Urinary Incontinence, Female (Adult)

Types of incontinence

There are different types of incontinence. The main types are described here. You can have more than 1 type.

• Stress incontinence. With this type, urine leaks when pressure (stress) is put on the bladder. This may happen when you cough, sneeze, laugh, lift something heavy, or exercise. Stress incontinence most often occurs because the pelvic floor muscles that support the bladder and urethra are weak. This can happen after pregnancy and vaginal childbirth or a hysterectomy. It can also be due to excess body weight or hormone changes. Young women active in sports may experience this type of incontinence.

• Urge incontinence (also called overactive bladder). With this type, a sudden urge to urinate is felt and some urine leaks out before you can make it to the toilet. This may happen even though there may not be much urine in the bladder. The need to urinate often during the night is common. Urge incontinence most often occurs because of bladder spasms. This may be due to bladder irritation or urinary tract infection. Damage to bladder nerves or pelvic muscles, constipation, and certain medicines can also lead to urge incontinence. It is most common in older women.

• Mixed incontinence. This type is when a person has both stress and urge incontinence.

• Overflow incontinence. This type occurs when the body makes more urine than the bladder can hold. Or the bladder is full and can't empty, causing urine to leak. This type is rare in women and is more common in men who have prostate problems. A common symptom is frequent urinating in small amounts.

• Functional incontinence. With this type, urine loss is from thinking or physical problems, such as a physical or mental disability, trouble speaking, or communicating your need to go to the toilet. It may be from dementia, stroke, or environmental issues. People with this type may not recognize the need to urinate.

Treatment depends on the cause. Further evaluation is needed to find the type you have. This will likely include an exam and certain tests. Based on the results, you and your doctor can then plan treatment. Until a diagnosis is made, the home care tips below can help ease symptoms.

Home care

• Do pelvic floor muscle exercises, if they are prescribed. Pelvic floor muscles help support the bladder and urethra. Many women find that their symptoms improve when doing special Kegel exercises that make these muscles stronger. To do the exercises, contract the muscles you would use to stop your stream of urine. But do this when you’re not urinating. Hold for 10 seconds, then relax. Repeat 10 to 20 times in a row, at least 3 times a day. Your doctor may give you other instructions for how to do the exercises and how often. Talk to your doctor about using biofeedback methods to improve your ability to perform pelvic muscle exercises.

• Keep a bladder diary. This helps track how much and when you drink liquids, how often and how much you urinate over a set period of time, and whether you leak urine. Bring this diary with you to your next visit with your doctor. The information can help your doctor learn more about your bladder problem.

• Try bladder training. This means urinating according to a scheduled timetable. Based on information from your bladder diary, your doctor can help you make a schedule. Once you have adjusted to this schedule, you can wait a little longer between your trips to the toilet. Your bladder will gradually regain its strength to hold the urine a bit longer.

• Lose weight, if advised to by your doctor. Extra weight puts pressure on the bladder. Your doctor can help you create a weight-loss plan that’s right for you. This may include exercising more and making certain diet changes.

• Don't have foods and drinks that may irritate the bladder. These can include spicy foods, carbonated drinks, citrus fruits and juices, alcohol, and caffeinated drinks.

• Quit smoking. Smoking and other tobacco use can lead to a long-term (chronic) cough that strains the pelvic floor muscles. Smoking may also damage the bladder and urethra. Talk with your doctor about treatments or methods you can use to quit smoking.

• If drinking large amounts of fluid makes you have symptoms, you may be advised to limit your fluid intake. You may also be advised to drink most of your fluids during the day and to limit fluids at night.

• If you’re worried about urine leakage or accidents, you may wear absorbent pads to catch urine. Change the pads often. This helps reduce discomfort. It may also reduce the risk of skin or bladder infections.

• Limit how much fluid you have about 2 to 3 hours before you go to bed.

• If you have diabetes, keep your blood sugar under control.

• Keep your bowel movements regular to prevent constipation. Try increasing fiber in your diet.

Follow-up care

Follow up with your doctor as directed. It may take some time to find the right treatment for your problem. But healthy lifestyle changes can be made right away. These include such things as exercising on a regular basis, eating a healthy diet, losing weight (if needed), and quitting smoking. Your treatment plan may include special therapies or medicines. Certain procedures or surgery may also be choices. Talk about any questions you have with your doctor.

When to contact your doctor

Contact your doctor right away if:

• You have a fever of 100.4°F (38°C) or higher, or as directed by your doctor.

• You have bladder pain or fullness.

• Your belly swells.

• You have nausea or vomiting.

• You have back pain.

• You have weakness, dizziness, or fainting.

• Your urine is cloudy or bloody.

• You have pain or burning when you urinate.

• You have trouble starting your urine flow.