The Facts

When someone isn't able to control the ability to urinate and there's an involuntary loss of urine, then this person is said to have urinary incontinence. It's also called "leaky bladder."

It's a very common problem, especially among older adults - as many as 25% of seniors experience this condition. It generally affects more women than men. Many people believe that urinary incontinence is a normal part of aging, when in fact it's not. For this reason, many people don't seek medical help and never get properly diagnosed. In many cases, urinary incontinence can be cured, or at least significantly relieved.

Causes

Loss of urine can occur for a number of reasons that are related to the bladder (where urine is stored in the body) or the bladder sphincter (a thick muscle that controls the flow of urine out of the bladder).

Although aging itself doesn't cause incontinence, normal changes that occur in the urinary and genital systems as people age make this condition more common in the elderly. For example, the bladder and the muscles that support it tend to sag with age, making it more difficult to store urine. As well, many medications taken by seniors for various illnesses (such as hypertension and arthritis) can increase bladder problems and lead to incontinence. A common cause of transient urinary incontinence is a urinary tract infection.

There are four types of urinary incontinence:

Transient incontinence: This is incontinence related to factors that can be corrected or changed, such as urinary tract infection, medications, or severe constipation.

Stress incontinence: Urine will leak out in sudden spurts when someone coughs, sneezes, strains, or even laughs. All these activities increase the pressure on the abdomen and bladder, causing urine to abruptly flow out. It's very common among women with uterine prolapse and pelvic relaxation, conditions that weaken or stretch the muscles that support the uterus and bladder. This loss of support prevents normal bladder functioning or continence. As well, the loss of estrogen associated with menopause can lead to weakness of the pelvic muscle support and cause stress incontinence.

Overflow incontinence: This occurs when the bladder stores more urine than it can handle. It often affects elderly men who have enlarged prostate glands (called benign prostatic hyperplasia). The large prostate squeezes or compresses the urethra (the tube that empties urine from the bladder) and prevents normal flow of urine. The urine then starts to collect in the bladder until there's so much excess that the bladder becomes distended (over-stretched) and urine leaks out.

Urge incontinence: This condition causes people to feel an "urgent" need to urinate due to muscle spasms in the bladder. Factors such as infection, inflammation, strokes, dementia, and prostate gland enlargement can stimulate the bladder to create spasms and cause urine loss.