Urinary Incontinence -- Female
(Incontinence, Urinary; Incontinence, Stress; Incontinence, Urge; Incontinence, Overflow; Incontinence, Functional; Stress Incontinence; Urge Incontinence; Overflow Incontinence; Functional Incontinence; Overactive Bladder)
- Muscle weakness
- Restricted mobility
- Endocrinological disorders (such as diabetes)
- Weakening of muscles that suspend the bladder
- Weakening of muscles that control urine flow
|Muscles Involved in Incontinence in Women|
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- A bladder that is blocked, such as by a scar in the urethra (stricture)
- Fecal impaction
- Drugs (such as antidepressants, hypnotics, antipsychotics, antihistamines, calcium channel blockers)
- Vitamin B12 deficiency
- Weak bladder muscles
Nerve damage due to:
- Spinal cord injuries
- Other factors
- Age: older than 65
- Having been pregnant multiple times, or having a complicated delivery
- Urinary tract infection
- Chronic lung disease
- Previous hysterectomy or urethral surgery
- Pelvic organ prolapse
- Dementia, including Alzheimer’s disease
- Multiple sclerosis
- Spinal cord injury or disease
Use of certain substances or medicines:
- Cholinergic agents
When Should I Call My Doctor?
- Stress test—you relax then cough as your doctor watches for loss of urine (this will confirm if you have stress incontinence)
- Urine tests
- Blood tests to detect diabetes
- Ultrasound—a test that uses sound waves to examine structures inside the body to determine the residual urine volume after voiding
- Cystoscopy—a thin tube with a tiny camera is inserted into the urethra to view the urethra and bladder
- Urodynamic tests—tests that measure the flow of urine and pressure in the bladder
Making muscles stronger by:
- Kegel exercises—These strengthen the muscles that hold the bladder in place and those that control urine flow.
- Painless electrical stimulation—This may strengthen the muscles more quickly and is helpful for stress incontinence.
- Pelvic floor exercises using cone-shaped weights that are placed in the vagina.
- Bladder training—Setting a regular, timed schedule for emptying your bladder. You may also be asked to drink fewer liquids.
- Biofeedback—When doing pelvic floor muscle exercises, a device signals how strong you are at contracting your muscles.
- 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 handy in your bedroom.
- If advised by your doctor, do exercises to strengthen your pelvic floor muscles, such as Kegel exercises. This is especially important if you are pregnant.
- Reduce your intake of substances that lead to incontinence (such as caffeine, alcohol, and certain drugs).
- Lose weight, if needed.
- Eat a healthy diet to avoid constipation.
Urology Care Foundation http://www.urologyhealth.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
Health Canada http://www.hc-sc.gc.ca
Women's Health Matters http://www.womenshealthmatters.ca
American Urological Association Foundation. Overactive bladder. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=112. Updated January 2011. Accessed September 14, 2012.
Corcos J, Gajewski J, et al. Canadian Urological Association guidelines on urinary incontinence. Can J Urol. 2006;13:3127-3138.
Incontinence. American Urologic Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143. Updated January 2011. Accessed September 14, 2012.
National Association for Continence. Overactive bladder treatment. National Association for Continence website. Available at: http://www.nafc.org/bladder-bowel-health. Updated September 2011. Accessed September 14, 2012.
Norton P, Brubaker L. Urinary incontinence in women. Lancet. 2006;367:57-67.
Sobhgol SS, Charandabee SM. Related factors of urge, stress, mixed urinary incontinence, and overactive bladder in reproductive age women in Tabriz, Iran: a cross-sectional study. Int Urogynecol J Pelvic Floor Dys Function. 2008;19(3):367-373.
Urinary incontinence. American Academy of Family Physicians. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/urinary-incontinence.html. Updated July 2012. Accessed September 16, 2012.
Urinary incontinence in women. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 29, 2012. Accessed September 14, 2012.
Urinary incontinence in women. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen. Published September 2010. 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.
2/5/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.
1/11/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: AHRQ evidence report on treatment for overactive bladder in women 2009. Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/clinic/tp/bladdertp.htm. Published August 2009. Accessed January 11, 2010.
3/5/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Vardy MD, Mitcheson HD, Samuels TA, et al. Effects of solifenacin on overactive bladder symptoms, symptom bother and other patient-reported outcomes: results from VIBRANT—a double-blind, placebo-controlled trial. Int J Clin Pract. 2009;63(12):1702-1714.
12/3/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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.
12/13/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: University of Texas at Austin, School of Nursing, Family Nurse Practitioner Program. Recommendations for the management of urge urinary incontinence in women. Agency for Healthcare Research and Quality website. Available at: http://www.guideline.gov/content.aspx?id=16322. Published May 2010. Accessed December 13, 2010.
3/5/2013 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007471.
- Reviewer: Adrienne Carmack, MD
- Review Date: 09/2012 -
- Update Date: 03/06/2013 -