Bladder control problems range from urinating too frequently to actual urine leakage (urinary incontinence). Urinary incontinence affects millions of people every year yet, many individuals feel too embarrassed to discuss the issue with their doctor, allowing the problem to continue to interfere with quality of life.
There are several types of incontinence and some people experience more than one kind.
- Urge incontinence (Overactive Bladder) - Urine leaks when the bladder inappropriately contracts, and you may not be able to get to the bathroom quickly enough.
- Stress incontinence - Exercising, coughing, sneezing or other activities put pressure on a weakened bladder sphincter and cause leaks.
- Overflow incontinence - In this type of incontinence, which mostly affects men, you don't feel the urge to urinate, your bladder doesn't empty well, and small amounts of urine may leak continuously.
- Total incontinence – This is the continuous leakage of urine.
- Mixed incontinence – This is a combination of any of the above types of urinary incontinence.
Causes of Incontinence and Bladder Control Problems
Certain diseases and conditions that damage nerves can lead to bladder control problems such as stress urinary incontinence and overactive bladder, including:
- Neurological conditions such as stroke, Parkinson's disease, and multiple sclerosis all affect the brain and nervous system and often cause bladder control problems.
- Spinal cord injuries can interrupt the nerve signals required to control the bladder
- BPH or an enlarged prostate in men causes a number of urinary symptoms including: weak urine stream, urinary urgency and leakage, frequent urination, nocturia, as well as overactive bladder.
- Pregnancy and childbirth, which can stretch, weaken or even damage pelvic floor muscles
- Chronic cough, oftentimes caused by smoking
- Certain medications, excessive alcohol consumption and caffeine
- Menopause, due to decreased hormones
- Pelvic surgery or radiation treatment
- Certain foods such as caffeine, alcohol and spicy foods worsen symptoms of OAB
Your physician will perform a comprehensive medical history and evaluation to accurately diagnose your urinary incontinence symptoms. He or she may also order additional tests including:
- Blood work
- A bladder diary
Other specialized diagnostic tests may include:
- Pelvic ultrasound
- Post void residual test (PVR): Determines how well you empty your bladder by measuring residual urine after voiding using a thin tube (catheter) passed through your urethra into the bladder.
- Cystoscopy: A tiny instrument called a cystoscope is inserted into the urethra to find and/or remove abnormalities.
- Urodynamics: A series of diagnostic tests that evaluate the function of your bladder and urethra.
Learn more about Urodynamics here.
Treatment Options for Bladder Control Problems
Treatment options range from lifestyle changes to medications to surgery. Every person is different and the physicians at Urological Consultants will determine the treatment right for you. Options may include:
- First line therapies including physical therapy and diet/behavior/lifestyle modifications
- Bladder injections (Botox)
- Neuromodulation therapy for OAB
- Urethral sling for stress urinary incontinence
- Artificial urinary sphincter