Incontinence and Overactive Bladder   Definition of Incontinence
Urinary Incontinence is the inability to control urinary functions effectively; the result is that a person is unable to make it to the toilet in time. Incontinence is often temporary, and it almost always results from an underlying medical condition. It is a condition that ranges from mild leakage to uncontrollable wetting.
Stress Incontinence happens when urine leaks during exercise, coughing, sneezing, laughing, \lifting heavy objects, or other body movements that put pressure on the bladder. It is the most common type of incontinence and can almost always be cured.
Urge Incontinence occurs when an overactive bladder contracts without your wanting it to do so. Although healthy people can have urge incontinence, it is often found in people who have diabetes, stroke, dementia, Parkinson's disease, or multiple sclerosis. It can also be a warning sign of early bladder cancer. In men, it is often a sign of an enlarged prostate.
Overflow Incontinence happens when small amounts of urine leak from a bladder that is always full. In older men, this can occur when the flow of urine from the bladder is blocked, usually by an enlarged prostate. It can sometimes be prevented by medication when early symptoms of prostate enlargement, such as frequent urination, appear. Some people with diabetes also have overflow incontinence.
Functional Incontinence happens in many older people who have relatively normal urine control but who have a hard time getting to the toilet in time because of arthritis or other crippling disorders.
Incontinence and Overactive Bladder   Diagnosing
The first and most important step in treating incontinence is to see a doctor for a complete medical exam. The doctor may check urine samples and ask questions about your history and specific situation. The RealAge Incontinence and Overactive Bladder Health Assessment ( Free Incontinence Assessment )can provide a list of your symptoms to take with you to discuss with your doctor. You may be referred to a urologist, a doctor who specializes in diseases of the urinary tract, or to a gynecologist, a specialist in the female reproductive system.
The symptoms of an overactive bladder or incontinence are different for everyone, but rarely do they go away on their own. If you are experiencing any of the following symptoms, talk to your doctor.
Incontinence and Overactive Bladder   Self-Treatment
To find the cause of incontinence and treat your condition, talk to your doctor. Only you and your doctor can determine the right treatment for your condition. You can, however, help avoid and minimize symptoms. Avoiding or Minimizing Symptoms
If you have already visited your doctor to determine the cause of your incontinence, or if you want to be proactive against incontinence, there are several things you can do to help keep your bladder healthy:
To learn which muscles you need to strengthen, try to stop the flow of urine the next time you go to the bathroom. One of the ways to do Kegel exercises is to tighten these muscles for a count of five and then relax them. Repeat this tightening 10 to 20 times. Do this exercise several times each day.
Incontinence and Overactive Bladder   What to Expect at the Doctor
After going over your history, your doctor may suggest testing to determine the cause of your incontinence and to determine which treatment is right for you. Your doctor may recommend one or more of the following tests to determine the cause of your incontinence. All of these tests can be done in a doctorís office and do not require surgery.
At the doctorís office restroom, you will collect a sample of your urine in a sterile cup. This sample will be analyzed at the lab for the presence of bacteria, blood, or other abnormalities. Some analyses can be done right away, such as testing for bacteria, and some will take a couple of days.
Post-void residual measurement
If you have the urge to urinate frequently, but you donít void much fluid, your doctor might recommend a post-void residual measurement test to see if you are emptying your bladder completely. Your doctor might insert a small, soft tube, called a catheter, into the bladder through the urethra to drain any remaining urine. Alternatively, your doctor might measure by using ultrasound. Ultrasound is when sound waves are directed at the bladder and images are shown on a monitor. These images show the size and shape of your bladder and can show how much urine remains in the bladder.
Your doctor may use ultrasound, or sound waves, to view and measure the size and shape of the kidneys, bladder, and prostate, and to check for abnormal growths or fluid.
Depending on your condition, your doctor might need to see the inside of the bladder. Your doctor would use a thin telescope-like instrument, called a cystoscope, which would be inserted into the bladder through the urethra.
This could be a series of tests that analyze the function of your bladder and sphincter muscles. These tests will tell your doctor whether you have normal bladder sensations and capacity and whether your bladder fills and empties in a healthy manner. For example, you might be X-rayed while voiding, coughing, or straining to measure how much the position of the bladder changes during these activities.
Your doctor most likely will recommend a combination of one of the following treatments: behavioral techniques, medication, surgery, using a pessary, using a catheter, or electrical stimulation.
Behavioral techniques such as pelvic muscle exercises, biofeedback, and bladder training can help control urination. These techniques can help you sense that your bladder is filling and help delay voiding until you can reach a toilet.
Stress incontinence can be eased by using a pessary, which is similar to the outer ring of a diaphragm. The pessary is inserted around a woman's cervix, where it gives support to the pelvic muscles. Your doctor may advise a pessary if lax pelvic muscles are contributing to the incontinence.
Catheters are often used to help with overflow incontinence. A catheter is a soft tube that you can learn to insert through the urethra into the bladder to drain urine. A catheter may be used only when you need it or constantly, in which case the tube connects to a bag that you can attach to your leg. If you experience any pain or burning while using a catheter, talk to your doctor. You could be experiencing symptoms of a urinary tract infection.
Brief doses of electrical stimulation can strengthen muscles in the lower pelvis in a similar way that exercising the muscles does. Electrical stimulation can help stabilize overactive muscles and exercise urethral muscles.
Doctors donít usually suggest surgery to alleviate incontinence until all other treatments have been tried. Sometimes surgery can improve or cure incontinence if it is caused by a structural problem. For example, most stress incontinence results from the bladder dropping down toward the vagina. Therefore, common surgery for stress incontinence involves pulling the bladder up to a more normal position.
Incontinence Resource Center