Urinary Incontinence

Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities.

For detailed information on various bladder health issues, visit our Bladder Conditions page.

There are six main types of urinary incontinence:

Stress incontinence. This is when urine leaks because you put pressure on your bladder by laughing, sneezing, exercising, lifting something heavy, etc.
Urge incontinence.
Overflow incontinence.
Functional incontinence.
Mixed incontinence.
Bedwetting.

Stress incontinence happens when physical movement or activity — such as coughing, laughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder, causing you to leak urine. Stress incontinence is not related to psychological stress.

Urge incontinence is a type of urinary incontinence that causes an urgent, uncontrollable need to urinate several times during the day and night. You may leak urine before you get to the bathroom. An overactive bladder causes urge incontinence

Treatment:

Stress incontinence: Surgery is performed to restore the normal position of the bladder neck and urethra. There are two main types of operations for incontinence: bladder neck suspension procedures and injecting bulking agents or “filler” procedures. Within the medical community, the comparative effectiveness of these procedures is still being debated but if done well can be up to 95% effective. If you are considering surgery, it is important that the decision be based on your individual circumstances, the amount of leakage and the exertion effort that cause the leakage.
Urge incontinence: The best treatment for urge incontinence is behaviour therapy in the form of pelvic floor muscle exercises. Medications, used as an adjunct to behaviour therapy, can provide additional benefit. Anticholinergic drugs form the mainstay of the pharmacological therapy. These medications can calm an overactive bladder and may be helpful for urge incontinence. Examples include oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium chloride.