If the cause can be treated, this may cure your incontinence. Stress incontinence is when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed. Your urethra is the tube that urine passes through to leave the body.
Any sudden extra pressure on your bladder, such as laughing or sneezing, can cause urine to leak out of your urethra if you have stress incontinence. Your urethra may not be able to stay closed if the muscles in your pelvis pelvic floor muscles are weak or damaged, or if your urethral sphincter — the ring of muscle that keeps the urethra closed — is damaged.
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder. The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.
The reason your detrusor muscles contract too often may not be clear, but possible causes include:. Overflow incontinence, also called chronic urinary retention, is often caused by a blockage or obstruction affecting your bladder. The electrical pulses can be adjusted to help relieve your symptoms. Augmentation cystoplasty is performed as a last resort for severe urge incontinence. In this surgery, a part of the bowel is added to the bladder.
This increases the bladder size and allows it to store more urine. Urinary incontinence is a long-term chronic problem. While treatments can cure your condition, you should still to see your provider to make sure you are doing well and check for possible problems. How well you do depends on your symptoms, diagnosis, and treatment. Many people must try different treatments some at the same time to reduce symptoms. Getting better takes time, so try to be patient.
A small number of people need surgery to control their symptoms. Physical complications are rare. The condition may get in the way of social activities, careers, and relationships. It can also make you feel bad about yourself.
Rarely, this condition can cause severe increases in bladder pressure, which can lead to kidney damage. Overactive bladder; Detrusor instability; Detrusor hyperreflexia; Irritable bladder; Spasmodic bladder; Unstable bladder; Incontinence - urge; Bladder spasms; Urinary incontinence - urge.
Drake MJ. Overactive bladder. Campbell-Walsh Urology. Philadelphia, PA: Elsevier; chap Lower urinary tract function and disorders: physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. Comprehensive Gynecology. J Urol. PMID: www. Conservative management of urinary incontinence: behavioral and pelvic floor therapy and urethral and pelvic devices. Resnick NM. Urinary incontinence. Goldman-Cecil Medicine. Stiles M, Walsh K.
Care of the elderly patient. Textbook of Family Medicine. Philadelphia, PA: Elsevier Saunders; chap 4. Updated by: Sovrin M. Review provided by VeriMed Healthcare Network. Editorial team. Urge incontinence. Two muscles help prevent the flow of urine: The sphincter is a muscle around the opening of the bladder. It squeezes to prevent urine from leaking into the urethra.
This is the tube that urine passes through from your bladder to the outside. The bladder wall muscle relaxes so the bladder can expand and hold urine. All of these systems must work together to control urination: Your bladder muscles and other parts of your urinary tract The nerves controlling your urinary system Your ability to feel and respond to the urge to urinate The bladder may contract too often from nervous system problems or bladder irritation.
Watch this video about: Bladder function - neurological control. Symptoms include: Not being able to control when you pass urine Having to urinate often during the day and night Needing to urinate suddenly and urgently.
Exams and Tests. During a physical exam, your health care provider will look at your belly and rectum. Women will have a pelvic exam. Men will have a genital exam. Tests include the following: Cystoscopy to view the inside of your bladder. Pad test. At the lab, your urine will be checked for infection or other causes of incontinence. Your doctor will use an ultrasound wand on the outside of your abdomen to take pictures of the kidneys, bladder, and urethra.
Your doctor will look for anything unusual that may be causing urinary incontinence. Bladder stress test. During this test, you will cough or bear down as if pushing during childbirth as your doctor watches for loss of urine. Your doctor inserts a thin tube with a tiny camera into your urethra and bladder to look for damaged tissue.
Depending on the type of cystoscopy you need, your doctor may use medicine to numb your skin and urinary organs while you are still awake, or you may be fully sedated. Your doctor inserts a thin tube into your bladder and fills your bladder with water.
This allows your doctor to measure the pressure in your bladder to see how much fluid your bladder can hold. How is urinary incontinence treated? What steps can I take at home to treat urinary incontinence? These steps may include: Doing Kegel exercises.
If you have stress incontinence, Kegel exercises to strengthen your pelvic floor muscles may help. Training your bladder. You can help control overactive bladder or urge incontinence by going to the bathroom at set times.
