Overview

Definition

If you are leaking urine, you may have incontinence, which means any loss of how well you control your bladder. Incontinence is considered a symptom of a condition and not a disease itself. The problem can happen to anyone but is more common in older people. At least one in 10 people who are 65 and older has this problem with symptoms ranging from mild leaking to wetting. About 13 million Americans -- 85 percent are women -- have urinary incontinence. However, this number may be much higher because many people don't get help early enough or at all.

The urinary system consists of two kidneys, two ureters, a bladder and a urethra. Waste products are removed by the kidneys, which produce urine. Ureters are tube-like structures that move urine from the kidneys to the bladder, where urine is stored until you can eliminate it through the urethra. A circular muscle called the sphincter controls the urethra.

The five types of incontinence include:

• Stress incontinence. Stress incontinence occurs when someone loses urine after pressure is placed on the abdomen, such as while exercising, sneezing, coughing, having sex, laughing, lifting, getting out of a chair, bending over or hugging.
• Urge incontinence. Also called overactive bladder, this occurs when a person has a sudden need to urinate and cannot control the urge. Urine is lost before the person can get to the toilet. Your bladder might empty during sleep, after drinking water or when you hear water running.
• Mixed urinary incontinence. This is a mixture of urge and stress incontinence.
• Overflow incontinence. Overflow incontinence results when the bladder does not empty correctly and the amount of urine overwhelms the capacity of the bladder. People with this type of incontinence have a blockage to the bladder or urethra, or a bladder that doesn't contract properly.
• Functional incontinence. This occurs when people have mental or physical problems that keep them from reaching a toilet. Someone with Alzheimer's disease may not be able to plan a trip to a restroom. Conditions such as arthritis may affect how you manage undoing your clothing or how fast you can reach the toilet. A person in a wheelchair may have trouble getting to a toilet in time. Functional incontinence can also affect the elderly.

Incontinence from surgery such as hysterectomies, caesarean section, prostatectomies (surgery to treat prostate cancer), lower intestinal surgery or rectal surgery is often temporary.

Prognosis

Many people don't get the help they need or wait years before getting help. However, you can regain control of your urination by getting treatment for the condition causing your incontinence. Treating incontinence can be as simple as switching medications, foregoing caffeine, taking antibiotics or exercising the muscles of the pelvic floor. Beyond that, a variety of behavioral modification techniques, drugs, devices, implants and surgeries can help.

More on Urinary Incontinence

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This article was reviewed and updated June 2007.