Urinary Incontinence: Types of Bladder Leaks, Common Causes and Care Options

What it involves

MedlinePlus describes urinary incontinence as being unable to keep urine from leaking out of the urethra, the tube that carries urine out of the body. Some people leak only now and then, while others cannot hold any. It names four patterns: stress, urge, overflow, and mixed incontinence.

Who this is for

• Patients who leak urine when they cough, sneeze, laugh, or exercise and want to know their options
• Patients with a sudden strong urge to urinate who sometimes cannot reach the bathroom in time
• Patients who dribble or feel their bladder never fully empties
• Patients who have been working around leaks quietly and are ready to talk about it with a provider

What to expect

• Questions about when leaks happen, how much, how often, and what medicines and drinks you take
• An exam, and a urine sample that can be checked for infection
• A review of conditions that can contribute, such as diabetes, constipation, or an enlarged prostate
• A plan that may include habit changes, bladder training, medicine, or a referral to a urologist or gynecologist

The four types

MedlinePlus separates incontinence by what triggers the leak, which guides the treatment:

• Stress incontinence, leaking with a cough, sneeze, laugh, or exercise
• Urge incontinence, a strong sudden need to go, then a loss before reaching the toilet
• Overflow incontinence, a bladder that does not empty, leading to dribbling
• Mixed incontinence, usually a combination of stress and urge

Causes that may pass

MedlinePlus says incontinence can be sudden and short-lived. Temporary causes include a urinary tract infection or inflammation, prostate infection, constipation with stool impaction, bed rest after surgery, pregnancy, weight gain, mental confusion, and medicines such as diuretics, antidepressants, antihistamines, and some cough and cold remedies. The urinary tract infection page and the constipation guide cover two of the commonest.

Longer-term causes

Causes that tend to last include weakness of the pelvic or urethral muscles, nerve damage from conditions like multiple sclerosis, stroke, or spinal injury, an enlarged prostate in men, pelvic organ prolapse in women, damage after pelvic radiation or surgery, bladder spasms, and diabetes. Blood sugar control can matter, as the diabetes management page explains.

Changes you can try

MedlinePlus lists keeping bowel movements regular with more fiber, quitting smoking to reduce coughing and bladder irritation, avoiding alcohol and caffeine, losing weight if needed, and steering clear of spicy foods, carbonated drinks, and citrus that can irritate the bladder. Absorbent pads or undergarments can help with leaks in the meantime.

Training the bladder

MedlinePlus describes bladder retraining and pelvic floor exercises, commonly called Kegels, as ways to regain control. It notes that many women do the exercises incorrectly even when they think they are right, so a provider can show how, and some people benefit from formal training with a pelvic floor specialist. Related urinary symptoms are explained in the frequent urination guide.

Medicines and procedures

MedlinePlus says medicines can calm bladder spasms, relax the bladder, and improve its function, and that surgery or a catheter may be recommended when other steps fail. It also lists electrical nerve stimulation and bladder injections for urge incontinence. Those procedures are done by specialists, so this practice would refer for them. A urine test is one early step, as the urinalysis guide describes.

Signs that need prompt attention

MedlinePlus says to call 911 or go to an emergency room for a sudden loss of urine control with trouble speaking or walking, sudden weakness or numbness in an arm or leg, loss of vision, confusion or loss of consciousness, or loss of bowel control. Contact a provider for cloudy or bloody urine, pain or burning, fever, trouble starting the stream, or dribbling.

Sources

• MedlinePlus — Urinary incontinence
• MedlinePlus — Urinary Incontinence health topic