Urinary Incontinence Causes and Treatment

Desperate woman wetting herself
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Urinary incontinence is the sudden loss of bladder control. If you have had this experience, you know that it can cause personal distress as well as embarrassment. There are a number of causes of incontinence, including medical illnesses, loss of consciousness, infections, and medications.

Most people don't realize that incontinence is often treatable. The first step is talking to your doctor, who can work with you to determine the cause.

Causes

With incontinence, you may completely lose control of urination all of the time, but it is more common to lose control some of the time. And, incontinence can mean a small flow or leak of urine, or it may mean the loss of significant amounts of urine. Incontinence can be temporary and reversible, or it may be permanent.

The most common causes include:

Pregnancy

During pregnancy, some women experience urinary incontinence as a result of pressure on the bladder exerted by the expanding uterus, which contains the developing baby. This problem is more noticeable during the later stages of pregnancy, but it may increase or decrease throughout pregnancy as the baby shifts position, changing the impact of pressure on the bladder.

Childbirth 

After childbirth, many women experience mild to moderate incontinence due to weakening of the pelvic muscles that control urination. Some women experience more severe incontinence after childbirth if there is damage of the nerves or muscles, which can occur during pregnancy or childbirth. 

Stress Incontinence

Stress incontinence describes the situation in which physical pressure in the bladder causes urine to leak out involuntarily (not on purpose.) This can happen as a result of laughing, sneezing, coughing or even as a result of physical movements that put pressure on the lower abdominal area, such as exercise or heavy lifting.

Bladder Spasm

Bladder spasm is the sudden contraction (squeezing) of the bladder, which can lead to involuntary urination. There are a number of causes of bladder spasm. A person who repeatedly experiences bladder spasm may be suffering from overactive bladder.

Overactive Bladder

Overactive bladder is a tendency to either feel the sudden urge to urinate or to have involuntary spasms of the bladder. Overactive bladder is a symptom of several medical conditions, including infections and neurological illnesses.

Diabetes

Diabetes may cause incontinence, particularly in young children who have not yet been diagnosed with diabetes. Polydipsia (drinking more than the usual amount of fluid) and polyuria (excessive urination) are among the early signs of diabetes Often, the high volume of urine produced as a result of diabetes can make a person lose control of urine, particularly during sleep.

Menopause

Menopause is often associated with urinary incontinence. There are a number of reasons for this and several of the associations are not well understood. For example, postmenopausal women who take hormonal therapy as well as postmenopausal women who do not take hormonal therapy appear to be at increased risk of urinary incontinence.

Prostate Enlargement

The prostate is an organ that is only present in males. It is located near the bladder and it may become enlarged after the age of 40. An enlarged prostate puts pressure on the bladder and may cause incontinence. Usually, an enlarged prostate is not a dangerous health problem, but sometimes it may result from prostate cancer.

Neurological Disease - Multiple Sclerosis (MS), Stroke, Spine Disease 

Many neurological disorders impact the brain or the spine. This can cause incontinence due to lack of control of the nerves that power the muscles involved in urination or due to a problem with decreased sensation of the bladder which results in decreased awareness of the need to urinate.

Dementia

Dementia is characterized by memory loss and trouble thinking. There are many causes of dementia, and dementia typically makes a person less able to take care of himself or herself. Often, people with dementia experience incontinence due to a decreased sensation of a full bladder or a decreased ability to control the muscles of urination. Some individuals with dementia experience incontinence due to behavioral changes such as apathy (decreased interest in the world around them) or loss of social inhibition (decreased interest in behaving as socially expected).

Bedwetting

Sometimes sleeping in an unfamiliar place, anxiety, or nightmares can cause incontinence, particularly among young children who have only recently been ‘potty trained.’ Bedwetting can be the sign of diabetes or a bladder infection, but it may also be an infrequent event without a medical cause.

Loss of Consciousness

Individuals who become unconscious as a result of a medical condition such as a seizure, a heart attack, a stroke, a drug overdose, head trauma or any other health problem may lose control of urine while unconscious.

Surgery

Sometimes, surgical procedures may damage the structures that are involved in the normal function of urination. This may be an unavoidable process, for example when a cancerous tumor is removed, or it may be the result of anatomical changes resulting from surgery.

Cancer

Cancer anywhere in the pelvic region can interfere with the ability to control urine. Cancers and tumors that affect urination include bladder cancer, prostate cancer or uterine cancer, which are nearby organs, or they may be cancers from another area of the body, such as the lungs or breast, that spread to the area in or around the bladder.

Neuropathy

Neuropathy is disease of the nerves. There are a number of causes of neuropathy, the most common being diabetic neuropathy and alcoholic neuropathy. Neuropathy can make the nerves that control urination less effective, resulting in urinary incontinence.

Diuretics

There are a variety of foods, drinks, and medications that cause the body to produce excessive amounts of urine. The most well known is caffeine, which is naturally present in drinks such as coffee, tea, and cocoa. Several medications can also cause excessive production of urine. For example, many medications that are used for the treatment of high blood pressure have diuretic effects. Taking a diuretic does not necessarily result in incontinence, but it can increase the likelihood especially if you also have another cause of incontinence.

Urinary Tract Infection

A urinary tract infection (UTI) is an infection involving the kidneys, the ureters, the bladder or the urethra. These infections are very common and are usually treated with antibiotics. The pain and discomfort associated with a urinary tract infection can instigate bladder incontinence.

Treatment

Behavioral changes, including diet and exercise, can help some people regain bladder control if performed consistently. In some cases, medications may be prescribed to supplement these strategies.

The most common therapeutic and supportive techniques include:

  • Bladder training involves a structured urination schedule.
  • Pelvic muscle training teaches you how to squeeze and release your kegel muscles to better control the urinary flow. This is particularly helpful for women who have lost some of their bladder control after pregnancy.
  • Modifying fluid Intake restricts the amount of fluids you drink as well as any beverages which have a diuretic effect. These include caffeinated drinks (coffee, tea, cola) that not only promote urination but can also irritate the bladder. The technique also prepares you for social events by restricting fluid intake two to three hours before leaving.
  • A pessary is a small soluble block that is inserted into the vagina. It may be used for post-menopausal women with bladder control issues. This is more a supplemental device rather than a form of treatment.
  • Male incontinence devices can be used in men who have failed other types of therapy. Options include an artificial sphincter, which is an inflatable cuff that presses the urethra, or a male sling, which is a wearable device that supports the urethra.
  • Bulking agents are substances, like collagen, that can be injected around the urethra to bolster sagging muscles and tissue. Women may require only a local anesthetic for this procedure, while men may require general or regional anesthesia.
  • Retropubic suspense is a surgical technique used in women to lift the sagging bladder neck and urethra.
  • A suburethral sling is a minimally invasive surgical procedure that aims to increase compression of the urethra in women. This is most typically used to treat stress incontinence.

A Word From Verywell

Whatever your experience with incontinence, you should seek medical attention for it. Usually, your doctors can find the cause, and treatment can help you avoid the symptoms, substantially improving your quality of life.

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Article Sources
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