Urinary Incontinence

Urinary incontinence (UI) - urinary leakage - is much more common in women than in men. There are different causes and types of UI, and the treatment depends on the type.
What should I do if I have urinary incontinence?
Usually there is a problem with the muscles or nerves involved with voiding the bladder. UI is more common in women because pregnancy, childbirth and menopause sometimes weaken pelvic floor muscles and other pelvic tissues that support the bladder and normally prevent urinary leakage. Problems from pregnancy and childbirth are due to the stress that has been placed on the pelvic floor muscles; the loss of estrogen associated with menopause may weaken urinary tissues as well.
Other causes of urinary incontinence:
  • medications such as diuretics which are used to treat heart problems and high blood pressure
  • chronic constipation, which can cause stress to pelvic floor muscles
  • diet, especially if it includes a lot of caffeine and/or alcohol
  • nerve damage caused by trauma or disease
  • polyps or growths, which are often accompanied by blood in your urine
  • being overweight, which can put too much pressure on the bladder
  • urinary tract infections, which should be a temporary problem
There are different reasons that you may have urinary leakage, and these lead to different types:
  • urge incontinence, in which there is a sudden urge to urinate, often brought on by behavioral triggers such as being cold or turning on a faucet
  • stress incontinence, in which added stress to the abdominal muscles (often brought on by sneezing or laughing) causes leakage
  • functional incontinence, which has more to do with having problems remembering to go to the toilet, such as happens in people with Alzheimer's disease
  • temporary incontinence brought on by a condition or illness, such as a urinary infection or pregnancy, which should go away once the infection or condition has passed.
Your type of urinary incontinence could be a combination of any of these.
You should tell your doctor if you think you have UI. Although the condition can be embarrassing, there are multiple ways your doctor may be able to help you. Your doctor will have some questions about your diet and medication, and the circumstances that bring on the incontinence, in order to establish the reason for your problem. 
The next step is a physical exam to determine how well your bladder is working and how much fluid it holds. These tests may include:
  • urinalysis to look for indications of problems such as infection in your urine
  • ultrasound imaging to look at your urinary system
  • bladder stress test to see how easily the leakage occurs
  • cytoscopy, in which your doctor feeds a thin tube with a camera through your urethra into your bladder to look for problems there
There are many treatments to try for urinary incontinence, partly depending on what the cause is. These include:
  • behavior modification, in which you train your body to urinate at set intervals and thus reduce your urges at other times
  • physical exercises to increase the strength of pelvic floor muscles
  • weight loss and/or dietary changes
  • medication
  • medical devices which help support your urethra
  • surgery
Your doctor will help you determine which treatment or combination of treatments will work best for you.
For more information 
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