What is urinary incontinence? Causes, symptoms and treatments

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What is urinary incontinence?

For many adults, especially women, urination problems are a source of disruption and strife. Urinary incontinence is surprisingly common, affecting anywhere from about 25 to 45 percent of all women. For men, it’s a bit less frequent, but still significant, with rates ranging from about 1 in 10 to just over one-third of older men. (For the purposes of this article, “women” and “men” refer to biological sex.)

Experts say this subject is so taboo that many people who suffer from it fail to report urinary incontinence to their health care providers. “Urinary incontinence is the largest epidemic in America that no one talks about,” proclaims Steven Gregg, PhD, executive director of the National Association for Continence. And yet, he adds, “It creates a big impact on quality of life, and comes with stigma and shame.”

Getting a better understanding of the causes and treatments of incontinence can set people on a path to feeling more in control again.

What are the types of incontinence?

There are two main types of urinary incontinence — stress incontinence and urge incontinence — and both are more common in women. Urinary incontinence also becomes increasingly common with age.

1. Stress urinary incontinence

Stress urinary incontinence (SUI) is triggered by pressure or movement. Think of someone coughing, jumping, lifting something heavy, running, sneezing or laughing so hard that they (literally) wet their pants. Stress incontinence can occur when the pelvic floor, which supports the bladder and urethra, is weakened or damaged.

“Pregnancy, vaginal delivery, hysterectomy or pelvic radiation are all risk factors for SUI,” says Lauren Wood Thum, MD, a urologist and female pelvic medicine and reconstructive surgeon at Urology Specialists in Sioux Falls, South Dakota. Male incontinence can also be caused by prostate surgery.

2. Urge incontinence (also called overactive bladder)

Urge incontinence arises from the sudden, uncontrolled urge to urinate — that persistent “gotta go” sensation — which may be accompanied by leaks.

Urge incontinence may be brought on by a number of factors, depending on a person’s biological sex:

Women

• Arthritis
• Certain medications (they may temporarily cause bladder control problems)
• Constipation
• Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes or Parkinson’s disease
• Overactive bladder muscles
• Pelvic organ prolapse
• Urinary tract infections (UTIs)
• Vaginal infection or irritation
• Weak bladder or pelvic floor muscles

Men

• Enlarged prostate gland
• Injury or damage to nerves or muscles from surgery
• Prostatitis

3. Mixed urinary incontinence

Mixed urinary incontinence, as the name suggests, is a combination of stress incontinence and urge incontinence.

Tracking symptoms

If someone is concerned about urinary incontinence, Gregg recommends they begin a bladder diary to show to their health care provider. (A health care provider may also provide patients with a similar document if they don’t have the chance to fill one out before the first visit.)

People can take note of how many drinks they consume, how many daily and nightly trips they take to the bathroom, any accidental urine leaks and any strong urges. Providing health care providers with this written account may also make it less embarrassing to start the conversation.

Incontinence treatment

“The good news is there are multiple treatment options for every type of incontinence,” Dr. Wood Thum says. Finding the best option means getting a proper diagnosis and developing a quality treatment plan with a qualified health care provider who will monitor your health. Gregg recommends seeing a urologist or urogynecologist. “A specialist should provide you with treatment options and set goals for treatment,” he says.

Treatment options for urinary incontinence may include:

• Maintaining a healthy weight
• Making lifestyle changes, such as fluid and diet management (drinking and eating at times that work better for your bladder)
• Practicing pelvic floor exercises (like Kegel exercises) to strengthen bladder and pelvic muscles
• Retraining the bladder (timing bathroom breaks or delaying urination)
• Staying physically active

Medical intervention also may be helpful, depending on the type and severity of the urinary incontinence. People should consult their health care provider to find out what treatment is best for them.

Incontinence products

Many adults who live with stress incontinence and urge incontinence use absorbent products like incontinence pads and underwear. These may be more comfortable and discreet than people think.

“There’s a great deal of innovation in incontinence products now,” says Gregg. Products are made specifically for various incontinence needs, such as for daytime or nighttime usage. Options include a range of protection from light to heavy, including CVS Health protective pantiliners with very light absorbency, Poise incontinence pads with moderate absorbency and CVS Health women’s maximum absorbency underwear. Read the packaging closely to find the incontinence solution that’s the best fit.