Conditions InDepth: Urinary Incontinence

Urinary incontinence is the loss of voluntary bladder control causing leakage of urine. The temporary or chronic condition has multiple mechanisms and many causes. It can occur when you are straining (lifting, sneezing, coughing), when your bladder is full, or when you have a bladder infection. Each cause has its own methods of diagnosis and its own treatment plan.

The Bladder

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Urinary bladder function is a careful balance between pressure from the bladder to empty and resistance from the sphincter (valve) at its outlet. Pressure to empty increases suddenly when the bladder reaches a certain volume.

Sphincter resistance depends not only on the strength of the muscle but also on its position. Both forces are controlled mostly by your autonomic (automatic) nervous system, the same system that regulates body temperature, heart rate, blood pressure, digestion, and everything else your body does without you thinking about it. You do, however, have control over the sphincter and can strengthen it with exercise.

The Female Urinary System

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In the United States, 20 million women have some form of urinary incontinence. It occurs daily or weekly in one quarter of women over age 60 and half of women confined to institutions. Because of anatomical differences in men and women, there is a substantial difference between the sexes in the incidence of the various types of incontinence. Because of the prostate gland, men have more problems with obstructive incontinence than with stress incontinence. Prostate surgery can occasionally cause incontinence.

What are the causes of incontinence?
What are the risk factors for urinary incontinence?
What are the symptoms of urinary incontinence?
How is urinary incontinence diagnosed?
What are the treatments for urinary incontinence?
Are there screening tests for urinary incontinence?
How can I reduce my risk of urinary incontinence?
What questions should I ask my healthcare provider?
What is it like to live with urinary incontinence?
Where can I get more information about urinary incontinence?

References:

Harrison’s Principles of Internal Medicine. 14th ed. McGraw-Hill; 1998.

National Association for Continence website. Available at: http://www.nafc.org/site2/index.html .



Last reviewed June 2007 by Miguel Antelo, 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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