Urinary incontinence – or loss of bladder control – is a common yet often embarrassing problem. The severity can range from leaking small amounts of urine when you cough, sneeze, or laugh to having an urge to urinate that’s so strong and sudden you might not make it to the toilet in time.

People often assume that urinary incontinence is an inevitable consequence of aging, but it can happen to anyone at any time. Your risk for urinary incontinence indeed increases as you get older, but you can also minimize its impact on your daily life, starting now.

TopLine MD Alliance is providing a comprehensive review of urinary incontinence, including the most common types and causes, preventive measures that can relieve your symptoms, non-surgical and surgical treatment options, and more. With urogynecology providers, OB/GYNs, and many other specialists in our network, you can count on TopLine MD Alliance to connect you with expert care and help you make informed decisions about your urinary health.

Keep reading to learn how to leave the inconvenient leaks and embarrassing accidents associated with urinary incontinence behind and finally take control of this condition that affects millions of adults.

What is urinary incontinence?

Your urinary system consists of many different organs that work together to filter, store, and remove waste from your body as urine. When your urinary system is working properly, you usually have plenty of time to get to the bathroom to urinate without leaking.

Urinary incontinence occurs when parts of your urinary system don’t operate as they should, causing you to lose control of your bladder and leak small or large amounts of urine.

Urinary incontinence is far more common in women than men. Over 60% of women over the age of 20 experience some type of urinary incontinence, and up to 75% of women over the age of 50, compared to less than 14% of men.

Who’s at risk for urinary incontinence?

As you age, your urinary tract muscles weaken, making it harder to hold in urine. Involuntary bladder contractions also become more frequent as you get older.

You have a higher risk of developing urinary incontinence if you:

• Are a woman, especially after pregnancy, childbirth, or menopause
• Are a man with prostate issues
• Are a smoker
• Have certain health problems (more information below)
• Are overweight
• Have a birth defect that affects the structure of your urinary tract
• Have a family history of urinary incontinence

Symptoms of urinary incontinence

The main symptom of urinary incontinence is leaking urine before you can reach the toilet. You might leak a lot of urine at once, have constant dripping, or only leak small amounts occasionally. Your symptoms will depend on the type of urinary incontinence you have, but may include:

• Urinating more than eight times a day
• Feeling like you need to use the bathroom often, but only a small amount comes out
• Waking up to urinate more than twice a night
• Urinating in your sleep
• Leaking urine during activities like coughing, sneezing, laughing, exercising, heavy lifting, or sexual intercourse

Types of urinary incontinence

There are many different types of urinary incontinence, each with different symptoms and causes. Your TopLine MD Alliance network provider can diagnose the type of urinary incontinence you have and offer personalized guidance about your treatment options.

Stress incontinence

Stress incontinence occurs when stress or pressure on your bladder – often due to the activities listed above – results in leaking urine.

Causes include weak pelvic floor muscles due to childbirth, aging, or obesity.

Urge incontinence

Urge incontinence is when you feel a strong, sudden urge to urinate, and some urine leaks out before you can make it to the bathroom. This form of urinary incontinence is most common in older adults.

Causes include an overactive bladder, urinary tract infection (UTI), bladder infection, or neurological conditions that disrupt signals between your bladder and your brain.

Overflow incontinence

Overflow incontinence happens when your bladder doesn’t empty all the way, causing urine to remain inside. Once your bladder gets too full, you leak urine. This form of urinary incontinence is most common in men.

Causes include an enlarged prostate, kidney stones, diabetes, a weakened bladder, or nerve damage.

Functional incontinence

Functional incontinence is when a physical or mental disability, difficulty speaking, or another pre-existing problem prevents you from reaching the toilet in time.

For example, someone with arthritis may have trouble unbuttoning their pants, while a person with Alzheimer’s may not realize they need to go to the toilet until it’s too late.

Transient incontinence

Transient incontinence is urine leakage that occurs because of a temporary issue. Once the issue is resolved, the incontinence goes away.

Causes include certain medications (such as diuretics), infections, constipation, or excessive alcohol or caffeine consumption.

Mixed incontinence

Mixed incontinence means that you have more than one type of incontinence at the same time, usually a combination of stress and urge incontinence.

How pregnancy, childbirth, and menopause affect urinary incontinence

Some urinary incontinence causes are temporary and go away with treatment, while others are related to chronic medical conditions. Fortunately, pregnancy, childbirth, and menopause fall into the temporary category. However, they each impact urinary incontinence in different ways:

• Pregnancy – Hormonal changes and the increased weight of a growing baby can lead to stress incontinence.
• Childbirth – Vaginal delivery can weaken the muscles that control your bladder and damage bladder nerves, creating a weak pelvic floor.
• Menopause – Women produce less estrogen after menopause, a hormone that helps keep the lining of your bladder and urethra healthy. The deterioration of these tissues can worsen urinary continence.

