Bladder control problems are conditions that affect the way a person holds or releases urine. Accidental loss or leaking of urine, called urinary incontinence (UI), is one of the most common bladder control problems. UI is not a disease but a condition that may be related to another health problem or life event, such as prostate problems or pregnancy.
Bladder control problems can be a small annoyance or can greatly affect your quality of life. You may be too embarrassed or afraid to participate in activities because of these problems, or you may be unable to complete your normal routine. For example, you may lose urine while running or coughing, or you may leak urine before you can get to a toilet.
Bladder control problems are common. Proper treatment may improve your quality of life. Talk with a healthcare professional about urine leaks. Healthcare professionals—especially gynecologists, urologists, and geriatricians—often talk with people about bladder control problems. Healthcare professionals can help treat the problem or manage the symptoms by suggesting simple lifestyle changes. Caregivers may find help from a healthcare professional or a support group. The sooner you get help, the sooner UI may improve.
Bladder control problems are common, especially in women. Researchers estimate that approximately half of all women experience UI. Women are more likely to develop UI during and after pregnancy, childbirth, and menopause. These events and how the female urinary tract is built make UI more common in women than men. Although UI is common, it is not a routine part of being a woman or getting older.
As many as 1 in 3 men over the age of 65 may lose urine by accident, and approximately half of men who seek treatment for lower urinary tract symptoms experience UI. A man is more likely to develop UI with age because prostate problems occur more often with age.
Factors that make you more likely to develop UI include:
You are more likely to have a particular type of UI if a family member has that same type of UI. For example, bedwetting often runs in families, and children may outgrow the problem at about the same age their parents did.
Bladder control problems that cause urine to leak are also called urinary incontinence (UI), urine leakage, and urine loss.
Types of bladder control problems are identified by their symptoms. The most common bladder control problems include:
Stress incontinence occurs when movement—coughing, sneezing, laughing, or physical activity—puts pressure on the bladder and causes urine to leak.
Urgency incontinence occurs when you have a strong urge or need to urinate, and urine leaks before you can get to a toilet. Urgency incontinence is often referred to as overactive bladder. This type of incontinence happens when certain nerves and bladder muscles don’t work together to hold urine in the bladder, and the urine is released at the wrong time.
You can have urgency and stress incontinence at the same time, which is called mixed incontinence.
With reflex incontinence, urine leaks without a warning or urge to urinate. This type of incontinence often happens when your bladder nerves are damaged and don’t “talk” to your brain correctly. During reflex incontinence, the bladder contracts, or reflexes, at the wrong time, causing urine to leak. Nerve damage from health conditions, such as multiple sclerosis, or from trauma, such as a spinal cord injury, are among the causes of reflex incontinence. Reflex incontinence is sometimes called “unaware” or “unconscious” incontinence.
Overflow incontinence occurs when the bladder doesn’t empty all the way, causing too much urine to stay in the bladder. With overflow incontinence, urine leaks because the bladder becomes too full.
Functional incontinence occurs when a physical disability or barrier, or a problem speaking or thinking, prevents you from reaching the toilet in time. For example, a person in a wheelchair may not be able to get to a toilet in time, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer’s disease may not realize he or she needs time to get to the toilet.
Temporary, or transient, incontinence lasts a short time due to a temporary situation, such as using a certain medicine or having an illness that causes leaking. For example, a urinary tract infection (UTI) or a bad cough may cause temporary incontinence.
Bedwetting, also called nocturnal enuresis, doesn’t only occur in children. Some adults leak urine while sleeping for a variety of reasons. Certain medicines or drinking caffeine or alcohol at night can make it hard to sleep through the night without leaking urine. In some cases, the bladder can’t hold enough urine overnight. Lifestyle changes often can improve these symptoms.
Some people wet the bed because they don’t produce enough of a certain hormone at night, which could be a sign of diabetes insipidus. Other health problems, such as a UTI, kidney stones, congestive heart failure, chronic kidney disease, prostate enlargement, or obstructive sleep apnea, can cause you to wet the bed or urinate frequently at night.
