Urinary Incontinence

Urinary incontinence — the inability to control the release of urine from your bladder — is a fairly common and rather embarrassing problem. The severity of urinary incontinence ranges from occasionally leaking urine when sneezing, laughing or coughing to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.  Some people experience occasional, minor leaks — or dribbles — of urine. Others wet their clothes frequently.

Types of urinary incontinence

* Stress incontinence. This leakage of urine with stress or an increase in abdominal pressure when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy. In women, causes of this type of incontinence include physical changes resulting from pregnancy, childbirth and menopause. In men, it may be caused by removal of the prostate gland.

* Urge incontinence. This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. With urge incontinence, you may feel the need to empty your bladder frequently, especially at night. This 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. 

* 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.  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.

* 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 consult a urologist

But if incontinence is frequent or is affecting your quality of life, seeking medical advice is important for several reasons:

  • Urinary incontinence may be a sign of 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.

Patient who complains of any of the above symptoms is evaluated and thouroughly examined, routine lab work is ordered  and some specialized tests (urodynamics) are performed to assess the function  of the bladder as to its storage and emptying capacity.

The patient is asked to maintain a intake/output fluid diary.

Depending from the underlying condition the patients are offered medical treatment with oral medications  (OAB), some candidates are selected for Pelvic Floor Rehabilitation Program and some with severe prolapse of the pelvic organs are offered reconstructive surgery.

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If urinary incontinence affects your day-to-day activities, don’t hesitate to contact your doctor. Dr. Plawner, urologist in New York (Manhattan or Brooklyn office), or urology specialist in New Jersey (Nutley office) is available for a consultation or appointment - call (212) 737-2330. In most cases, simple lifestyle changes or medical treatment can ease your discomfort or stop urinary incontinence.