Incontinence, or the leakage of urine, can affect both men and women. Leakage can occur during the day or at night. The amount of urine that leaks may be a few drops or the entire content of the bladder. While this is not necessarily dangerous to one’s health, it can be very detrimental to lifestyle and rest. This section will review the different types of urinary leakage, their evaluation and treatment options.
The most common type of incontinence occurs due to external forces on the bladder, this is known as stress urinary incontinence. This usually occurs after physical activity such as jumping or change positions or after coughing or laughing. There is usually very little warning that leakage is going to occur. In women, this leakage is usually related to prior vaginal childbirth. In men, this form of leakage can be common after prostate cancer surgeries. In both men and women, the body’s sphincter that keeps urine from leaking is weakened in some manner. Usually a careful history and physical exam can diagnose stress incontinence; however, in some cases, further testing may be warranted. Treatment usually consists of pelvic floor exercise, such as Kegels, or with surgical therapy to increase the body’s ability to hold urine back when pressure is placed on the bladder.
Another form of incontinence occurs when one has the urge to urinate and is unable to make it to the restroom in time, this is known as urge urinary incontinence. Leakage related to urgency may occur at any time, day or night, and is not related to activity. This occurs when the bladder contracts in an inappropriate manner causing urine to leak before one voluntarily wants to urinate. This type of leakage can be related to an over active bladder and can require an office visit as well as some specialized testing to evaluate. Usually there are medications that can be used to call the bladder to prevent this type of leakage; however, when these fail there are therapies that can help to calm the bladder down further.
While these two forms of incontinence are differently, the can occur together. Your urologist will be able to help you distinguish between the two and develop a treatment plan that will help manage your urinary incontinence.