Urinary incontinence affects 10% to 30% of American women ages 50 to 64. In a national poll, Canadians reported an increasing prevalence of incontinence with increasing age. The good news is that about 90% of those suffering from various forms of bladder control problems can obtain relief.

Some of the most common urinary problems include:

• Stress incontinence is urine leakage that occurs during times of increased abdominal pressure such as coughing, sneezing, laughing, or lifting. It is the most common type of urinary incontinence.
• Urge incontinence is caused when the bladder muscles squeeze at the wrong time, or all the time. This results in an urgent need to urinate and the inability to get to a toilet on time, resulting in involuntary loss of urine. The prevalence of urge incontinence appears to increase with age.

Contributors to incontinence include being overweight, infections of the bladder and the urethra, weakening of pelvic muscles from aging and childbirth, medical conditions such as diabetes and multiple sclerosis, and some prescription drugs such as diuretics (medication that helps the body get rid of fluid).

Proper diagnosis and treatment can often completely cure the problem or at least decrease the number of incontinence episodes. To diagnose the type and cause of incontinence, a clinician obtains a medical and sexual history, performs a physical examination, and analyzes a urine sample. Additional specialized studies of the bladder are often needed, especially if surgery is being considered.

A wide range of interventions can help with incontinence depending on the type and cause, including:

1. Drinking adequate amounts of water: This dilutes the urine and decreases bladder irritation. Also avoid caffeine, nicotine, and acidic foods, which can irritate the bladder.
2. Maintaining good hygiene: Keep genitals clean and change soiled pads frequently.
3. Exercising pelvic muscles: Remember Kegel exercises? When done done regularly, they strengthen the muscles in the pelvic floor which helps prevent involuntary loss of urine.
4. Using vaginal devices: Small devices can be inserted into the vagina or over the urethra to either support the bladder, block urine leakage, or help determine which muscles to contract and relax during Kegel exercises.
5. Electrical stimulation therapy: Painless therapy used to retrain the muscles used in urination.
6. Biofeedback: Usually accomplished with the help of a monitoring device, women learn to train their senses to control bodily function.
7. New voiding techniques: Regular urination at short intervals that are gradually extended to help retrain the bladder.
8. Medications: Different medications are available that can sometimes help. For urge incontinence, FDA-approved therapies include drugs (such as Detrol) and muscle relaxants (such as Ditropan or Urispas). For stress incontinence, there are currently no FDA-approved medications. However, decongestants are sometimes used for their potential to increase closure of the urethra. Estrogen and antihistamines may also be suggested. Study results about the effects of estrogen on stress incontinence are variable.
9. Bulking agents: Substances such as collagen can be injected into the area around the urethra to help stem leakage.
10. Surgery: An option for some types of incontinence. There are many techniques and it is important to find a surgeon with expertise and experience in this area. Urogynecologists have such specialized training.

For additional information, or to find an incontinence professional, contact the following:

National Association for Continence

The Simon Foundation for Continence

The Canadian Continence Foundation