Diet changes for urinary incontinence

Here’s the good news: lifestyle modifications like diet and exercise can improve your urinary incontinence symptoms.

For starters, avoid the following foods and drinks that may act as diuretics, stimulating your bladder and increasing your volume of urine:

• Alcohol
• Caffeine
• Carbonated drinks
• Artificial sweeteners
• Chocolate and other high-sugar foods
• Acidic foods, such as citrus fruits
• Spicy foods, such as chili peppers

Eating more fiber can help prevent constipation, which causes urinary incontinence.

Avoid drinking lots of fluids before starting an activity and before bedtime, especially if you have frequent urination or leaks at night.

Exercises for urinary incontinence

Exercising regularly and staying at a healthy weight can help reduce your urinary incontinence symptoms as well. Be sure to urinate before any physical activity to avoid leaks.

Your TopLine MD Alliance network provider may recommend pelvic floor exercises (also known as Kegel exercises) to help strengthen the muscles that control urination. These exercises are especially effective for stress incontinence but may help urge incontinence as well.

To do pelvic floor exercises, follow these steps:

• Imagine that you are trying to stop your urine flow, then tighten the muscles that you would use to stop urinating.
• Hold for five seconds, then relax for five seconds.
• Work your way up to holding the contractions for 10 seconds each time.
• Aim for at least three sets of 10 contractions each day.

Bladder training can also help delay urination. Start by trying to hold off for 10 minutes every time you feel the urge to urinate. The goal is to gradually lengthen the time between trips to the toilet until you are urinating every 2-3 hours. This process can also help stretch your bladder so it holds more urine.

Double voiding helps empty your bladder more to avoid overflow incontinence. After urinating, wait a few minutes and then try again. You should also urinate every 2-3 hours on your own instead of waiting to feel like you need to go.

Non-surgical treatment options for urinary incontinence

Medications

Medications commonly used to treat incontinence include:

• Anticholinergics – These medications can help calm an overactive bladder and may be helpful for urge incontinence.
• Mirabegron – Also used to treat urge incontinence, this medication relaxes your bladder muscle. It can increase the amount of urine your bladder can hold and the amount you can urinate at one time, helping to empty your bladder more completely.
• Topical estrogen – Applying low-dose, topical estrogen (available as a vaginal cream, ring, or patch) may help rejuvenate damaged tissues in your urethra and vaginal areas.
• Alpha blockers – For men who have urge incontinence or overflow incontinence, these medications relax muscle fibers in the bladder and prostate.

Electrical stimulation

Electrodes are temporarily inserted into your vagina or rectum to stimulate and strengthen pelvic floor muscles. Gentle electrical stimulation can be effective for stress incontinence and urge incontinence.

Medical devices

A urethral insert is a small, tampon-like disposable device you place into your urethra before starting an activity that may trigger urinary incontinence. The insert acts as a plug to help prevent leakage and is removed before you urinate.

A pessary is a flexible silicone ring you insert into your vagina and wear all day to support your urethra and prevent urine leakage.

Botox injections

Injecting Botox into your bladder muscle may benefit you if you have an overactive bladder and urge incontinence. Botox is generally prescribed only if other non-surgical treatments haven’t worked.

Nerve stimulators

These devices use painless electrical pulses to stimulate the nerves responsible for bladder control (known as sacral nerves). One type is implanted under the skin in your buttock and connected to wires on your lower back. The other is a removable plug inserted into your vagina. Like Botox, sacral nerve stimulation is usually only suggested after trying other non-surgical treatments.

What kinds of surgery are available for urinary incontinence?

If other treatments aren’t successful, your TopLine MD Alliance network provider may recommend surgical options for urinary incontinence, such as:

Sling procedure

Synthetic mesh or strips of body tissue are used to create a pelvic sling under your urethra and the area where your bladder connects to your urethra. This sling helps keep your urethra closed, especially when you cough or sneeze.

Bladder neck suspension

This procedure is also designed to provide support to your urethra and the area where your bladder connects to your urethra. It involves an abdominal incision under general or spinal anesthesia.

Artificial urinary sphincter

A small, fluid-filled ring is implanted to keep your urinary sphincter shut until you need to urinate. To urinate, you press a valve implanted under your skin that causes the ring to deflate and allows urine to flow safely.

Get compassionate care from expert providers.

Urinary incontinence isn’t always an easy topic to discuss. By connecting you with TopLine MD Alliance’s network of top-tier providers, diagnostic centers, and imaging facilities, we make seeking care for urinary incontinence and other sensitive medical issues easier than ever.

To get started, find a provider near you today.

The TopLine MD Alliance is an association of independent physicians and medical practice groups who are committed to providing a higher standard of healthcare services. The members of the TopLine MD Alliance have no legal or financial relationship with one another. The TopLine MD Alliance brand has no formal corporate, financial or legal ties to any of the affiliated physicians or practice groups.