Incontinence

If you suspect you have urinary incontinence, you may leak urine from time to time – or you may not be able to hold any urine. Atrium Health Floyd and Harbin Clinic will provide discreet assistance in identifying any underlying diseases and treating your symptoms.

What is urinary incontinence?

Urinary incontinence is the involuntary loss of bladder control. It happens when you’re not able to keep urine from leaking out of your urethra, the tube that carries urine out of your body from your bladder.

Types of urinary incontinence

The three main types of urinary incontinence are:

• Stress incontinence: Occurs during activities like coughing, sneezing, laughing, exercise or movement.
• Urge incontinence: Involves a strong, sudden need to urinate. Then the bladder squeezes and you lose urine. You don’t have enough time after you feel the need to urinate to get to the bathroom before you do urinate.
• Overflow incontinence: Occurs when the bladder cannot empty. This leads to dribbling.

Mixed incontinence occurs when you have more than one type of urinary incontinence.

Causes of urinary incontinence

Causes of or conditions that contribute to urinary incontinence include:

• Blockage in the urinary system
• Brain or nerve problems
• Dementia or other mental health problems that make it hard to feel and respond to the urge to urinate
• Nerve and muscle problems
• Problems with the urinary system

Incontinence may be sudden and go away after a short period of time, or it may continue long-term.

Causes of sudden or temporary incontinence

If you experience sudden or temporary incontinence, it may be caused by:

• Bedrest – for example, when recovering from surgery
• Certain medications such as diuretics, antidepressants, tranquilizers, some cough and cold remedies, and antihistamines
• Mental confusion
• Pregnancy
• Prostate infection or inflammation
• Stool impaction from severe constipation, which puts pressure on the bladder
• Urinary tract infection or inflammation
• Weight gain

Causes of long-term incontinence

Long-term urinary incontinence may be related to other conditions, such as:

• Alzheimer’s disease
• Bladder cancer
• Bladder spasms
• Depression
• Large prostate in men
• Nervous system conditions, such as multiple sclerosis or stroke
• Nerve or muscle damage after radiation treatment to the pelvis
• Problems with the urinary tract
• Spinal cord injuries

Some women may experience pelvic prolapse – the falling or sliding of the bladder, urethra or rectum into the vagina. Pelvic prolapse may be caused by pregnancy and birth.

Symptoms of urinary incontinence

Symptoms of urinary incontinence include:

• Cloudy or bloody urine
• Dribbling
• Fever
• Frequent or urgent need to urinate
• Pain or burning when you urinate
• Trouble starting your urine flow

Diagnosis of urinary incontinence

Your doctor will perform a physical exam and take your medical history. They’ll ask about your symptoms and the medicines you use. They’ll want to know if you’ve been sick recently or had surgery. Your doctor also may order tests, which might include:

• Urine and blood tests
• Tests that measure how well you empty your bladder

In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine. Your family doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.

Treatment for urinary incontinence

If you have symptoms of incontinence, see your Atrium Health Floyd and Harbin Clinic provider for tests and a treatment plan. Which treatment you get depends on what causes your incontinence and what type you have.

There are four main treatment approaches for urinary incontinence: lifestyle changes, bladder training and pelvic floor exercises, medications, and surgery.

Lifestyle changes

Some lifestyle changes may help improve incontinence. You may need to make these changes along with other treatments:

• Avoid alcohol and caffeinated drinks such as coffee, which can stimulate your bladder.
• Avoid foods and drinks that may irritate your bladder. These may include spicy foods, carbonated drinks, and citrus fruits and juices.
• For urine leaks, wear absorbent pads or undergarments.
• Keep your bowel movements regular to avoid constipation, which can contribute to incontinence. Try increasing the fiber in your diet.
• Maintain a healthy weight.
• If you have diabetes, keep your blood sugar under good control.
• Quit smoking to reduce coughing and bladder irritation.

Bladder training and pelvic floor exercises

Bladder training helps you gain better control over your bladder. Kegel exercises can help strengthen the muscles of your pelvic floor. Your health care provider or physical therapist can show you how to do them.

Often, people benefit from formal bladder strengthening and retraining with a pelvic floor physical therapist.

Medications

Depending on the type of incontinence you have, your provider may prescribe one or more medicines. These drugs help prevent muscle spasms, relax the bladder and improve bladder function.

Surgery

If other treatments don’t work or you have severe incontinence, your provider may recommend surgery. The type of surgery you have will depend on:

• The type of incontinence you have (such as urge, stress or overflow)
• How severe your symptoms are
• The cause (such as pelvic prolapse, enlarged prostate, enlarged uterus or other causes)

If you have overflow incontinence or you cannot fully empty your bladder, you may need to use a catheter. You may use a catheter that stays in long term or one that you are taught to put in and take out yourself.