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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

TypeWhat happensCauses and notes
Stresspressure on the bladder — coughing, sneezing, laughing, lifting, exercise — makes you leakweak pelvic floor muscles; a bladder out of position
Urgea sudden strong need to urinate, and you leak before reaching the toiletoften 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
Overflowthe bladder doesn't empty fully, overfills and leaksmost common in men; tumors, kidney stones, diabetes, some medicines
Functionala physical or mental disability, trouble speaking or another problem keeps you from the toilet in timee.g., arthritis making buttons hard, or Alzheimer's disease
Mixedmore than one typeusually stress plus urge
Transienta temporary cause, such as an infection or new medicinegoes away when the cause does
Bedwettingleaking during sleepmost 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:

OptionHow it helps
Medicinesrelax the bladder to prevent spasms; block nerve signals behind frequency and urgency; in men, shrink the prostate and improve flow
Devicesa 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 agentsinjected into the bladder neck and urethra to thicken them and help close the opening
Electrical nerve stimulationchanges the bladder's reflexes with electrical pulses
Surgerysupports 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.

LanguagesEnglish

Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov

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