There are several different types of urinary incontinence. It often takes a visit to your doctor’s office to receive the testing necessary to confirm your diagnosis and form the best treatment plan for your urinary leakage.

Stress Incontinence

 

 Women

Men

Who

Common in women who have undergone prior childbirth, pelvic surgery or menopause.

May occur in men who have undergone a radical prostatectomy or other urogenital surgery.

When

Occurs when pelvic floor and urethral muscles weaken.

Occurs when the urinary sphincter mechanism is disrupted. 

How 

A strong pelvic floor muscle helps holds the urethra, bladder, vagina and rectum in place. When this muscle weakens, the continence mechanism in the urethra does not work as well, and small increases in abdominal pressure can cause urine to leak.   

After removal of the prostate, some men may experience some loss of urinary control for a number of reasons. Because of the sensitive location of the prostate, its surgical removal may cause disruption of either the anatomic continence mechanism or the nerves that influence urinary control.  

What

Urine loss occurs with activities that increase intra-abdominal pressure —sneezing, coughing, laughing, standing, lifting, etc.

Urine loss occurs with activities that increase intra-abdominal pressure — sneezing, coughing, laughing, standing, lifting, etc.  

 

Mixed Incontinence: Symptoms of Both Stress & Urge Incontinence

Either an obstruction blocks the outflow of urine from the bladder

OR

The bladder loses its contractile power, and can no longer efficiently squeeze out urine.

 Some causes for obstruction:

  • Benign prostatic hypertrophy

  • Strictures that cause narrowing of the urethra

  • Diseases that affect the nerves associated with urinary sphincter function — multiple sclerosis is a common example

Some causes for loss of contractility:

  • Pelvic surgeries such as a hysterectomy or major bowel surgery

  • Lower back surgeries

  • Diseases that affect the nerves associated with bladder function — multiple sclerosis and diabetes are two common examples

    Causes for Overflow Incontinence

    Either an obstruction blocks the outflow of urine from the bladder

    OR

    The bladder loses its contractile power, and can no longer efficiently squeeze out urine.

    Some causes for obstruction:

    • Benign prostatic yypertrophy

    • Strictures that cause narrowing of the urethra

    • Diseases that affect the nerves associated with urinary sphincter function - multiple sclerosis is a common example

    Some causes for loss of contractility:

    • Pelvic surgeries such as a hysterectomy or major bowel surgery

    • Lower back surgeries

    • Diseases that affect the nerves associated with bladder function - multiple sclerosis and diabetes are two common examples

Loss of bladder control is an important health problem known to affect a large number of women. Since many women do not seek help, it is impossible to know exactly how many suffer with unintended urine loss. There is no one cause for female urinary incontinence, but several risk factors do exist.

Some risk factors for female incontinence:

  • Childbirth

  • Urinary tract infections

  • Menopause

  • Prior pelvic surgeries – radical hysterectomy

  • Increased weight

  • Neurologic illnesses – multiple sclerosis, diabetes, or stroke

  • Advanced age


Treatments

If you have stress incontinence, your physician will likely recommend pelvic muscle exercises, also known as Kegel exercises, biofeedback and medication. A device called a pessary is another option. A pessary is a stiff ring that the physician or nurse inserts into the vagina. This helps reposition the urethra to help reduce stress incontinence.

Another option for some women is a minor procedure during which the physician injects a substance into the wall of the urethra to “bulk it up” to help reduce leakage. During this procedure, the doctor inserts a thin tube called a cystoscope into the urethra and injects collagen or a similar substance into the tissue around the urethra.

One of the most common surgeries for stress incontinence is the placement of a "sling" under the urethra. During this minimally invasive outpatient procedure, the surgeon inserts a strip of lightweight mesh under the urethra through a small incision in the vagina. The mesh helps the urethra remain closed when appropriate, preventing involuntary urine leakage.

Men can experience loss of bladder control after illnesses, surgeries, or simply with advanced age. Although male incontinence may have many causes, men are much more likely than women to suffer from overflow incontinence. This is because men have prostates that may become enlarged with age and block the outflow of urine from the bladder.

Some risk factors for male incontinence:

  • Prostate enlargement

  • Urinary tract infections

  • Prior pelvic surgeries – bowel resections, prostatectomy

  • Neurologic illnesses – multiple sclerosis, diabetes, or stroke

  • Advanced age

Treatments

Whenever urinary leakage occurs, it is important to see your urologist so they can correctly diagnose the type of incontinence. Many treatment options are available for male incontinence, including pharmaceutical, behavioral, and surgical interventions.

For some men with urinary incontinence caused by nerve damage, surgery may be the best option. Some of the common procedures include:
  • An artificial sphincter, an implanted device that keeps the urethra closed until men are able to urinate. The device includes a cuff that fits around the urethra, a small balloon inserted in the abdomen and a pump placed in the scrotum. When it is time to urinate, the man squeezes the pump to open up the cuff so that urine moves into the balloon and flows out the urethra.

  • A male sling, a surgery that provides extra support for the urethra. The surgeon wraps a strip of material round the urethra and attaches the ends to the pelvic bone. This puts more pressure on the urethra so it doesn’t release urine accidentally.