Then slowly add about 15 minutes between bathroom visits. Urinate each time, even if you do not feel the urge to go. By gradually increasing the amount of time between visits, your bladder learns to hold more urine before it signals the need to go again.
Losing weight. Extra weight puts more pressure on your bladder and nearby muscles, which can lead to problems with bladder control. If you have overweight, your doctor or nurse can help you create a plan to lose weight by choosing healthy foods and getting regular physical activity. Your doctor or nurse may refer you to a dietitian or physical therapist to create a healthy eating and exercise plan.
Changing your eating habits. Drinks with caffeine, carbonation such as sodas , or alcohol may make bladder leakage or urinary incontinence worse. Your doctor might suggest that you stop drinking these drinks for a while to see if that helps. Quitting smoking. Smoking can make many health problems, including urinary incontinence, worse.
Treating constipation. Your doctor might recommend that you eat more fiber, since constipation can make urinary incontinence worse. What are Kegel exercises? How do I do Kegel exercises? To do Kegels: Lie down. It may be easier to learn how to do Kegels correctly while lying down. Squeeze the muscles in your genital area as if you were trying to stop the flow of urine or passing gas.
Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks because then you will not be using your pelvic floor muscles. Squeeze the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 each day. Practice Kegels anywhere. When your muscles get stronger, try doing Kegels while sitting or standing.
You can do these exercises at any time, such as while sitting at your desk or in the car, waiting in line, or doing the dishes.
This can weaken your pelvic floor muscles over time. How soon after starting Kegel exercises will urinary incontinence get better?
Should I drink less water or other fluids if I have urinary incontinence? What are some medical treatments for stress incontinence? If steps you can take at home do not work to improve your stress incontinence, your doctor may talk to you about other options: Medicine. After menopause, applying vaginal creams, rings, or patches with estrogen called topical estrogen can help strengthen the muscles and tissues in the urethra and vaginal areas.
A stronger urethra will help with bladder control. Learn more about menopause treatments. Vaginal pessary. A reusable pessary is a small plastic or silicone device shaped like a ring or small donut that you put into your vagina.
The pessary pushes up against the wall of the vagina and the urethra to support the pelvic floor muscles and help reduce stress incontinence. Pessaries come in different sizes, so your doctor or nurse must write a prescription for the size that will fit you.
Another type of pessary looks like a tampon and is used once and then thrown away. You can get this type of pessary at a store that also sells feminine hygiene products. Bulking agents. Your doctor can inject a bulking agent, such as collagen, into tissues around the bladder and urethra to cause them to thicken. This helps keep the bladder opening closed and reduces the amount of urine that can leak out. Surgery for urinary incontinence is not recommended if you plan to get pregnant in the future.
Pregnancy and childbirth can cause leakage to happen again. The two most common types of surgery for urinary incontinence are: 13 Sling procedures.
The mid-urethral sling is the most common type of surgery to treat stress incontinence. The sling is either a narrow piece of synthetic man-made mesh or a piece of tissue from your own body that your doctor places under your urethra. The sling acts like a hammock to support the urethra and hold the bladder in place. Serious complications from the sling procedure include pain, infection, pain during sex, and damage to nearby organs, such as the bladder. The Food and Drug Administration FDA reports that in 1 out of every 50 patients who have synthetic mesh for urinary incontinence, the mesh moves after surgery and stick outs, into the vagina, causing pain.
This surgery also helps hold the bladder in place with stitches on either side of the urethra. This is often referred to as a Burch procedure. What are some nonsurgical treatments for urge incontinence? If steps you can take at home do not work to improve your urge incontinence, your doctor may suggest one or more of the following treatments: Medicines. Medicines to treat urge incontinence help relax the bladder muscle and increase the amount of urine your bladder can hold.
Common side effects of these medicines include constipation and dry eyes and mouth. Botox helps relax the bladder and increases the amount of urine your bladder can hold. You may need to get Botox treatments about once every 3 months. Nerve stimulation. This treatment uses mild electric pulses to stimulate nerves in the bladder. The pulses may increase blood flow to the bladder and strengthen the muscles that help control the bladder.
Talk to your doctor about the different types of nerve stimulation. Biofeedback helps you see how your bladder responds on a screen. A therapist puts an electrical patch on the skin over your bladder and urethral muscles.
A wire connected to the patch is linked to a screen.
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