Technically the word incontinence only describes half of a condition. The medical definition of the term incontinence is the inability to voluntarily control the elimination of waste. So from a purely medical standpoint there are two broad types of incontinence: Fecal incontinence – the lack of ability to control elimination of solid waste and urinary incontinence – the lack of ability to control elimination of liquid waste. However since most people who use the word incontinence are referring to the later, and if you were suffering from the former, you would likely be already under medical care and not searching a website for information – we will concern ourselves only with urinary incontinence. When using the term incontinence throughout this article we will only be referring to urinary incontinence.
Types of Urinary IncontinenceThere are many types of urinary incontinence. Urinary incontinence effects both men and women. In fact overall incontinence effects more men than women, but certain types of incontinence effect more women than men. Obviously since the urinary tract is different for men and women, causes of incontinence and treatments for incontinence can differ for men and women.
Stress Incontinence - Stress incontinence seems to occur more in women than men. Stress incontinence is due to a weakness in the muscles of the pelvic floor. This weakening is characterized by little bits of urine draining from the urethra upon laughing, coughing, sneezing or any other movement that puts pressure on the lower abdomen and presses upon the bladder. It occurs more often in women because women can suffer a greater variety of conditions that can weaken the pelvic floor including childbirth, menopause, and pregnancy. However it is also a common form of incontinence in men due mostly to the physical changes following a Proststectomy. Stress incontinence is treatable in both men and women.
Urge Incontinence – Urge incontinence is characterized by the sudden feeling of having to urinate, and then not being able to “hold it” resulting in release of urine. Urge incontinence effects both men and women. People with urge incontinence are often referred to as having an “overactive bladder”. People with urge incontinence can experience incontinence in the shower, while sleeping, almost any place or any time. Some people with urge incontinence have what doctors call reflexive incontinence –where the uncontrollable urge to urinate is brought on by the sight or sound of running water.
Functional Incontinence – is a condition where people have lost the ability to recognize the need to urinate. It is the least common and usually due to dementia, Alzheimer’s or other cognitive difficulties. Being physically unable to get to a bath room in time due to mobility disorders, is also a form of Functional incontinence.
Overflow Incontinence – is the inability “turnoff the faucet” so to speak. Overflow incontinence is when even after the urge to urinate has passed and after urinating urine continues to flow as if the bladder never empties. It is rare in women, but is the most common incontinence in men and therefore the most common incontinence their is. It is usually caused by an enlarged prostate and experienced to some degree by most aging males.
Diagnosis and TreatmentOnly a medical professional that specializes in diseases and disorders of the Urinary Tract can properly diagnose and treat incontinence. For men that means a Urologist, for women that usually means her Gynecologist, however there is a subspecialty of OB-GYN’s who specialize in the female urinary tract called urogynecologists.
The first thing a doctor will do when attempting to diagnose if indeed you are “incontinent” and if so what type of incontinence you may be suffering from, is take a detailed history. Only by fully understanding what your “normal” pattern is for urination, will he be able to determine if there is a problem. A physical examination will be made for any signs of obvious problems such as an enlarged prostate or any growths or tumors that could be interfering with the proper flow of urine. A urine analysis will of course be taken to check for any infections and for proper kidney function. Additional diagnostic tests may be performed such as a test for stress incontinence where you will be asked to stand still and cough vigorously while the doctor checks for signs of leakage.
Treatments for IncontinenceThere are many successful and treatments for incontinence. Treatments will vary based on the type of incontinence diagnosed and of course can vary for men and women. The good news is just about every type of incontinence is treatable once a medical professional can determine its root cause. Treatments for incontinence can include but are not limited to:
Exercises: Certain exercises for men and women such as Kegel exercises, and only for women such as Vaginal Cone Therapy, have been developed that have been shown to strengthen the muscles of the pelvic floor.
Biofeedback – Which uses techniques to help a patients better recognize the need to urinate.
Prescription Drugs – The is a wealth of prescription medications proven to be safe and effective for treating many different forms of incontinence.
Pessary Ring - A treatment for women, in which a ring is placed within the vagina to help “hold back” the bladder.
Surgeries – Your doctor has many surgical techniques available to deal with incontinence such as repositioning the bladder and insertion of slings.
Any kind of incontinence can be a very embarrassing condition for adults. Urge or stress incontinence can have a severe impact on lifestyle. But there is no reason to suffer in silence or keep building your life around the nearest bathroom because help is available.