Urinary incontinence is the loss of voluntary bladder control leading to urine leakage. It can be temporary or last for a long time. Incontinence is a symptom, not a condition.
Temporary incontinence can be caused by:
Permanent urinary incontinence may be one of four types. Some people have a mixture of these types.
This is the most common type of incontinence. It may be caused by:
Muscles Involved in Incontinence in Women
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This is also known as overactive bladder. It may be caused or worsened by:
This occurs when the bladder will not empty. Urine builds up and the bladder overflows. This leads to leaking of urine. It may be caused by:
This occurs when you have normal bladder control, but you can't reach the toilet in time. It may be caused by medical conditions like severe arthritis. Drugs that cause confusion or sedation can also cause functional incontinence.
Some incontinence may be caused by a fistula. A fistula is an abnormal opening between the bladder and outside.
Incontinence has several different causes. The cause could also be unclear.
Risk factors include:
Urinary incontinence is a symptom of other conditions. Any loss of bladder control can be considered incontinence.
Stress incontinence is when certain activities lead to increased pressure on the bladder. Triggers may be laughing, sneezing, lifting heavy objects, or exercise.
Urge incontinence is a loss of bladder control following a strong urge to urinate. The bladder is unable to hold urine long enough to make it to a restroom.
Call your doctor if you have a loss of urine control. Your doctor can help you determine the underlying cause.
Your doctor will ask about your symptoms and medical history. You will be asked how often you empty your bladder, and about patterns of urine leakage. Your doctor will do a physical exam to look for any physical causes. These include blockages and nerve problems.
Your doctor may ask you to keep a diary of your urination habits. You may be referred to an urologist or an urogynecologist.
Tests to help determine a cause may include:
Treatments may include:
Behavioral therapy includes:
If you are a woman who is overweight or obese, losing weight may help reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a weight loss program that is right for you.
Medicines called anticholinergics may be prescribed to relax the bladder muscles. They are often used in treating urge incontinence.
Nerve stimulation is effective for urge urinary incontinence. It can be done by stimulating a nerve in your ankle. Or, it can be done by implanting a device that stimulates the bladder nerves.
In women, surgery can support weakened muscles related to bladder function. One type of surgery is called a urethral suspension. Other procedures involve collagen injections into the urethra.
Absorbent diapers are often used with incontinence.
Plugs and patches that hold urine in place are available for women. Catheters are sometimes used to treat more severe cases.
A supportive device called a pessary may also be used in women. Pessaries are devices that raise the uterus or the prolapsed bladder. It can decrease pressure on the bladder.
Incontinence is really a symptom of many other conditions. There are several ways to prevent incontinence:
Urology Care Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
Women's Health Matters
American Urological Association Foundation. Overactive bladder. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=112. Updated January 2011. Accessed September 14, 2012.
Corcos J, Gajewski J, et al. Canadian Urological Association guidelines on urinary incontinence. Can J Urol. 2006;13:3127-3138.
Incontinence. American Urologic Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143. Updated January 2011. Accessed September 14, 2012.
National Association for Continence. Overactive bladder treatment. National Association for Continence website. Available at: http://www.nafc.org/bladder-bowel-health. Updated September 2011. Accessed September 14, 2012.
Norton P, Brubaker L. Urinary incontinence in women. Lancet. 2006;367:57-67.
Sobhgol SS, Charandabee SM. Related factors of urge, stress, mixed urinary incontinence, and overactive bladder in reproductive age women in Tabriz, Iran: a cross-sectional study. Int Urogynecol J Pelvic Floor Dys Function. 2008;19(3):367-373.
Urinary incontinence. American Academy of Family Physicians. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/urinary-incontinence.html. Updated July 2012. Accessed September 16, 2012.
Urinary incontinence in women. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 29, 2012. Accessed September 14, 2012.
Urinary incontinence in women. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen. Published September 2010. Accessed September 14, 2012.
Wein A, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management. J Urol. 2006;175:S5-10.
2/5/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.
1/11/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: AHRQ evidence report on treatment for overactive bladder in women 2009. Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/clinic/tp/bladdertp.htm. Published August 2009. Accessed January 11, 2010.
3/5/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Vardy MD, Mitcheson HD, Samuels TA, et al. Effects of solifenacin on overactive bladder symptoms, symptom bother and other patient-reported outcomes: results from VIBRANT—a double-blind, placebo-controlled trial. Int J Clin Pract. 2009;63(12):1702-1714.
12/3/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int. 2010;106(6):816-821.
12/13/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: University of Texas at Austin, School of Nursing, Family Nurse Practitioner Program. Recommendations for the management of urge urinary incontinence in women. Agency for Healthcare Research and Quality website. Available at: http://www.guideline.gov/content.aspx?id=16322. Published May 2010. Accessed December 13, 2010.
3/5/2013 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007471.
Last reviewed September 2012 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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