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• urge incontinence, which is an urgent need to urinate followed by urine leakage
• stress incontinence, which is the leakage of urine when laughing, coughing, sneezing, or lifting heavy objects
• overflow incontinence, which occurs when small amounts of urine leak from a full bladder
• total incontinence, or a constant dripping of urine day and night
• psychological incontinence, which has an emotional rather than a physical cause
• mixed incontinence, which is a mixture of the causes listed

What is going on in the body?

Urinary incontinence can occur at any age. The kidneys constantly produce urine. Urine flows through two long tubes, or ureters, to the bladder, where urine is stored. A muscle at the bottom of the bladder stays contracted, or tightened, so urine remains in the bladder until it is full. When the decision is made to urinate, the muscle relaxes and urine flows out. The entire process is complex. The ability to control urination can be disrupted in different ways, resulting in urinary incontinence.

What are the signs and symptoms of the condition?

• uncontrolled leakage of urine
• urine leakage after coughing, laughing, or sneezing
• bedwetting

What are the causes and risks of the condition?

Urinary incontinence can occur at any age. Women are twice as likely as men to be affected. The cause of this condition is different among different age groups.

• urinary tract infection
• stones in the bladder
• emotional disturbances
• side effects of medications
• weakened bladder muscles
• excessive caffeine or alcohol intake
• nerve damage to the bladder
• severe constipation
• overactivity of the bladder
• in women, lack of the primary female hormone known as estrogen
• weakening of the tissues around the bladder and urethra from childbirth or surgery
• enlargement of the prostate or benign prostatic hyperplasia

What can be done to prevent the condition?

• Exercising the muscles of the pelvic floor can help. To find these muscles, a person can simply stop the flow of urine while urinating. This exercise should be practiced several times a day to strengthen the muscles.
• Drinking one or two glasses of cranberry juice each day will help prevent infection.
• Drinking at least eight glasses of water each day will keep the urine dilute.

How is the condition diagnosed?

People often live with incontinence without seeking help. Many cases can be cured or controlled if the treatment is started early. Most cases of urinary incontinence are diagnosed primarily by the pattern of symptoms.

A case of urge incontinence that starts suddenly is most likely a bladder infection. Usually the healthcare professional strongly suspects this diagnosis after listening to the history and performing a physical exam. Appearance of bacteria and white blood cells in the urine confirms the presence of infection.

Stress incontinence, likewise, has a typical history, a gradually increasing problem with leakage of urine when laughing, coughing, sneezing, or running. Usually these symptoms occur in women who have had pelvic surgery or have borne children. The diagnosis can be confirmed with tests that measure the function of the bladder and urethra.

The other types of incontinence can usually be diagnosed from the pattern of symptoms and associated conditions.

What are the long-term effects of the condition?

Urinary incontinence is the second leading cause of institutionalizing elderly people. The problem contributes to the development of pressure sores, bladder and kidney infections, and depression. Depression is a common long-term effect.

Incontinence disrupts the normal activities of daily living. Without correct diagnosis and treatment, the problem will worsen and will be even more difficult to treat. Urinary incontinence is also embarrassing and frustrating.

What are the treatments for the condition?

Treatment depends on the type of incontinence. A healthcare professional can outline the available options to the individual. The best treatment needs careful analysis of the problem in each person. Newer treatments involve electrical stimulation of the muscles that close the bladder. Women with severe stress incontinence may need surgery to repair and strengthen the tissues around the bladder.

Sometimes, treatment consists of simple steps to regain bladder control. These steps include:

• avoiding alcohol and drinks containing caffeine such as coffee and sodas
• drinking lots of water to keep urine dilute
• urinating frequently to keep the bladder as empty as possible
• refraining from taking any medications that may irritate the bladder

What are the side effects of the treatments?

The side effects of treatment depend on the type of incontinence that is diagnosed and the method used to treat it. Surgery can be complicated by bleeding, infection, or reactions to anesthesia. It is important to check with a healthcare professional before stopping any medication.

How is the condition monitored?

Follow up is important in any treatment to make sure progress is being made.