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Urinary Incontinence

What is urinary incontinence?

Urinary incontinence (UI) is when you leak urine.

What causes UI?

UI occurs because your bladder cannot store or empty urine properly. The following are the most common types of UI:

  • Stress incontinence is when you leak urine due to increased bladder pressure. This may happen when you cough, sneeze, or exercise.

  • Urge incontinence is when you feel the need to urinate right away and leak urine accidentally.

  • Mixed incontinence is when you have both stress and urge UI.

What increases my risk for UI?

  • Pregnancy and childbirth

  • Age older than 50

  • Obesity

  • Constipation

  • Past surgery, such as pelvic surgery, prostate surgery, or hysterectomy

  • Medical conditions, such as a urinary tract infection, growths in your urinary system, or a spinal cord injury

  • Medicines, such as diuretics or blood pressure medicine

What are the signs and symptoms of UI?

  • You feel like your bladder does not empty completely when you urinate.

  • You urinate often and need to urinate immediately.

  • You leak urine when you sleep, or you wake up with the urge to urinate.

  • You leak urine when you cough, sneeze, exercise, or laugh.

How is UI diagnosed?

Your healthcare provider will ask how often you leak urine and whether you have stress or urge symptoms. Tell him which medicines you take, how often you urinate, and how much liquid you drink each day. You may need any of the following tests:

  • Urine tests may show infection or kidney function.

  • A pelvic exam may be done to check for blockages. A pelvic exam will also show if your bladder, uterus, or other organs have moved out of place.

  • A cough stress test is used to check for urine leakage while you cough. The test is done when you have a full bladder.

  • A pad test is when you wear an absorbent pad for a certain amount of time. When the test is complete, healthcare providers weigh the pad to see how much urine you leaked.

  • A post void residual test will show how much urine is left in your bladder after you urinate. You will be asked to urinate and then healthcare providers will use a small ultrasound machine to check the urine left in your bladder.

  • Cystometry is used to check the function of your urinary system. Your healthcare provider checks the pressure in your bladder while filling it with fluid. Your bladder pressure may also be tested when your bladder is full and while you urinate.

How can I manage my symptoms?

  • Do pelvic floor muscle exercises often to help strengthen your pelvic muscles and improve bladder control. Tighten and relax your pelvic muscles as often as directed.

  • Train your bladder. Go to the bathroom at set times, such as every 2 hours, even if you do not feel the urge to go. You can also try to hold your urine when you feel the urge to go. For example, hold your urine for 5 minutes when you feel the urge to go. As that becomes easier, hold your urine for 10 minutes. Work up to every 3 or 4 hours to help control your bladder.

  • Exercise regularly and maintain a healthy weight. Ask your healthcare provider how much you should weigh and about the best exercise plan for you. Weight loss and exercise will decrease pressure on your bladder and help you control your leakage. Ask him to help you create a weight loss plan if you are overweight.

  • Keep a UI record. Write down how often you leak urine and how much you leak. Make a note of what you were doing when you leaked urine.

  • Drink liquids as directed. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. You may need to limit the amount of liquid you drink to help control your urine leakage. Limit or do not have drinks that contain caffeine or alcohol. Do not drink any liquid right before you go to bed.

  • Prevent constipation. Eat a variety of high-fiber foods. Good examples are high-fiber cereals, beans, vegetables, and whole-grain breads. Prune juice may help make your bowel movement softer. Walking is the best way to trigger your intestines to have a bowel movement.

How is UI treated?

  • Medicines can help strengthen your bladder control.

  • Electrical stimulation is used to send a small amount of electrical energy to your pelvic floor muscles. This helps strengthen your pelvic floor muscles. Electrodes may be placed outside your body or in your rectum. For women, the electrodes may be placed in the vagina.

  • A bulking agent may be injected into the wall of your urethra to make it thicker. This helps keep your urethra closed and decreases urine leakage.

  • Devices such as a clamp, pessary, or tampon may help stop urine leaks. Ask your healthcare provider for more information about these and other devices.

  • Surgery may be needed if other treatments do not work. Several types of surgery can help improve your bladder control. Ask your healthcare provider for more information about the surgery you may need.

When should I seek immediate care?

  • You have severe pain.

  • You are confused or cannot think clearly.

When should I contact my healthcare provider?

  • You have a fever.

  • You see blood in your urine.

  • You have pain when you urinate.

  • You have new or worse pain, even after treatment.

  • Your urine is cloudy or smells bad.

  • Your mouth feels dry or you have vision changes.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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