What Is Urinary Incontinence?

What is urinary incontinence?

Urinary incontinence is leaking urine when you are not trying to urinate (pee). You may lose a few drops of urine or all the urine in your bladder. The loss of urine may be enough that you have to wear a panty liner or pad to keep from soaking your underwear or clothes. When urine is pushed out when you cough, sneeze, laugh, or lift, it is called stress incontinence. Losing urine during a sudden strong feeling of needing to go that you can’t control is called urge incontinence. Many women have some of both of these problems.

How does urine normally stay in my bladder?

Urine is made in your kidneys and travels to your bladder where it stays until your bladder is full enough that you feel the need to urinate. Usually your bladder stays relaxed when it is filling, and your urethra (tube that connects your bladder to the outside of your body) stays tightly closed. The nerves in your bladder send a signal to your brain when your bladder is full. When you get ready to empty your bladder, your brain signals to urinate. Your bladder tightens to empty while your urethra relaxes to allow the urine to pass out of your body.

What causes urinary incontinence?

Incontinence usually involves some combination of the bladder not relaxing and tightening correctly, the urethra not holding urine well, and/or the pelvic muscles not holding everything in place well. Lots of things can increase these problems, including genetics, aging, pregnancy and birth, some surgeries, being overweight, long-term constipation, or severe coughing. Health habits that can cause incontinence include drinking too much or too little and always waiting too long to urinate.

How can I find out why I have urinary incontinence?

Several simple tests can help figure out what is causing you to leak urine. First, you may have your urine tested to see if you have an infection. Your health care provider may ask you to write down how much liquid you drink, how often and how much you urinate, whether you feel the need to urinate, and how many times you leak urine in a day. This is called a bladder diary and can help you and your provider learn what type of urinary incontinence you have. Your health care provider will likely do a vaginal exam to test the muscles in your pelvis and feel if your bladder is falling into your vagina. Sometimes, special tests of your bladder and urethra are needed.

What are the treatments for urinary incontinence?

The treatment for urinary incontinence depends on the cause and how much leaking you have. These are some common treatments that your health care provider may suggest:

  • Bladder training: Bladder training can help you control the leaking better. If your bladder muscle is too active, it might help to sit on the toilet as long as it takes to empty your bladder all the way. You can also try going to the bathroom every 2 to 4 hours whether or not you feel like you need to go. When you are training your bladder muscle to work better, you will need to be careful about how much you drink. It is also best to stay away from food and drinks that can bother your bladder such as caffeine, alcohol, or chocolate.
  • Strengthen your pelvic floor: Pelvic muscle exercises, often called Kegel exercises, can make the muscles that control and support your bladder and urethra stronger. One way to do these exercises is described below. Some women work with a physical therapist to help them learn how to strengthen these muscles.
  • Medicine: There are several different medicines that can be used to help incontinence. The medicine your provider suggests will depend on the cause of the urinary incontinence.
  • Other Treatments: A small device can be used to plug your urethra during exercise if you have stress incontinence. A pessary (plastic ring that goes in the vagina) can help hold up your bladder and keep urine from leaking.
  • Surgery: If other treatments are not working, there are several types of surgery that can be used to treat urinary incontinence. The type of surgery your provider suggests will depend on the type of incontinence that you have.

How can I prevent urinary incontinence?

  • Avoid foods and drinks that bother your bladder lining such as alcohol, coffee, tea, soft drinks, artificial sweeteners, corn syrup, and acidic foods like citrus fruits and tomatoes.
  • Ask your health care provider if urinary incontinence is a side effect of any medications you are taking. Some medications can cause your bladder to contract or increase the amount of urine you make.
  • Stay at a healthy weight.
  • Do pelvic muscle exercises throughout your life, not only when you are pregnant or just had a baby.
  • Eat more foods that have a lot of fiber to avoid getting constipated. It will help if you do not have to push hard to have a bowel movement.
  • Urinate often, between 5 and 7 times per day, and once (or not at all) during the night.
  • Drink enough water and fluids. Your urine should be pale yellow. Dark yellow or brown urine may be a sign that you are dehydrated (not drinking enough).

How to do Pelvic Muscle Exercises

To do pelvic muscle exercises, imagine that you’re trying to stop your urine flow. Then:

  • Tighten (contract) the muscles you would use to stop urinating and hold for 5 seconds, and then relax for 5 seconds. (If this is too hard to do, start by holding for 2 seconds and relaxing for 3 seconds.)
  • Work up to holding the contractions for 10 seconds at a time.
  • The number of exercises you need to do each day isn’t known for sure. One suggestion is to do 3 sets of 10 contractions each day.
  • Have some way to remember to do the exercises. It may help to do them at the same time you do something else you do every day, such as brushing your teeth.

Be sure to talk about these exercises with your health care provider, who can help you make sure you are doing them right.

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