National Institute on Aging incontinent. If this problem is happening to you, there is help. Incontinence can often be cured or controlled. Talk to your AgePage healthcare provider about what you can do. Causes of Incontinence Incontinence can happen for many Urinary reasons. For example, urinary tract in- Incontinence fections, vaginal infection or irritation, constipation, and some medicines can cause bladder control problems that last Sarah loves to spend time with her friends a short time. When incontinence lasts talking about her grandchildren and going longer, it may be due to: to exercise classes with neighbors. But she’s F Weak bladder muscles started to have a problem that keeps her from getting out. It’s embarrassing, but lately F Overactive bladder muscles Sarah hasn’t been able to get to the bathroom F Damage to nerves that control the before she wets her pants. She doesn’t know bladder from diseases such as mul- what’s happening, but the problem is keeping tiple sclerosis or Parkinson’s disease Sarah at home. F Blockage from an enlarged prostate Sarah may have a in men problem with bladder F Diseases such as arthritis that may control called urinary make it difficult to get to the bath- incontinence (the room in time accidental leakage of urine). While it What’s Happening? may happen to anyone, urinary incontinence is The body stores urine in the more common in older people. bladder. During urination, muscles in Women are more likely than men to be the bladder tighten to move urine into

2 a tube called the urethra. At the same Types of Incontinence time, the muscles around the urethra relax and let the urine pass out of the There are different types of body. Incontinence typically occurs if the incontinence: muscles relax without warning. F Stress incontinence occurs when urine leaks as pressure is put on Diagnosis the bladder, for example, during The first step in treating exercise, coughing, sneezing, incontinence is to see laughing, or lifting heavy objects. It’s a doctor. He or she the most common type of bladder will give you a control problem in younger and physical exam middle-age women. It may begin and take your medical around the time of menopause. history. The doctor will ask F Urge incontinence happens when about your symptoms and people have a sudden need to urinate the medicines you use. He or and aren’t able to hold their urine she will want to know if you have been long enough to get to the toilet. It sick recently or had surgery. Your doctor may be a problem for people who also may do a number of tests. These have diabetes, Alzheimer’s disease, might include: Parkinson’s disease, multiple sclerosis, F Urine and blood tests or stroke. F Tests that measure how well you F Overflow incontinence happens empty your bladder when small amounts of urine leak from a bladder that is always full. A In addition, your doctor may ask man can have trouble emptying his you to keep a daily diary of when you bladder if an enlarged prostate is urinate and when you leak urine. Your blocking the urethra. Diabetes and family doctor may also send you to an spinal cord injury can also cause this urologist, a doctor who specializes in type of incontinence. urinary tract problems.

3 4 F Functional incontinence occurs in many older people who have Kegel Exercises normal bladder control. They just Here is a brief description of Kegel have a problem getting to the toilet exercises that help tighten your because of arthritis or other disorders pelvic floor muscles. that make it hard to move quickly. Women – Locate your pelvic muscles Treatment by stopping the flow of urine mid- stream. Empty your bladder, lie down, Today, there are more treatments squeeze and hold these muscles for for urinary incontinence than ever be- a count of three, then relax them for fore. The choice of treatment depends a count of three. Do this 10 times. on the type of bladder control problem Your goal is to do at least three sets you have, how serious it is, and what of 10 each day. best fits your lifestyle. As a general Men – Identify your pelvic floor rule, the simplest and safest treatments muscles by stopping the flow of urine should be tried first. in midstream. Empty your bladder, Bladder control training may help and then lie on your back with knees you get better control of your bladder. apart and bent. Squeeze your pelvic Your doctor may suggest you try the muscles for a count of three and relax following: for a count of three. Work up to doing 10 of these exercises three times a day. F Pelvic muscle exercises (also known as Kegel exercises) work If you are having symptoms of the muscles that you use to stop leaking or often need to rush to the urinating. Making these muscles bathroom, talk to your healthcare stronger helps you hold urine in provider. It’s best to treat this your bladder longer. problem in the early stages when the exercises are most helpful. For F Biofeedback uses sensors to make more information about Kegel you aware of signals from your exercises, please see the National Institute of Diabetes and Digestive and Kidney Diseases website at www2.niddk.nih.gov.

