Urinary Incontinence

Introduction Signs Your Healthcare Provider May Find Urinary incontinence is defined as the uncontrolled or on Examination involuntary loss of urine of any amount. Urinary • Leakage of urine when asked to cough or bear down incontinence affects as many as 25 million Americans, during an examination with or without a full bladder. both men and women. Incontinence is a symptom, not a • Uncontrollable bladder contractions found on disease, and is never due to “just old age.” Incontinence specialized bladder testing. is a treatable and often curable condition. • Large amounts of urine left in the bladder after voiding found on an ultrasound evaluation or other specialized Four Different Types of Incontinence testing. • Stress Incontinence – The leakage of urine due to • Narrowing or blockage of the urethra found after increased abdominal pressure when sneezing, specialized testing. laughing, lifting, changing position, or exercising (i.e. jogging). Treatment • Urge Incontinence – The leakage of urine due to a • Limit your consumption of bladder irritants, including strong urge to urinate, usually on the way to the alcohol, caffeine, artificial sweeteners, carbonated bathroom. beverages, and foods and beverages high in sugar • Mixed Incontinence – A combination of both stress and citric acid. and urge incontinence. • Retrain your bladder with regular, timed voiding • Chronic Retention of Urine/Overflow throughout the day. When voiding, try to empty your Incontinence – A flaccid or enlarged bladder. It is the bladder completely. leakage that occurs when the bladder cannot fully • Perform daily exercises to strengthen the pelvic empty. It may be due to obstruction or injury, such as muscles. Studies have shown that the best way to enlarged prostate in men, scarring, or narrowing of the learn to do pelvic floor exercises is to work with a urethra (as a result of previous surgery, congenital trained healthcare professional. To perform these defects, sexually transmitted diseases or straddle exercises: squeeze your rectum like you are trying to injuries). Other causes include diabetes, stroke, stop from passing gas as this localizes the correct multiple sclerosis, spinal cord injury, and other muscles. Another way to locate these muscles, try to neurological disease. Overflow incontinence may also stop the flow of urine during voiding (do not do this be a side effect of medications. often). Perform quick and long contractions (holding and relaxing). You may do these exercises lying/sitting Symptoms You May Notice down or standing throughout the day. • Leakage of urine with physical activities, such as • Discuss with your healthcare professional whether or exercise, coughing, laughing, sneezing, or changing not medications that can reduce uncontrollable urges positions. to urinate are right for you. Also ask about the • A strong urge to urinate followed by uncontrollable possibility that your current medications may be leakage. affecting your bladder. • A need to strain when passing urine. • Ask your healthcare professional if you need a • Frequent urination; urinating more than 8 times per day referral to a specialist (urologist, gynecologist, or or more than 2 times per night. urogynecologist) to talk further about your diagnosis and treatment options.

Society of Urologic Nurses and Associates East Holly Avenue Box 56 Pitman, NJ 08071-0056 Phone 888-TAP-SUNA or 856-256-2335 [email protected] | www.suna.org © 2019 Society of Urologic Nurses and Associates, Inc. • Treatments for stress incontinence include lifestyle • Practice pelvic muscle exercises regularly to strengthen changes (weight loss; reducing dietary irritants, such as the muscles that support your pelvic organs. caffeine, artificial sweeteners); avoiding constipation • Stop smoking. Coughing due to smoking can increase and smoking cessation. Non-surgical treatments abdominal pressure and may contribute to stress include pelvic floor muscle exercises, pessary incontinence. Nicotine may cause frequency and placement in women; and possible bulking agent urgency, leading to urge incontinence. injections, such as collagen. Surgical treatments • Limit the use of alcohol. Alcohol can cause urgency include placement of an artificial urinary sphincter, and frequency, leading to incontinence. bladder neck suspension, or urethral sling. • Have a regular bowel routine. Constipation can lead to • Treatment for urge incontinence include: fluid difficulty emptying the bladder. Maintaining an management; time and amount of fluid, limiting adequate amount of fiber, whole grains, fruits, and alcoholic and caffeine beverages, dietary management vegetables in your diet will promote regularity. and weight reduction, avoiding constipation, pelvic • If you suspect a problem, keep a record of your diet floor exercises, bladder retraining and medications and voiding habits, and take them with you to your including antimuscarinics, mirabegron, and botulinum next appointment. This information will help your toxin injections. Surgical treatments include: placement healthcare professional discuss any concerns you may of sacral nerve stimulators, percutaneous tibial nerve have. stimulation (PTNS), and bladder augmentation. • Talk to your healthcare professional and find out how • Treatment for mixed incontinence includes your medications may be affecting your bladder combinations of the above treatments. control. Changes in dosage or times may prevent • Treatments for overflow incontinence include incontinence. surgical repair of urethral strictures, removal or • Be informed. Educate yourself by attending lectures, reduction of the obstruction, scheduled timed voiding, seminars, and health fairs in your community to learn clean intermittent catheterization, and most more about the causes of and treatment options for importantly, addressing or curing the underlying urinary incontinence. condition or cause. Reviewed and edited by Jennifer Abbott, PAC and Prevention Erica Harrell-Tompkins, MSN, RN, CWON, CCCN

• Maintain a healthy weight. Obesity can lead to Reference incontinence. • Empty your bladder regularly (at least every 2 to 4 Newman, D. K., Wyman, J. F., & Welch, V. W. (2017). Core Curriculum for Urology Nursing (1st ed.). Pitman, NJ: Anthony J. hours). It is also important to sit on or stand in front of Jannetti. the toilet and wait for your bladder to empty completely.

This material is for educational purposes only and should in no way be taken to be the practice or provision of medical, nursing or professional healthcare advice or services. The information should not be used in place of a visit, call, consultation or advice of your physician, nurse or other health care provider. The information obtained herein is not exhaustive and does not cover all aspects of the specific disease, ailment, physical condition or their treatments. Should you have any health care related questions, please call or see your physician, nurse or other health care provider promptly.

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