What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of urine control, or the inability to hold your urine until you can reach a restroom. More than 15 million men and women in the United States experience incontinence. UI can strike at any age. Women over age 50 are the most likely to develop UI. Urinary incontinence may be a temporary condition, resulting from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.
 

What causes urinary incontinence?

Incontinence is not an inevitable result of aging, but is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications, and/or the onset of an illness. Sometimes, it is the first and only symptom of a urinary tract infection.

What are some of the different types of urinary incontinence?

The following are some of the different types of urinary incontinence:

• urge incontinence-the inability to hold urine long enough to reach a restroom. It is often found in people who have conditions such as diabetes, stroke, dementia, Parkinson's disease, and multiple sclerosis, but may be an indication of other diseases or conditions that would also warrant medical attention.

• stress incontinence-the most common type of incontinence that involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.
• functional incontinence-leakage due to a difficulty reaching a restroom in time because of physical conditions such as arthritis.

• overflow incontinence-leakage that occurs when the quantity of urine produced exceeds the bladder's capacity to hold it.

What are the symptoms of urinary incontinence?

The following are the most common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:

• inability to urinate

• pain related to filling the bladder and/or pain related to urination without a proven bladder infection

• progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying

• an increased rate of urination without a proven bladder infection

• needing to rush to the restroom and/or losing urine if you do not get to restroom in time

• abnormal urination or changes in urination related to a nervous system
 

• leakage of urine that prevents activities

• leakage of urine that began or continued after surgery

• leakage of urine that causes embarrassment

• frequent bladder infections

The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
 

How is urinary incontinence diagnosed?

For people with urinary incontinence, it is important to consult a physician for a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. In many cases, patients will then be referred to a urologist, a physician who specializes in diseases of the urinary tract.
Treatment for urinary incontinence:

Specific treatment for urinary incontinence will be determined by your physician based on:

• your age, overall health, and medical history
 

• extent of the disease

• your tolerance for specific medications, procedures, or therapies
 

• expectations for the course of the disease

• your opinion or preference

Treatment may include:

• certain behavioral techniques (including pelvic muscle exercises, biofeedback, and bladder training)

• medications

• surgery (if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage) 

• diet modifications (including eliminating caffeine in coffee, soda, and tea, and/or eliminating alcohol)

Surgical procedures performed at Eastern Long Island Hospital for incontinence include sacral nerve stimulation where a small device is implanted under the skin.  Often referred to as a pacemaker for the bladder, the patient’s incontinence is managed through regular nerve stimulation. This Interstim Sacral Nerve stimulator is for overactive bladder patients who fail all medications and has an 80% success rate.  The new “miniArc sling” which allows for even quicker recovery is a minimally invasive surgical procedure for stress urinary incontinence where patients experience immediate dryness and can get back to normal activity within 24 hours.  

Talk to your urologist about which types of treatments are best for you.

Scott Press, MD, is a board certified urologist at Eastern Long Island Hospital and Peconic Bay Medical Center with office hours at the Medical Village in Greenport.