Urinary incontinence

Urinary incontinence (or loss of bladder control) can be embarrassing—even humiliating—but many people understand the problem because they experience it themselves. More than 10 million people, including at least 10 to 20 percent of all older adults—live with incontinence, though most won't talk about it much.

Before age sixty-five, incontinence affects three to five times more women than men. Women who have had children experience more problems because pregnancy places intense pressure on the bladder and muscles of the pelvic floor; in addition, labor and delivery can tear the muscles and surrounding tissues, sometimes leaving them less resilient than before. About 40 percent of women experience some incontinence during pregnancy, and 10 percent continue to have problems afterward. At menopause, the decrease in estrogen can weaken the pelvic floor muscles and thin the lining of the urethra, loosening the seal at the neck of the bladder.

Men experience less incontinence, in part because they have longer urethras (10 inches, versus about 2 inches for women). The prostate gland also helps support a man's urethra, helping to prevent leakage. An enlarged prostate, however, can put pressure on the bladder, so that after age sixty-five men and women have an almost equal chance of becoming incontinent.

Urinary incontinenceStill, you don't have to accept incontinence as an inevitable part of aging. Most cases of incontinence can be either controlled or cured. Incontinence isn't a disease, but a symptom of an underlying problem, such as weak muscles in the pelvic floor or an obstruction of the bladder outflow.

There are five basic types of chronic Urinary incontinence.

•   Stress Urinary incontinence is a condition in which small amounts of urine dribble out when you exercise, cough, laugh, sneeze, or move in other ways that put pressure on the bladder. Most cases of stress incontinence are associated with weak muscles in the pelvic floor, though in severe cases there may be nerve damage or tears in the sphincter muscles.

•   Urge Urinary incontinence usually involves the loss of large amounts of urine with little warning. It occurs when the need to urinate comes on so quickly that there isn't enough time to make it to the toilet. Urge incontinence can be caused by stroke, Parkinson's disease, kidney or bladder stones, or bladder infection.

•   Overflow Urinary incontinence involves urination with no warning or sensation. In such cases the urine overflows and spills out when a person shifts position or stands up. Often the person feels the need to urinate again a few minutes later but cannot empty the bladder completely. People with overflow incontinence have a high risk of bladder infection. It sometimes occurs following pelvic surgery or a bladder suspension operation. Diabetes or an enlarged prostate can contribute to overflow incontinence as well.

•   Reflex Urinary incontinence involves involuntary, spontaneous urination—no warnings, no urges, no rush to the bathroom. This lack of bladder control is usually caused by spinal cord injury, diabetes, multiple sclerosis, and other serious medical conditions.

•   Urinary incontinenceFunctional Urinary incontinence strikes people who have normal bladder control and warnings but cannot reach the bathroom fast enough due to physical limitations.

In addition, temporary Urinary incontinence can be caused by the use of diuretics and other medications. Most cases of incontinence can be controlled or managed by correcting the underlying health problem or condition.

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Urinary incontinence
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