Urinary Incontinence

Is this your symptom?

  • Passing urine when you don’t mean to, such as when you cough, sneeze or laugh
  • Sudden urgent need to pass urine and you empty your bladder before you get to the toilet
  • New onset of wetting the bed
  • Dribbling urine after you think you have finished emptying your bladder

Causes of Incontinence

  • Stress Incontinence is the most common type in women. It sometimes occurs in men after surgery or radiation therapy for prostate cancer. It occurs when pressure builds in the bladder and the bladder outlet cannot hold the urine back. If the muscles that support the bladder are weak, some movements put extra pressure on the bladder and urine can accidentally leak. It may happen when you cough, laugh, sneeze, jump or run. This gets more common with age. It can also happen in women who have had children or are obese.
  • Urge Incontinence is also called overactive bladder. Urine is passed when the bladder muscle contracts. With urge incontinence, the bladder muscle contracts too early and bladder control is lost or reduced. It can be caused by damage to the nerves that control bladder function, such as in Multiple Sclerosis, Parkinson’s disease, spinal cord problems or after a stroke.
  • Mixed Incontinence. Some people have a mixture of urge and stress incontinence.
  • Overflow Incontinence occurs when the bladder outlet (the part where urine leaves the bladder) is blocked by something. The bladder muscle has to work hard to push the urine out. If the bladder can’t be emptied properly, urine may leak out past the blockage. An enlarged prostate in men is a common cause of overflow incontinence. It can be treated with surgery to remove the prostate or with medicines to shrink the prostate. Other surgery options can lift the prostate out of the way.
  • Bed Wetting. New onset of bed wetting can be caused by a urinary infection or other causes, such as overflow incontinence. Seek the advice of your doctor.
  • Functional Incontinence is the term used when no cause is found for the loss of bladder control. Incontinence may be from poor mobility and you cannot get to the toilet on time.
  • Other Types of Incontinence. Congenital problems may affect the urinary system. Injury from accident or surgery can also be a cause of incontinence.
  • Urinary Tract Infections(bladder or kidney) can be diagnosed by checking a urine sample. Symptoms are pain in the lower part of the abdomen (tummy), pain or burning feeling when you pass urine, needing to pass urine more often than usual, or a feeling you need to pass urine urgently. The urine can look cloudy or have blood in it. Some women get urinary infections more often after menopause.
  • Interstitial Cystitis / Painful Bladder Syndrome. There is recurrent or constant pain in the bladder area which gets worse as the bladder fills. There is also frequency of passing urine and a need to get up to urinate during the night. The cause is unknown. Infections need to be ruled out first before the diagnosis can be made.
  • Diabetes. If diabetes is not well controlled, high sugar levels in the blood may make you pass urine more frequently. It is important to see your doctor to get your blood and urine tested. Urinary infection is also more common with diabetes.
  • Bladder Cancer. Symptoms include blood in the urine, but it is not usually painful to pass urine. In most cases, the cancer only affects the lining of the bladder and can be removed. If treated early, this may cure the cancer completely. Do not ignore bladder symptoms. Seek care from your doctor. Bladder cancer could be the reason for an obstruction of the bladder outlet and cause overflow incontinence.
  • Medication. Some meds can cause urinary symptoms. Diuretics and lithium can make you pass urine more frequently or make you feel you need to pass more urgently. You may be lose bladder control at times.

When to Call for Urinary Incontinence

When to Call for Urinary Incontinence

Call 911 Now

  • Not moving or too weak to stand
  • Seizure
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Fever or chills are present
  • Stomach, side or back pain
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You think you might have an STI (sexually transmitted infection)
  • Blood in urine
  • You have diabetes
  • Pain when passing urine
  • Very thirsty
  • Taking a new medication
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You are pregnant
  • Bladder control problems started after having a baby
  • You are limiting your activities due to loss of bladder control
  • You are constipated, or often have constipation
  • You have ongoing symptoms
  • Your symptoms are getting worse
  • You have other questions or concerns

Self Care at Home

  • You drink a lot of caffeine, alcohol or sodas and can start drinking less of them

Call 911 Now

  • Not moving or too weak to stand
  • Seizure
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Fever or chills are present
  • Stomach, side or back pain
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You think you might have an STI (sexually transmitted infection)
  • Blood in urine
  • You have diabetes
  • Pain when passing urine
  • Very thirsty
  • Taking a new medication
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You are pregnant
  • Bladder control problems started after having a baby
  • You are limiting your activities due to loss of bladder control
  • You are constipated, or often have constipation
  • You have ongoing symptoms
  • Your symptoms are getting worse
  • You have other questions or concerns

Self Care at Home

  • You drink a lot of caffeine, alcohol or sodas and can start drinking less of them

Care Advice for Blood in the Urine

  1. What You Should Know:
    • Urinary incontinence is when you pass urine when you don’t mean to.
    • It is a common problem and affects women more than men. About 20% of women age 40 or older have some urinary incontinence.
    • Incontinence can occur in men who have had treatment for cancer of the prostate, including surgery to remove the prostate or radiation therapy.
    • There are many types of incontinence (see Causes section). The most common are:
      • Stress Incontinence: you pass urine when you, cough, laugh or strain for some reason, and
      • Urge Incontinence: you feel an urgent need to pass urine and may not make it to the toilet before your bladder empties.
    • It is often treatable, so do not be embarrassed about talking with your doctor.
    • It can be a hygiene problem if it happens often.
    • Here is some care advice that should help.
  2. Changing How Much You Drink:
    • If you drink a lot of fluids, you will make and pass more urine. Cutting back on fluids too much can lead to dehydration. It can also irritate the bladder and make urge incontinence worse. Drink enough to quench your thirst.
    • If you feel you need to drink large amounts, it could be that you have undetected diabetes so see your doctor to get your blood and urine checked.
  3. Change What You Drink:
    • Avoid or reduce how much caffeine you drink (tea, coffee, hot chocolate and colas). These can make urge incontinence worse.
  4. Change When You Drink:
    • It may help to drink less, or not drink, just before you travel or go somewhere that toilets may be limited.
    • Drinking late at night may mean you will need to pass urine during the night.
  5. Weight Loss
    • If you are overweight, losing weight can improve urinary incontinence.
  6. Avoid Constipation
    • Long-term constipation can keep the bladder from emptying properly. It may cause overflow incontinence.
    • If constipation is a problem, eat a balanced diet and drink enough fluids to avoid getting dehydrated.
  7. Bladder Training and Pelvic Exercises
    • Your doctor will help you rule out treatable causes of incontinence, such as infection or diabetes.
    • He/she can also advise you about exercises to strengthen the muscles that support your bladder. Bladder training exercises can help your bladder get used to holding more urine.
    • These take time to work and are worth the effort before trying other types of treatment, such as surgery.
  8. Incontinence Products
    • There are many types of pads, pants and other products you can purchase to help with bladder leaks. These can help you carry out your usual work or activities without fear of embarrassment.
  9. Hygiene
    • Urine is sterile, but once outside the body bacteria can grow in it. This can cause infection or a bad smell.
    • Change wet pads and clothing often to avoid infection and damage to the skin.
    • Bathe or shower regularly to keep your skin clean.
  10. Call Your Doctor If:
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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