Incontinence is the involuntary loss of bladder control—a symptom caused by everyday habits or an underlying medical condition. Incontinence affects over 33 million people each year and many more cases go unreported. Aging, pregnancy, and prostate problems are the most common causes of urinary incontinence. Obesity and overall poor health can also increase the risk and exacerbate underlying symptoms.
There are four types of incontinence: urge incontinence, stress incontinence, overflow incontinence, and functional incontinence.
Urge incontinence, also known as an overactive bladder (OAB), is the frequent need to urinate throughout the entire day, and becomes more common with advancing age. The cause of OAB is unclear but it can be managed through exercises and a change of lifestyle.
Stress incontinence occurs due to insufficient strength of the closure of the bladder. The changes women experience from pregnancy, childbirth, and menopause are the leading causes of stress incontinence. The lower estrogen levels from menopause can lead to lower muscle pressure around the urethra and increase the chances of incontinence. Some remedies for stress incontinence include losing weight, performing kegel and pelvic floor exercises, and by drinking less caffeine and carbonated beverages.
Overflow incontinence occurs when a person has blockage of the bladder outlet or when the detrusor urinary muscle cannot empty the bladder normally. An enlarged prostate in men is the most common cause of overflow incontinence, but other causes may include a blocked urethra (e.g.: kidney stones), nerve damage, and certain medications. Treatment may be difficult and may require surgery.
The final type is functional incontinence, which is when a person is aware they must urinate but cannot due to physical or degenerative conditions such as dementia. Functional incontinence is common in elderly people as these conditions develop as one ages.
Enuresis refers to incontinence in children and includes nocturnal enuresis (bed wetting), diurnal enuresis (daytime wetting), and mixed enuresis, the combination of wetting both during the day and at night. The causes of enuresis include slower physical development, anxiety, and sleep apnea.
There are many treatments for incontinence, including behavioral changes, medication, surgery, and pelvic exercises. A physical therapist can assist you with an anti-incontinence exercise routine in order to strengthen the pelvic muscles, using biofeedback, or through electrical stimulation.
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