Urinary Incontinence in Adults

Urinary incontinence is urinating (peeing) without meaning to.

• Incontinence can be a little dribbling or leaking a lot of urine

• You may have incontinence all the time, only at night, or only when you cough or sneeze

• Incontinence is more common in older people, especially older women, but it isn't a normal part of aging

See a doctor right away if you have urinary incontinence and these warning signs of spinal cord damage, such as:

• Weakness in your legs

• Not being able to feel your legs or around your genitals or anus

If you have urinary incontinence without these warning signs, call your doctor. Your doctor will decide how soon to see you based on your other symptoms.

Some people feel embarrassed talking with their doctor about incontinence or they feel it’s just a normal part of aging. It’s not. You should see a doctor if your incontinence bothers you, stops you from doing daily activities, or causes you to avoid social situations.

Causes of urinary incontinence include:

• Weakness in the muscles that hold urine in your bladder—this can happen to women after childbirth or to men after surgery for prostate cancer

• A bladder blockage, such as from a kidney stone or enlarged prostate gland, that makes your bladder stay filled up so it overflows

• Muscle spasms in your bladder

• Problems with the nerves that control your bladder (neurogenic bladder)

Sometimes people are incontinent only because they have a problem that keeps them from getting to a toilet. People who've had a stroke or dementia may have trouble getting to the bathroom on their own.

Drinking a lot of liquid or taking water pills (diuretics) by itself doesn't cause incontinence. But it can worsen incontinence if you've already got the problem.

Doctors will ask about your symptoms and examine you (for women, they'll do a pelvic exam). They'll ask about any medicine you're taking. They may ask you to keep a record of your urination over a day or 2.

Doctors may also do tests such as:

• Urine or blood test

• Measuring how much water they can put in your bladder through a small tube before you feel the need to urinate (cystometry)

• Having you urinate into a special device that measures how fast and how much urine comes out (peak urinary flow rate)

• Measuring bladder pressures when the bladder is filled with various amounts of water (cystometrography)

Doctors will treat the specific cause of your incontinence. If a medicine you take causes incontinence, doctors will try switching you to another medicine.

For any cause of incontinence, it may help to:

• Limit fluids at bedtime and avoid caffeine

• Train your bladder by following a fixed schedule for urination

• Do Kegel exercises to strengthen your pelvic muscles (tightly squeeze and relax the muscles that start and stop urination)

Other treatments include:

• Medicine

• Estrogen cream for women

• Electrical stimulation

• Sometimes surgery, a catheter, or other devices