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Up to 84 percent of women (and 30 percent of men) have to deal with urinary incontinence at some point in their lives. The inability to "hold it in" can be caused by:
- Urge incontinence: Involuntary leakage of urine as soon as the urge to urinate is felt, not being able to get to the bathroom fast enough.
- Stress incontinence: Involuntary leakage urine caused by physical stress, such as climbing stairs, laughing, coughing, sneezing, orgasm, or doing abs exercises. Any physical stress on the abdominal cavity conveys pressure to the bladder.
- Mixed incontinence: A combination of urge incontinence and stress incontinence, a combination of leakage when you feel there is a "need to go" and when physical activities like those listed above stress the bladder.
- Overflow incontinence: Production of urine greater than the capacity of the bladder.
- Functional incontinence: The inability to hold urine due to reasons other than lower urinary tract dysfunction or stress, such as delirium, psychiatric disorders, urinary tract infections, or confinement to a bed or wheelchair.
- Overactive bladder: A nerve condition that causes the bladder to overreact to common stimuli.
Incontinence may be triggered by the sound of running water. Many people lose bladder control as soon as they walk in the front doors of their homes but before they can get to the toilet; their parasympathetic nervous systems stop sending signals to the muscles around the bladder to retain urine on sight of but before physically reaching the bathroom. Smoking as well as abuse of either caffeine or alcohol increases the frequency of incontinence, as do a history of urinary tract infections, pelvic surgery, multiparity (having lots of babies, for instance, the author knows a woman who became incontinent after she delivered her seventeenth child), fecal incontinence, pelvic organ prolapse (organs that turn inside out), and previous surgeries to stop incontinence.
Urinary incontinence can be caused or exacerbated by:
- Any condition that causes chronic cough,
- Spinal cord injuries,
- Congestive heart failure, and,
- In women, low estrogen levels after menopause (or in women of any age, surgical removal of the ovaries and/or uterus),
- In men, prostate enlargement or prostate cancer.
A variety of medications can cause urinary incontinence, including alpha-blockers, angiotensin-converting enzyme inhibitors, muscle relaxants, sedatives, diuretics, over the counter allergy medications, and estrogen replacement therapy.
Treatments for incontinence range from:
- Pelvic floor exercises and Kegel exercises, anti-incontinence devices, and surgery for stress incontinence.
- Changes in diet, new medications, pelvic floor exercises, and surgical intervention for urge incontinence.
- Pelvic floor exercises, drugs that regulate the parasympathetic nervous system, and surgery for mixed incontinence.
- Placement of a catheter and a collection bag for overflow incontinence, and
- Treatment of the underlying health problem in functional incontinence.
While you and your doctor are sorting out your options, or while you are waiting for your treatment to work you may need to use incontinence products. You aren't supposed to need to use incontinence supplies like adult diapers indefinitely, however. It's never an acceptable result of treatment not to have bladder control. Women who have bladder control issues can often make faster progress when they lose weight.