Signs and symptoms of urinary incontinence (UI) can include:
Health changes and problems, including those with your nervous system, and lifestyle factors can cause or contribute to UI in women and men.
Health changes and problems that can lead to UI include:
Some health problems can be short-term, like a urinary tract infection or constipation, and can cause temporary incontinence.
Problems with the nervous system are common causes of UI. Nerves carry messages from the bladder to the brain to let it know when the bladder is full. Nerves also carry messages from the brain to the bladder, telling muscles either to tighten or release. The brain decides if it’s an acceptable time to urinate. Functional incontinence can occur when there is a problem getting the messages from your brain to a part of your urinary tract—usually the bladder, the sphincters, or both.
Bladder nerves and muscles can be damaged or affected by:
Triggers that may cause a sudden, strong urge to urinate can include drinking or touching water, hearing running water, or being in a cold environment, such as reaching into the freezer at the grocery store.
Lifestyle factors that make women and men more likely to experience UI include:
Temporary incontinence is usually a side effect of a medicine or short-term health condition. Temporary incontinence can also be a result of eating and drinking habits, including using alcohol or caffeine.
Certain life events and health problems can lead to stress incontinence in women by weakening the pelvic floor muscles:
Weak pelvic floor muscles can make it hard for your bladder to hold urine in during stress incontinence. Stress incontinence occurs when an action—coughing, sneezing, laughing, or physical activity—puts pressure on your bladder and causes urine to leak. A weak pelvic floor can also cause fecal incontinence, or bowel control problems.
Men sometimes develop UI along with prostate problems.
Men have a prostate gland that surrounds the opening of the bladder. The prostate gets bigger as a man grows older. When a man’s prostate gets too big but isn’t cancerous, he has a condition called prostate enlargement, or benign prostatic hyperplasia (BPH). Men with an enlarged prostate may have:
Treatment for BPH can lead to stress incontinence, but it is usually temporary.
Men who have a history of radiation or surgery for prostate cancer may have short-term or long-term UI. Surgery, radiation, or other prostate cancer treatments can lead to nerve damage, bladder spasms, or stress incontinence. Bladder control problems after prostate cancer treatment can get better over time.
A healthcare professional will ask about your family and medical history and give you a physical exam. The exam will look for medical problems that may lead to accidental urine loss, also called urinary incontinence (UI). You may be asked to cough while your bladder is full to see if you leak urine. This is called a stress test, and healthcare professionals use it to help diagnose stress incontinence.
Additionally, you may be asked to keep a bladder diary, and your healthcare professional may order labs and other diagnostic tests.
A bladder diary is a record of:
You may want to keep a bladder diary for two to three days before seeing your health care professional. This helps your healthcare professional see patterns to narrow down the cause of your bladder control problems.
Your healthcare professional may order one or more tests to help find the cause of UI.
Physical activity is important for overall health and may prevent further bladder control problems. However, some activities such as running, jumping, or brisk walking may cause some people with UI to leak. If you haven’t found a medicine or other treatment that’s right for you, or you want extra peace of mind, new incontinence briefs and pads are discreet and effective at absorbing leaks and controlling odor. New technology and designs can make these products more comfortable to wear and may give you the confidence to get moving again.
Talk with your healthcare professional if your bladder control problems are making it difficult for you to be active.
Bladder problems don’t have to limit your activities. Getting help from a healthcare professional may keep you moving.
Untreated bladder problems can upset your lifestyle. You may avoid activities you once enjoyed. You might stop going to movies, meetings, or events because you don’t want to use the restroom in the middle of an activity or have an accident. These lifestyle changes can lead to depression or social anxiety.
If you often feel depressed or anxious about living with bladder control problems, talk with a healthcare professional.
Some people may avoid intimacy because they worry they may leak urine during sex. Talk with a healthcare professional if your bladder control problems are getting in the way of your sex life. Gynecologists and urologists regularly talk with people about health problems and can offer solutions.
If you have UI
