Urinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries urine out of your body from your bladder. You may leak urine from time to time. Or, you may not be able to hold any urine.
The three main types of urinary incontinence are:
Mixed incontinence occurs when you have both stress and urge urinary incontinence.
Bowel incontinence is when you are unable to control the passage of stool. It is not covered in this article.
Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary; Overactive bladder
Common conditions include: Stress Urinary Incontinence
Causes of urinary incontinence include:
Incontinence may be sudden and go away after a short period of time. Or, it may continue long-term. Causes of sudden or temporary incontinence include:
Causes that may be more long-term:
If you have symptoms of incontinence, see your health care provider for tests and a treatment plan. Which treatment you get depends on what caused your incontinence and what type you have.
There are several treatment approaches for urinary incontinence:
Lifestyle changes. These changes may help improve incontinence. You may need to make these changes along with other treatments.
For urine leaks, wear absorbent pads or undergarments. There are many well-designed products that no one else will notice.
Bladder training and pelvic floor exercises. Bladder retraining helps you gain better control over your bladder. Kegel exercises can help strengthen the muscles of your pelvic floor. Your provider can show you how to do them. Many women do not do these exercises correctly, even if they believe they are doing them correctly. Often, people benefit from formal bladder strengthening and retraining with a pelvic floor specialist.
Medicines. Depending on the type of incontinence you have, your provider may prescribe one or more medicines. These drugs help prevent muscle spasms, relax the bladder, and improve bladder function. Your provider can help you learn how to take these medicines and manage their side effects.
Surgery. If other treatments do not work, or you have severe incontinence, your provider may recommend surgery. The type of surgery you have will depend on:
If you have overflow incontinence or you cannot fully empty your bladder, you may need to use a catheter. You may use a catheter that stays in long-term, or one that you are taught to put in and take out yourself.
Bladder nerve stimulation. Urge incontinence and urinary frequency can sometimes be treated by electrical nerve stimulation. Pulses of electricity are used to reprogram bladder reflexes. In one technique, the provider inserts a stimulator through the skin near a nerve in the leg. This is done weekly in the provider's office. Another method uses battery-operated implanted device similar to a pacemaker that is placed under the skin in the lower back.
Botox injections. Urge incontinence can sometimes be treated with an injection of onabotulinum A toxin (also known as Botox). The injection relaxes the bladder muscle and increases the storage capacity of the bladder. The injection is delivered through a thin tube with a camera on the end (cystoscope). In most cases, the procedure can be done in the provider's office.
Talk to your provider about incontinence. Providers who treat incontinence are gynecologists and urologists that specialize in this problem. They can find the cause and recommend treatments.
Call your local emergency number (such as 911) or go to an emergency room if you suddenly lose control over urine and you have:
Call your provider if you have:
Eric Rovner is an Urologist in Mount Pleasant, South Carolina. Rovner has been practicing medicine for over 32 years and is rated as an Elite expert by MediFind in the treatment of Urinary Incontinence. He is also highly rated in 26 other conditions, according to our data. His top areas of expertise are Urinary Incontinence, Stress Urinary Incontinence, Neurogenic Bladder, Uterine Prolapse, and Endoscopy. He is licensed to treat patients in South Carolina. Rovner is currently accepting new patients.
Holly Richter is an Obstetrics and Gynecologist in Birmingham, Alabama. Richter has been practicing medicine for over 31 years and is rated as an Elite expert by MediFind in the treatment of Urinary Incontinence. She is also highly rated in 13 other conditions, according to our data. Her top areas of expertise are Urinary Incontinence, Bowel Incontinence, Stress Urinary Incontinence, Sacral Nerve Stimulation, and Hysterectomy. She is licensed to treat patients in Alabama. Richter is currently accepting new patients.
Victor Nitti is an Urologist in Los Angeles, California. Nitti has been practicing medicine for over 38 years and is rated as an Elite expert by MediFind in the treatment of Urinary Incontinence. He is also highly rated in 11 other conditions, according to our data. His top areas of expertise are Urinary Incontinence, Stress Urinary Incontinence, Bladder Outlet Obstruction, Prostatectomy, and Sacral Nerve Stimulation. He is licensed to treat patients in California. Nitti is currently accepting new patients.
Summary: The investigators propose a clinical trial and nested qualitative study to 1) quantify the effectiveness of an insertable vaginal cup to manage fistula urinary incontinence, 2) examine user and implementer acceptability, and 3) quantify fistula management cost. Two intervention models will be compared among women awaiting fistula surgery or whose surgery was unsuccessful: 1) a vaginal cup ('cup'),...
Summary: The purpose of this study is to test a new ultrasound method called Quantitative Ultrasound Bladder Vibrometry to detect abnormal bladder function.
Published Date: October 14, 2020
Published By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Heesakkers JPFA, Blok B. Electrical stimulation and neuromodulation in storage and emptying failure. In: Partin AW, Dmochowski RR, Kavoussi LR , Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 122.
Kirby AC, Lentz GM. Lower urinary tract function and disorders: physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 21.
Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.
Resnick NM. Incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 23.
Reynolds WS, Dmochowski R, Karram MM, Mahdy A. Surgical management of refractory overactive bladder and detrusor compliance abnormalities. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 90.