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(Incontinence, Urinary; Incontinence, Stress; Incontinence, Urge; Incontinence, Overflow; Incontinence, Functional; Stress Incontinence; Urge Incontinence; Overflow Incontinence; Functional Incontinence; Overactive Bladder)
- Prostate enlargement
- Bladder that is blocked, such as by a scar in the urethra (stricture)
- Fecal impaction putting pressure on the urethra
- Drugs (such as antidepressants, hypnotics, antipsychotics, beta-blockers, antihistamines, calcium channel blockers)
- Vitamin B12 deficiency
- Weak bladder muscles
- Nerve damage
- Age: older than 65
- History of prostate surgery
- Prostate enlargement due to benign prostatic hyperplasia (BPH), infection, or prostate cancer
- Urinary tract infection
- Chronic lung disease
- Dementia (including Alzheimer’s disease )
- Multiple sclerosis
- Spinal cord injury or disease
Use of certain substances or medications:
- Cholinergic agents
When Should I Call My Doctor?
- Stress test—you relax, and then cough as your doctor watches for loss of urine (this will confirm if you have stress incontinence)
- Urine tests
- Tests to explore problems with your prostate (such as a prostate exam or blood tests)
- Blood tests to detect diabetes
- Ultrasound—uses sound waves to examine structures inside the body to determine if any urine remains in your bladder after urinating
- Cystoscopy —a thin tube with a tiny camera is inserted into the urethra to view the urethra and bladder
- Urodynamic tests—used to measure the flow of urine and the pressure in the bladder
Making muscles stronger by doing
- These strengthen the muscles that hold the bladder in place and control urine flow.
- Painless electrical stimulation is sometimes used. It can strengthen the muscles more quickly. It is helpful for stress incontinence.
- Creating a regular schedule to empty your bladder (called bladder training). This training may also involve drinking fewer liquids
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- Take care of your skin by gently cleaning yourself after an episode of incontinence. Let the skin air dry.
- Make it easier to get to the bathroom. For example, rearrange furniture and remove throw rugs. Add night-lights in the hallway and in the bathroom.
- If needed, keep a bedpan or urine canister handy in your bedroom.
- Reduce your intake of substances that lead to incontinence. These include caffeine, alcohol, and certain drugs.
- Lose weight.
- Avoid and treat constipation.
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
Urology Care Foundation http://www.urologyhealth.org
Canadian Nurse Continence Advisors http://www.cnca.ca
Health Canada http://www.hc-sc.gc.ca
Corcos J, Gajewski J, et al. Canadian Urological Association guidelines on urinary incontinence. Can J Urol. 2006;13:3127-3138.
Incontinence. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143. Updated January 2011. Accessed September 14, 2012.
Occhino J, Siegel S. Sacral nerve modulation in overactive bladder. Curr Urol Rep. 2010;11(5):348-352.
Prevention of incontinence. Continence Foundation website. Available at: http://www.continence-foundation.org.uk. Accessed September 14, 2012.
Subak L, Wing R, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.
Urinary incontinence in men. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 29, 2012. Accessed September 14, 2012.
Urinary incontinence in men. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/uimen/#treated. Published June 29, 2012. Accessed September 14, 2012.
Wein A, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management. J Urol. 2006;175:S5-10.
Yang C, Schwartz S, et al. A new, simple device to manage male urinary incontinence. International Continence Society website. Available at: http://www.icsoffice.org/publications/2005/pdf/0464.pdf. Accessed September 14, 2012.
12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int. 2010;106(6):816-821.
7/28/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mangera A, Apostolidis A, et al. An updated systematic review and statistical comparison of standardised mean outcomes for the use of botulinum toxin in the management of lower urinary tract disorders. Eur Urol. 2014;65(5):981-990.
- Reviewer: Adrienne Carmack, MD
- Review Date: 12/2013
- Update Date: 00/72/2014