Urinary incontinence FAQs
What is urinary incontinence and what causes it?
Urinary incontinence is the involuntary, or unintentional, passing of urine. There are many causes of urinary incontinence including infection, medication, weak bladder muscles, a blockage caused by an enlarged prostate, complications from surgery or chronic diseases such as diabetes, multiple sclerosis (MS) and Parkinson's disease. Other diseases that affect the bladder nerves or spinal cord could also cause urinary incontinence.
Who gets urinary incontinence?
Both women and men can have trouble with bladder control from neurological (nerve) injury, birth defects, strokes, multiple sclerosis and physical problems associated with ageing. Older women have more bladder control problems than younger women do. Loss of bladder control in women most often happens because of problems with the muscles that help to hold or release urine and can be made worse by menopause.
What are the different types of urinary incontinence?
Stress incontinence: Leaking small amounts of urine during physical movement (such as coughing, sneezing and exercising). Stress incontinence is the most common form of incontinence in women. It is treatable.
Urge incontinence or overactive bladder: An uncontrollable urge to urinate or leaking large amounts of urine at unexpected times including during sleep, after drinking a small amount of water, or when you touch water or hear it running.
Functional incontinence: Not being able to reach a toilet in time because of physical disability, obstacles or problems in thinking or communicating. For example, a person with Alzheimer’s disease may not think well enough to plan a trip to the toilet in time to urinate or a person in a wheelchair may be unable to get to a toilet in time due to impaired mobility or poor access.
Overflow incontinence: Leaking small amounts of urine the bladder hasn’t emptied completely. This could be due to nerve damage or an obstruction.
Mixed incontinence: A combination of incontinence, most often when stress and urge incontinence occur together.
Transient incontinence: Leaking urine on a temporary basis due to a medical condition or infection that will go away once the condition or infection is treated. It can be triggered by medication, a urinary tract infection, mental impairment, restricted mobility and stool impaction (severe constipation).
How are the different types of incontinence diagnosed?
To diagnose urinary incontinence, your healthcare professional will first ask you about your symptoms, your medical history and do a physical examination. You will also be asked about your bladder habits: how often you empty your bladder, how and when you leak urine, or when you have accidents, for example.
Next you may be asked to drink plenty of fluids so a test may be done to work out how much your bladder can hold and how well your bladder muscles function. Other tests include:
- Stress test: You relax, then cough hard as the healthcare professional watches for loss of urine. This should be done in an upright position.
- Urinalysis: You give a urine sample that is then tested for signs of infection or other causes of incontinence.
- Blood tests: You give a blood sample, which is sent to a laboratory to assess kidney function and to investigate possible problems that may cause incontinence.
- Ultrasound: Sound waves are used to take a picture of the kidneys, bladder and urethra, so any problems in these areas that could cause incontinence can be seen. Also residual urine can be estimated in a poorly emptying bladder.
- Cystoscopy: A thin tube with a tiny camera is placed inside the urethra to view the inside of the urethra and bladder to look for abnormalities.
- Urodynamics: Pressure in the bladder and the flow of urine are measured using a special technique.