Urinary incontinence (UI) is loss of bladder control. It is common, ranges from a minor nuisance to something that disrupts daily life — and it can get better with the right treatment.
Types
| Type | What happens | Causes and notes |
|---|---|---|
| Stress | pressure on the bladder — coughing, sneezing, laughing, lifting, exercise — makes you leak | weak pelvic floor muscles; a bladder out of position |
| Urge | a sudden strong need to urinate, and you leak before reaching the toilet | often an overactive bladder; most common in older people; can signal a UTI or occur with neurological conditions such as multiple sclerosis and spinal cord injury |
| Overflow | the bladder doesn't empty fully, overfills and leaks | most common in men; tumors, kidney stones, diabetes, some medicines |
| Functional | a physical or mental disability, trouble speaking or another problem keeps you from the toilet in time | e.g., arthritis making buttons hard, or Alzheimer's disease |
| Mixed | more than one type | usually stress plus urge |
| Transient | a temporary cause, such as an infection or new medicine | goes away when the cause does |
| Bedwetting | leaking during sleep | most common in children |
Bedwetting is normal for many children, more common in boys, and often not a health problem, especially if it runs in the family. If it still happens often at 5 and older, it may be a bladder control problem — from slow development, illness, making too much urine at night, or several causes. In adults, causes include some medicines, caffeine, alcohol, diabetes insipidus, UTIs, kidney stones, an enlarged prostate and sleep apnea.
Who is at risk
Adults are at higher risk if they:
- are female, especially after pregnancy, childbirth or menopause;
- are older — urinary tract muscles weaken with age;
- are men with prostate problems;
- have diabetes, obesity or long-lasting constipation;
- smoke;
- have a birth defect of the urinary tract.
In children, bedwetting is more common in younger children, boys, and children whose parents wet the bed.
Diagnosis
- a medical history — you may be asked to keep a bladder diary for a few days: how much and when you drink, when and how much you urinate, and any leaks;
- a physical exam, possibly a rectal exam, and for women a pelvic exam;
- urine and/or blood tests;
- bladder function tests;
- imaging.
Treatment
It depends on the type and cause, and may combine approaches. Self-care usually comes first:
- Lifestyle: drink the right amount at the right times, stay active, keep a healthy weight, avoid constipation, don't smoke.
- Bladder training: urinate on a schedule built from your diary, then gradually lengthen the time between trips, stretching the bladder to hold more.
- Pelvic floor exercises (Kegels): tighten and relax the muscles that control urine flow.
If those aren't enough:
| Option | How it helps |
|---|---|
| Medicines | relax the bladder to prevent spasms; block nerve signals behind frequency and urgency; in men, shrink the prostate and improve flow |
| Devices | a catheter to drain urine (a few times a day or continuously); for women, a ring or tampon-like insert that presses against the urethra to reduce leaks |
| Bulking agents | injected into the bladder neck and urethra to thicken them and help close the opening |
| Electrical nerve stimulation | changes the bladder's reflexes with electrical pulses |
| Surgery | supports the bladder in its normal position, sometimes with a sling attached to the pubic bone |
Sources
Based on "Urinary Incontinence," MedlinePlus, U.S. National Library of Medicine, drawing on the NIH National Institute of Diabetes and Digestive and Kidney Diseases; a work of the United States government in the public domain.
ライセンス： CC0 1.0（パブリックドメイン） · 出典 medlineplus.gov
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