5 6 body. This may help you regain manage incontinence: control over the muscles in your F Medicines can help the bladder bladder and urethra. Biofeedback empty more fully during urination. can be helpful when learning pelvic Other drugs tighten muscles and muscle exercises. can lessen leakage. F Timed voiding may help you control F Some women find that using an your bladder. In timed voiding, estrogen vaginal cream may help you urinate on a set schedule, relieve stress or urge incontinence. for example, every hour. You can A low dose of estrogen cream is slowly extend the time between applied directly to the vaginal walls bathroom trips. When timed voiding and urethral tissue. is combined with biofeedback and F A doctor may inject a substance that pelvic muscle exercises, you may find thickens the area around the urethra it easier to control urge and overflow to help close the bladder opening. incontinence. This reduces stress incontinence in F Lifestyle changes may help with women. This treatment may need to incontinence. You may benefit from: be repeated. losing weight, quitting smoking, F Surgery can sometimes improve or saying “no” to alcohol, drinking cure incontinence if it’s caused by less caffeine (found in coffee, a change in the position of the tea, and many bladder or blockage due to an sodas), preventing enlarged prostate. constipation, and avoiding lifting Male Incontinence heavy objects. Most incontinence in men is related Management to the prostate gland. Male incontinence may be caused by: Besides bladder control training, you may want to talk F Disease or injury to your doctor about other ways to help F Prostatitis – a painful inflammation of the prostate gland

7 8 F Damage to nerves or muscles from Incontinence and surgery Alzheimer’s Disease F Damage to nerves from People in the later stages of Alzheimer’s diseases such as diabetes disease often have problems with urinary F Stroke, Parkinson’s incontinence. This can be a result of disease, or multiple not realizing they need to urinate, sclerosis forgetting to go to the bathroom, or F Spinal cord injury not being able to find the toilet. F Nerve problems which To minimize the chance of accidents, result in an overactive the caregiver can: bladder • Avoid giving drinks like caffeinated F An enlarged prostate gland in men, coffee, tea, and some sodas that which can lead to Benign Prostate increase urination. But don’t limit Hyperplasia (BPH), a condition water. where the prostate grows as men • Keep the pathways clear and the age. Symptoms of BPH include: bathroom clutter-free with a light n Hesitant, weak, and irregular on at all times. urine stream • Make sure you provide regular n Feeling of urgency with leaking bathroom breaks. or dribbling • Supply underwear that is easy to n Frequent urination, especially get on and off. at night • Use absorbent underclothes for trips Over time, BPH can cause away from home. serious problems. Treating BPH early may reduce your chance of For more information about Alzheimer’s having urinary tract infections, disease, visit the Alzheimer’s Disease incontinence, and bladder and Education and Referral (ADEAR) Center kidney stones. website at www.nia.nih.gov/alzheimers, call 1-800-438-4380 (toll-free), or email [email protected].

9 10 For More Information For more information on health and aging, contact: Here are some helpful resources: National Institute on Aging National Association for Continence Information Center P.O. Box 1019 P.O Box 8057 Charleston, SC 29402-1019 Gaithersburg, MD 20898-8057 1-800-252-3337 (toll-free) 1-800-222-2225 (toll-free) www.nafc.org 1-800-222-4225 (TTY/toll-free) National Institute of Diabetes and www.nia.nih.gov Digestive and Kidney Diseases www.nia.nih.gov/espanol National Kidney and Urologic To sign up for regular email alerts Diseases Information Clearinghouse about new publications and other 3 Information Way information from the NIA, go to Bethesda, MD 20892-3580 www.nia.nih.gov/health. 1-800-891-5390 (toll-free) 1-866-569-1162 (TTY/toll-free) Visit www.nihseniorhealth.gov, a senior- http://kidney.niddk.nih.gov friendly website from the National Institute on Aging and the National National Library of Medicine Library of Medicine. This website has MedlinePlus health and wellness information for www.medlineplus.gov older adults. Special features make it Simon Foundation for Continence simple to use. For example, you can P.O. Box 815 click on a button to make the type larger. Wilmette, IL 60091 1-800-237-4666 (toll-free) www.simonfoundation.org

NIH...Turning Discovery Into Health®

June 2008 | Updated February 2013

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