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urinary incontinence

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Female pelvic organs

Male urinary system

Kidneys and ureters

Male genitourinary system

Urinary incontinence is the uncontrollable loss of urine. The six main types of urinary incontinence are:
  • urge incontinence, which is an urgent need to urinate followed by urine leakage
  • stress incontinence, which is the leakage of urine when laughing, coughing, sneezing, or lifting heavy objects
  • overflow incontinence, which occurs when small amounts of urine leak from a full bladder
  • total incontinence, or a constant dripping of urine day and night
  • psychological incontinence, which has an emotional rather than a physical cause
  • mixed incontinence, which is a mixture of the causes listed
What is going on in the body? 
Urinary incontinence can occur at any age. The kidneys constantly produce urine. Urine flows through two long tubes, or ureters, to the bladder, where urine is stored. A muscle at the bottom of the bladder stays contracted, or tightened, so urine remains in the bladder until it is full. When the decision is made to urinate, the muscle relaxes and urine flows out. The entire process is complex. The ability to control urination can be disrupted in different ways, resulting in urinary incontinence.

What are the signs and symptoms of the condition? 
The symptoms of urinary incontinence include:
  • uncontrolled leakage of urine
  • urine leakage after coughing, laughing, or sneezing
  • bedwetting
What are the causes and risks of the condition? 
Urinary incontinence can occur at any age. Women are twice as likely as men to be affected. The cause of this condition is different among different age groups. There are many possible causes of urinary incontinence. These include:
  • urinary tract infection
  • stones in the bladder
  • emotional disturbances
  • side effects of medications
  • weakened bladder muscles
  • excessive caffeine or alcohol intake
  • nerve damage to the bladder
  • severe constipation
  • overactivity of the bladder
  • in women, lack of the main female hormone known as oestrogen
  • changes in the body from childbirth or surgery
  • enlargement of the prostate or benign prostatic hyperplasia
What can be done to prevent the condition? 
There are ways to prevent urinary incontinence:
  • Exercising the muscles of the pelvic floor can help. Physiotherapists can help you with these exercises. These exercises should be practiced several times a day to strengthen the muscles.
  • Drinking one or two glasses of cranberry juice each day may help prevent infection.
  • Drinking eight glasses of water each day will keep the urine dilute.
How is the condition diagnosed? 
People often live with incontinence without seeking help. Many cases can be cured or controlled if the treatment is started early.

The condition is diagnosed mainly on the pattern of symptoms. Different types of urinary incontinence are diagnosed if symptoms started recently and suddenly, or if they developed over a period of time. If symptoms started suddenly, the cause is most likely a bladder problem. The most common bladder problem is infection. Usually the cause can be discovered by a doctor by taking a thorough history of the problem and performing a physical examination. A test of the urine, called a urine culture, must be done to check for infection.

Sometimes special tests during urination may be required.

What are the long-term effects of the condition? 
Urinary incontinence is the second leading cause of institutionalising elderly people. The problem contributes to the development of pressure sores, bladder and kidney infections, and depression. Depression is a common long-term effect. The condition disrupts the normal activities of daily living. Without correct diagnosis and treatment, the problem will worsen and will be even more difficult to treat. Urinary incontinence is also embarrassing and frustrating.

What are the treatments for the condition? 
Treatment depends, in part, on the problem. A doctor can discuss the available treatments. The best treatment needs careful analysis of the problem in each person. Sometimes surgical procedures are required with stress incontinence. Treatment often involves simple steps to regain bladder control. These steps include:
  • avoiding alcohol and drinks containing caffeine such as coffee and soft drinks
  • drinking lots of water to keep urine dilute
  • urinating frequently to keep the bladder as empty as possible
  • refraining from taking any medications that may irritate the bladder
What are the side effects of the treatments? 
The side effects of treatment depend on the type of incontinence that is diagnosed and the method used to treat it. It is important to check with a doctor before stopping any medication.

How is the condition monitored? 
Follow up is important in any treatment to make sure progress is being made.

Author: Dr. Karen Wolfe, MBBS, MA
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 26/10/2004
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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