Urinary Incontinence

Urinary incontinence is one of those annoying symptoms of menopause.  Like vaginal dryness, women don’t really want to talk about it–not even to their doctors.  But it is something that should be addressed because it can be a very embarrassing situation if it happens at an inconvenient time. 

Urinary incontinence is the inability to control the release of urine from your bladder. Some people experience occasional, minor leaks — or dribbles — of urine. Others wet their clothes frequently.

Types of urinary incontinence include:

• Stress incontinence. This is loss of urine when you exert pressure — stress — on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Stress incontinence occurs when the sphincter muscle of the bladder is weakened. In women, physical changes resulting from pregnancy, childbirth and menopause can cause stress incontinence. In men, removal of the prostate gland can lead to this type of incontinence.
• Urge incontinence. This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Your bladder muscle contracts and may give you a warning of only a few seconds to a minute to reach a toilet. With urge incontinence, you may need to urinate often, including throughout the night. Urge incontinence may be caused by urinary tract infections, bladder irritants, bowel problems, Parkinson’s disease, Alzheimer’s disease, stroke, injury or nervous system damage associated with multiple sclerosis. If there’s no known cause, urge incontinence is also called overactive bladder.
• Overflow incontinence. If you frequently or constantly dribble urine, you may have overflow incontinence, which is an inability to empty your bladder. Sometimes you may feel as if you never completely empty your bladder. When you try to urinate, you may produce only a weak stream of urine. This type of incontinence may occur in people with a damaged bladder, blocked urethra or nerve damage from diabetes and in men with prostate gland problems.
• Mixed incontinence. If you experience symptoms of more than one type of urinary incontinence, such as stress incontinence and urge incontinence, you have mixed incontinence.
• Functional incontinence. Many older adults, especially people in nursing homes, experience incontinence simply because a physical or mental impairment keeps them from making it to the toilet in time. For example, a person with severe arthritis may not be able to unbutton his or her pants quickly enough. This is called functional incontinence.
• Gross total incontinence. This term is sometimes used to describe continuous leaking of urine, day and night, or the periodic uncontrollable leaking of large volumes of urine. In such cases, the bladder has no storage capacity. Some people have this type of incontinence because they were born with an anatomical defect. This type of incontinence can be caused by injuries to the spinal cord or urinary system or by an abnormal opening (fistula) between the bladder and an adjacent structure, such as the vagina.

When to see a doctor
You may feel uncomfortable discussing incontinence with your doctor. But if incontinence is frequent or is affecting your quality of life, seeking medical advice is important for several reasons:

• Urinary incontinence may indicate a more serious underlying condition, especially if it’s associated with blood in your urine.
• Urinary incontinence may be causing you to restrict your activities and limit your social interactions to avoid embarrassment.
• Urinary incontinence may increase the risk of falls in older adults as they rush to make it to the toilet.

***Part of this article is courtesy of the Mayo Clinic website.***