Date Published: 1/31/2013

Incontinence: A Fairly Common Problem

Do you know that millions of Americans suffer with this healh problem?

Millions of Americans suffer from chronic urinary incontinence, according to a study by the Agency for Healthcare Research and Quality. A large percentage of those with incontinence severely limit their interaction with other people to avoid embarrassment, and most do not even disclose their problem to their doctor.

Urinary incontinence is not related to fecal incontinence, which is much less common. Constipation, which can be part of the problem of bowel incontinence, can lead to urinary difficulties by creating pressure on the bladder that the brain misreads, causing an urge to empty a bladder that is not yet full.

Types of incontinence
Bladder and bowel control are complex processes that involve the brain, spinal cord, and muscles of the bladder, bowel, and pelvis. Loss of bladder or bowel control can be caused by problems with any of these components. Incontinence, or loss of the ability to control urination or defecation, is a symptom, not a disease. Some of the causes include normal changes in muscles because of aging, birth defects, pelvic surgery, injuries to the pelvic region or the spinal cord, neurological diseases, multiple sclerosis, infection, degenerative changes associated with aging, and pregnancy and childbirth.

There are four basic types of urinary incontinence:

Diagnosis and treatment
Because incontinence is a symptom, not a disease, treatment depends on the results of diagnostic tests by your doctor, which may include X-rays, blood work, and urine analysis, and examination of bladder capacity, the amount of urine left in the bladder after urination, urethral pressure, and sphincter condition.

Three major categories of treatment are behavior change, medications, and surgery.

These are common behavioral approaches:


Drinking less water is not a good way to avoid problems with urinary incontinence because this may cause dehydration. Concentrated urine caused by dehydration can cause the lining of the bladder and urethra to become irritated and actually make incontinence worse. Drinking two to three quarts, preferably water, a day may help. Some fluids, like alcohol and caffeinated drinks, may make incontinence worse. Stop drinking any fluids two to three hours before bedtime. A high-fiber diet that prevents constipation helps with fecal and urinary incontinence. Constipation makes urinary incontinence worse.


Medications may be prescribed to help control incontinence. Medications relax the bladder and reduce spasms or instability. These drugs help prevent the bladder contracting spontaneously. Sometimes a health care provider will take a person off a medication that is causing or contributing to incontinence. Of course, only your healh care provider should tell you to stop using a drug that he or she has prescribed.


Topical estrogen applied to the vaginal area can help if the cause of urinary incontinence is related to menopause or an estrogen deficiency.
Surgery should be performed only after being thoroughly evaluated by a health care provider. All appropriate nonsurgical treatments should be tried before deciding on surgery. Many different surgical procedures may be used to treat urinary incontinence. The type of operation recommended depends on the type and cause of your incontinence. Some of the more common procedures performed to treat urinary incontinence include "suspending" internal organs with your own tissue or a mesh, injecting collagen around the urethra to ensure closure, and implanting an artificial urinary sphincter or sacral nerve stimulator.


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