Urinary incontinence (in-CON-ti-nents) is the loss of bladder
control or the leakage of urine. It can happen to anyone, but is
very common in older people. At least 1 out of 10 people age 65 or
older suffers from incontinence. It is a condition that rages from
mild leakage to uncontrollable and embarrassing wetting. Urinary
incontinence is a major health problem because it can lead to
disability and dependency.
Many people with incontinence pull
away from their family and friends. They try to hide the problem
from everyone, even their doctors. The good news is that in most
cases urinary incontinence can be treated and controlled, if not
cured. The bad news is that caregivers may not know that treatment
is a choice. They may think that nursing home care is the only
answer for an older person with incontinence.
does not happen because of aging. It may be caused by changes in
your body due to disease. For example, incontinence may be the first
and only symptom of a urinary tract infection. Curing the infection
may relieve or cure the problem. Some drugs may cause incontinence
or make it worse.
If you are having trouble with
incontinence, see your doctor. Even if it can't be completely cured,
modern products and ways of managing incontinence can ease its
discomfort and inconvenience.
Types of Incontinence
The most common types of urinary incontinence
Stress incontinence happens when urine
leaks during exercise, coughing, sneezing, laughing, lifting heavy
objects, or other body movements that put pressure on the bladder.
It is the most common type of incontinence and can almost always be
Urge incontinence happens if you
can't hold your urine long enough to reach a toilet. Although
healthy people can have urge incontinence, it is often found in
people who have diabetes, stroke, dementia, Parkinson's disease, or
multiple sclerosis. It can also be a warning sign of early bladder
cancer. In men, it is often a sign of an enlarged
Overflow incontinence happens when
small amounts of urine leak from a bladder that is always full. In
older men, this can occur when the flow of urine from the bladder is
blocked. Some people with diabetes also have this
Functional incontinence happens in
many older people who have relatively normal urine control but who
have a hard time getting to the toilet in time because of arthritis
or other crippling disorders.
The first and most important step in treating incontinence is to
see a doctor for a complete medical exam. The doctor will ask for a
detailed history of your health and give you a physical exam. The
doctor may want to check urine samples. You may be referred to a
urologist, a doctor who specializes in diseases of the urinary
tract, or to a gynecologist, a specialist in the female reproductive
Treatment of urinary incontinence should be designed to meet your
needs. As a general rule, the least dangerous procedures should be
tried first. The many options include:
- Behavioral techniques such as pelvic muscle exercises,
biofeedback, and bladder training can help control urination.
These techniques can help you sense your bladder filling and help
delay voiding until you can reach a toilet.
- A doctor can prescribe medicines to treat incontinence.
However, these drugs may cause side effects such as dry mouth, eye
problems, or urine buildup.
- Sometimes surgery can improve or cure incontinence if it is
caused by a structural problem such as an abnormally positioned
bladder or blockage due to an enlarged prostate. Implanting
devices that replace or aid the muscles controlling urine flow has
been tried in people with incontinence.
If your incontinence cannot be cured, it can be managed in
- You can get special absorbent underclothing that is no more
bulky than normal underwear and can be worn easily under everyday
- A flexible tube (indwelling catheter) can be put into the
urethra (the canal that carries the urine from the bladder) to
collect urine in a container. Long-term catheterization--although
sometimes necessary--creates many problems, including urinary
infections. Men have the choice of an external collecting device.
This is fitted over the penis and connected to a drainage bag.
Remember, under a doctor's care, incontinence can be treated and
often cured. Even if treatment is not fully successful, careful
management can help.
For more information about incontinence,
National Association for
P.O. Box 8306
Foundation for Continence
National Kidney and Urologic
Bethesda, MD 20892-3580
For a list of free
publications on health and aging from the National Institute on
Aging (NIA), contact:
P.O. Box 8057
National Institute on Aging
U. S. Department
of Health and Human Services
Public Health Service
Institutes of Health