By Jamie H. Chao, MD , May 16, 2017

Ever have a little “oops” leak down there? That’s how it usually starts. We’re talking about urinary incontinence.

Some people with this medical condition may have frequent or sudden urges to urinate. For other people, the disorder results in an inability to control the bladder. This can lead to leaks.

Both men and women can have urinary incontinence (UI). Women experience this condition about twice as often. Up to 45 percent of women have UI to some degree. 

Incidents of UI tend to increase with age. Among women age 20 to 39, up to 37 percent report some degree of UI. Among women older than 60, up to 39 percent report daily UI.

What Causes Urinary Incontinence?

There are many causes of UI, including:

• Pregnancy, childbirth, menopause and the structure of the female urinary tract are reasons the condition is more common in women.
• Diseases like diabetes, Parkinson’s and multiple sclerosis (MS) can damage the nerves that control your bladder.
• Urinary tract diseases, infections, strokes, surgeries and treatments for pelvic cancers can also cause UI.
• Tumors or obstructions.
• Poor kidney function.
• Certain medications.
• Certain foods or beverages.
• High fluid intake

Types of Urinary Incontinence

There are several types of UI. Each has a unique set of symptoms.

• Stress incontinence — Common in women, especially if you’ve given birth vaginally. Triggered by coughing, sneezing, laughing, bending or lifting. These triggers can cause urine leakage.
• Urge incontinence — Common in older men and women. Characterized by increased urinary urgency (overactive bladder), an uncontrollable flow of urine and increased urinary frequency.
• Overflow incontinence — Extremely frequent urination and an inability to completely empty the bladder. Dribbling urine.
• Functional incontinence — When you can’t move, think or communicate well enough to get to the bathroom on time. Most prevalent among the elderly and people with diseases such as Alzheimer’s or Parkinson’s disease.
• Mixed incontinence — A combination of the symptoms described above.

Nerve damage and prostate problems (in men) can cause incontinence.

What Are the Treatments for Urinary Incontinence?

Here’s good news: A number of treatment options are available. You can take a number of stepsyourself to remedy UI. If self-care doesn’t help, your health care provider can discuss approaches that may work for you and your lifestyle. Here are some of the common medical treatments.

• Behavioral modification therapy — Your provider can suggest techniques for you to adopt. These can include limiting the amount of fluid you drink, eliminating caffeine (which can irritate your bladder) or teaching yourself to hold your urine longer.
• Physical therapy or exercises — These strengthen your pelvic floor, which is the group of muscles that help to control urine flow.
• Vaginal insert (pessary) — Meant to support the urethra, these removable vaginal inserts can help prevent stress incontinence.
• Medications — Some block chemical messages in the nerves around the bladder, which relax the bladder muscles to increase your bladder capacity.
• Injections of medications — Certain substances can thicken your urethra wall so it seals more tightly to stop urine from leaking.
• Botox — For women who haven’t been helped by other injections, Botox injections can relax overactive bladder muscles. Benefits can last several months. Repeat injections may be needed once or twice each year.
• InterStim^® therapy — A small device – about the size of a stopwatch – is implanted under the skin of your hip. It sends mild electric impulses to the nerve that controls your bladder muscles.
• Sling procedures — During this minimally invasive surgery, your provider puts a sling made of synthetic or natural material around your urethra to support it, which helps prevent stress incontinence.

Your health care provider can review the benefits of each treatment and how they might work for you. If you’re thinking about a surgical solution, consider getting a second opinion.

If you’re coping with urinary incontinence, take heart. Help is available.