What Causes Incontinence?
Urinary incontinence is not a disease but a common symptom caused by a variety of different medical conditions. With increasing age, nearly 15 percent of men will experience incontinence, the accidental or uncontrollable leaking of urine, according to the Merck Manual. Prostate disease and neurological disorders are also commonly to blame, but many other conditions can affect bladder control. Incontinence does not require dramatic lifestyle changes; with planning and preparation you can keep up with your regular activities.
Anatomy
For your bladder to successfully store and void urine without leaking, the whole system needs to be working together. Nerves running between the bladder and brain tell you when your bladder is full and help coordinate bladder activity. The muscles in your bladder wall relax to store urine and tighten up during voiding, while the bladder sphincter muscles do just the opposite to stop and start urine flow. An unobstructed urethra and healthy surrounding pelvic muscles also play key roles in bladder control. Several medical conditions can affect one or more of these elements, resulting in a few common types of incontinence.
Stress Incontinence
When your pelvic muscles or bladder sphincter are damaged and weakened, increased pressure in the abdomen can cause urine to leak more easily from the bladder. Sneezing, coughing, exercise or lifting increase your abdominal pressure, as does obesity. Stress incontinence occurs more commonly in women, but it also occurs in some men who have had prostate surgery, those with pelvic nerve damage and those on certain medications.
Urge Incontinence
Urge incontinence, sometimes called overactive bladder, results from problems of the bladder wall muscles. If these muscles contract too often or at the wrong time, they create a sudden strong need to urinate, often coming on so suddenly that there’s no time to reach the bathroom. Common causes include increasing age, obstruction from prostate enlargement, urinary tract infections, constipation and neurologic disorders such as Parkinson’s disease. Bladder irritation from medications or excessive intake of caffeine, alcohol or acidic fruit juices also can lead to temporary urge incontinence.
Overflow Incontinence
Repeated incomplete emptying of your bladder over time can cause bladder stretching, overfilling and leakage, known as overflow incontinence. Obstructions to urine flow, weak bladder walls or nerve damage can lead to poor bladder emptying. Prostate enlargement, bladder stones, chronic constipation and nerve damage from a surgery or other injuries can cause this type of incontinence, more commonly seen in men than women.
Treatment
Incontinence can be difficult or embarrassing to discuss, but the first step to getting better is talking with your health care provider. Treatment options can include simple lifestyle changes, Kegel exercises to strengthen pelvic muscles, bladder training, medication or even surgery, depending on the underlying cause and severity of your symptoms. With appropriate treatment, urinary incontinence can be improved or cured in nearly 80 percent of people, the National Association for Continence says.