Stress Incontinence

This results when certain activities lead to increased pressure on the bladder. Triggers may be laughing, sneezing, lifting heavy objects , or exercise. This is the most common type of incontinence. It may be caused by:

• Weakening of the muscles that suspend the bladder
• Weakening of muscles that control urine flow
• Obesity

Muscles Involved in Incontinence in Women

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Urge Incontinence

Urge incontinence is a loss of bladder control following a strong urge to urinate. The person is not able to hold urine long enough to make it to a restroom. This is also known as overactive bladder. It may be caused or worsened by:

• Urinary tract infection
• Diabetes type 1 and 2
• Bladder irritation (stone, tumor)
• Drugs (eg, hypnotics, diuretics)
• Caffeine
• Alcohol
• Nerve damage due to:
  • Spinal cord injury
  • Stroke
  • Multiple sclerosis
  • Parkinson's disease
• Constipation

Overflow Incontinence

This occurs when the bladder will not empty. Urine builds up, and this causes an overflow and leaking of urine. It may be caused by:

• A bladder that is blocked, such as by a scar in the urethra (stricture)
• Fecal impaction
• Drugs (eg, antidepressants, hypnotics, antipsychotics, antihistamines, calcium channel blockers)
• Vitamin B12 deficiency
• Weak bladder muscles
• Nerve damage due to:
  • Surgery
  • Diabetes
  • Spinal cord injuries
  • Other factors

Functional Incontinence

This occurs when there is normal bladder control, but an inability to reach the toilet in time. An example would be severe arthritis . Drugs that cause confusion or sedation can also cause functional incontinence.

Behavioral Therapy

Behavioral therapy includes:

• Making muscles stronger by doing Kegel exercises
  • This strengthens the muscles that hold the bladder in place and those that control urine flow.
  • Painless electrical stimulation is sometimes used to strengthen the muscles more quickly and is helpful for stress incontinence.
• Bladder training
  • This can be done by setting a regular, timed schedule for emptying your bladder and by drinking fewer liquids.

Weight Loss

If you are a woman who is overweight or obese, losing weight may help to reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a weight loss program that is right for you.

Medication

Medicines may be prescribed to relax the bladder muscles.

Nerve Stimulation

Nerve stimulation is effective for urge urinary incontinence. It can be done by stimulating a nerve in your ankle. Or, it can be done by implanting a device that stimulates the bladder nerves.

Surgery

In women, surgery can repair weakened muscles related to bladder function. Other procedures involve collagen injections into the urethra. The bladder sphincter can be repaired or implants can be inserted.

Devices

Absorbent diapers are often used with incontinence.

Plugs and patches that hold urine in place are available for women. Catheters are sometimes used to treat more severe cases. Alternatively, pessaries may be used in women. Pessaries are devices that raise the uterus or the prolapsed bladder. This decreases pressure on the bladder.