Urinary incontinence

Medications that may be prescribed include drugs that relax the bladder, increase bladder muscle tone, or strengthen the sphincter.

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Surgery may be required to relieve an obstruction or deformity of the bladder neck and urethra. Uterine or pelvic suspension operations are sometimes needed in women. Men may require prostatectomy (removal of the prostate gland). Incontinence can sometimes be managed by artificial sphincters. These are synthetic cuffs that are surgically placed around the urethra to help retain urine.

If you have overflow incontinence or cannot empty your bladder completely, a catheter may be recommended. But using a catheter exposes you to potential infection.

PREVENTION

Performing Kegel exercises while you are pregnant and soon after delivery may help prevent incontinence related to childbirth.

Call your health care provider if:

Discuss incontinence with your doctor. Gynecologists and urologists are the specialists most familiar with this condition. They can evaluate the causes and recommend treatment approaches.

Call 911 or go to an emergency room if any of the following accompany a sudden loss of urine control:

Difficulty talking, walking, or speaking
Sudden weakness, numbness, or tingling in an arm or leg
Loss of vision
Loss of consciousness or confusion
Loss of bowel control

Call your doctor if:

You have been constipated for more than one week.
You have difficulty starting your urine flow, dribbling, nighttime urination, pain or burning with urination, increased frequency or urgency, or cloudy or bloody urine.
You are taking medications that may be causing incontinence. DO NOT adjust or stop any medications without talking to your doctor.
You are over 60 years old and your incontinence is new, especially if you are also having trouble with your memory or caring for yourself.
You have the urge to go often, but are only passing small amounts of urine.
Your bladder feels full even after you have just urinated.
Incontinence persists for more than 2 weeks even with exercises to strengthen your pelvic muscles.

What to expect at your health care provider's office:

Your doctor will take your medical history and perform a physical examination, with a focus on your abdomen, genitals, pelvis, rectum, and neurologic system.

Medical history questions may include:

How long has incontinence been a problem for you?
How many times does this happen each day?
Are you aware of the need to urinate before you leak?
Are you immediately aware that you have passed urine?
Are you wet most of the day?
Do you wear protective garments in case of accidents? How often?
Do you avoid social situations in case of accidents?
Have you had urinary tract infections in the past? Do you think that you may have one now?
Is it more difficult to control your urine when you cough, sneeze, strain, or laugh?
Is it more difficult to control your urine when running, jumping, or walking?
Is your incontinence worse when sitting up or standing?
Are you constipated? For how long?
Is there anything you do to reduce or prevent accidents?
Have you ever been treated for this condition before? Did it help?
Have you tried pelvic floor exercises (Kegel)? Do they help?
What procedures, surgeries, or injuries have you had?
What medications do you take?
Do you drink coffee? How much?
Do you drink alcohol? How much?
Do you smoke? How much each day?
Do you have diabetes or a family history of diabetes?
Do you have any other symptoms?