R. Wayne Whitted MD, MPH

Paul A. Pietro MD

Marina Santana MMS, PA

8740 N Kendall Dr. Suite 101

Miami, Florida 33176

Phone: 305-596-3744

Urinary Incontinence: Embarrasing but Treatable

What is urinary incontinence?

Urinary incontinence means that you can't always control when you urinate. As a result, you wet your clothes. This

can be embarrassing, but it can be treated.

About 12 million adults in the United States have urinary incontinence. It's most common in women over 50 years

old. But it can also affect younger people, especially women who have just given birth.

Be sure to talk to your doctor if you have this problem. If you hide your incontinence, you risk getting rashes, sores,

and skin and urinary tract infections. Also, you may find yourself avoiding friends and family because of fear and

embarrassment.

What causes incontinence?

Urinary incontinence can be caused by many different medical problems, including weak pelvic muscles or

diabetes. See the box below for a list of common causes.

Causes of urinary incontinence

• For women, thinning and drying of the skin in the vagina or urethra, especially after menopause

• For men, enlarged prostate gland or prostate surgery

• Weakened pelvic muscles

• Certain medicines

• Build-up of stool in the bowels

• Not being able to move around

• Urinary tract infection

• Problems such as diabetes or high calcium levels

Are there different types of incontinence?

Yes. There are 4 types of urinary incontinence. A brief explanation of each follows.

Stress incontinence

Stress incontinence is when urine leaks because of sudden pressure on your lower stomach muscles, such as

when you cough, laugh, lift something or exercise. Stress incontinence usually occurs when the pelvic muscles are

The Association of Minimally Invasive Gynecologic Surgeons

…dedicated to safe, state-of-the-art surgery and health life-styles for women of all ages

weakened, for example by childbirth or surgery. Stress incontinence is common in women.

Urge incontinence

This occurs when the need to urinate comes on too fast -- before you can get to a toilet. Your body may only give

you a warning of a few seconds to minutes before you urinate. Urge incontinence is most common in the elderly

and may be a sign of an infection in the kidneys or bladder.

Overflow incontinence

This type of incontinence is a constant dripping of urine. It's caused by an overfilled bladder. You may feel like you

can't empty your bladder all the way and you may strain when urinating. This often occurs in men and can be

caused by something blocking the urinary flow, such as an enlarged prostate gland or tumor. Diabetes or certain

medicines may also cause the problem.

Functional incontinence

This type occurs when you have normal urine control but have trouble getting to the bathroom in time. You may not

be able to get to the bathroom because of arthritis or other diseases that make it hard to move around.

Is urinary incontinence just part of growing older?

No. But changes with age can reduce how much urine your bladder can hold. Aging can make your stream of urine

weaker and can cause you to feel the urge to urinate more often. This doesn't mean you'll have urinary

incontinence just because you're aging. With treatment it can be controlled or cured.

How can it be treated?

Treatment depends on what's causing the problem and what type of incontinence you have. If your urinary

incontinence is caused by a medical problem, the incontinence will go away when the problem is treated. Kegel

exercises and bladder training help some types of incontinence. Medicine and surgery are other options.

What are Kegel exercises?

Stress incontinence can be treated with special exercises, called Kegel exercises (see the box below). These

exercises help strengthen the muscles that control the bladder. They can be done anywhere, any time. Although

designed for women, the Kegel exercises can also help men. It may take 3 to 6 months to see an improvement.

Kegel exercises

•

To locate the right muscles, try stopping or slowing your urine flow without using your stomach, leg

or buttock muscles. When you're able to slow or stop the stream of urine, you've located the right

muscles.

• Squeeze your muscles. Hold for a count of 10. Relax for a count of 10.

• Do this 20 times, 3 to 4 times a day.

• You may need to start slower, perhaps squeezing and relaxing your muscles for 4 seconds each

and doing this 10 times, 3 or 4 times a day. Work your way up from there.

What is bladder training?

Some people with urge incontinence can learn to lengthen the time between urges to go to the bathroom. You start

by urinating at set intervals, such as every 30 minutes to 2 hours--whether you feel the need to go or not. Then

gradually lengthen the time between when you urinate--say by 30 minutes--

until you're urinating every 3 to 4 hours.

You can practice relaxation techniques when you feel the urge to urinate before you

r time is up. Breathe slowly and

deeply. Think about your breathing until the urge goes away. You can also do Kegel exercises if they help control

your urge.

After the urge passes, wait 5 minutes and then go to the bathroom even if you don't feel you need

to go. If you don't

go, you might not be able to control your next urge. When it's easy to wait 5 minutes after an urge, begin waiting 10

minutes. Bladder training may take 3 to 12 weeks.

Will medicine or surgery help?

Medicine helps some types of urinary incontinence. For example, estrogen cream to put in the vagina can be

helpful for some women who have mild stress incontinence. A medicine called oxybutynin (brand name: Ditropan)

can be used for urge incontinence and too-frequent urination.

Surgery can be helpful. It is usually done if other things haven't worked or if the incontinence is severe.

Other Organizations

National Kidney and Urologic Diseases Information Clearinghouse

http://kidney.niddk.nih.gov/index.htm

3 Information Way

Bethesda, MD 20892-3580

Simon Foundation for Continence

http://www.simonfoundation.org/html/

P.O. Box 835

Wilmette, IL 60091

800-237-4666

National Association for Continence

http://www.nafc.org/

P.O. Box 1019

Charleston, SC 29402 -1019

800-BLADDER