at home might help you get to the bathroom faster.


Your healthcare provider will want to know about your past and present health and about medicines you take, including over-the-counter and herbal products. Some medicines and herbal products can cause or worsen urinary incontinence. You'll have a physical exam to look for health problems that might cause incontinence.


Your healthcare provider may want you to give a sample of urine or blood for testing or to get an X-ray done. These extra tests can help identify or rule out other health problems that may need treatment, such as a bladder infection, diabetes, or poor kidney function.


How will my healthcare provider treat my urinary incontinence?

Treatment depends on which type of incontinence you have.


Stress incontinence usually can be treated with behavioral techniques (such as going to the bathroom to urinate every 2 to 3 hours), pelvic muscle exercises, and medicines.


Urge incontinence can be treated by using behavioral techniques and by limiting daily fluid intake to 34 to 85 ounces (1 to 2.5 L). Don't drink anything within 2 hours of bedtime. Your healthcare provider also may prescribe medicine to keep your bladder muscles from contracting too often, which causes the urge to urinate.


Overflow incontinence may be treated with intermittent catheterization (when a slim, flexible tube is inserted into the bladder to empty it) and medicine.


Treatment for functional incontinence depends on your situation. For example, if you're having accidents because you have trouble getting to the bathroom in time, physical therapy may help you.


If you need to use a containment product, such as briefs or pads, your nurse and healthcare provider can help you choose the one that suits you best. They'll also explain how you can protect your skin from damage by urine.