Urinary incontinence means a person leaks urine by accident. While it may happen to anyone, urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled. Talk to your healthcare provider about what you can do.

What happens in the body to cause bladder control problems? The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don’t work the way they should, urine can leak. Incontinence typically occurs if the muscles relax without warning.

UI is the loss of bladder control, or being unable to control urination.

UI can affect men, women, and children, but women are twice as likely as men to experience UI. This is due to the structure of the female urinary tract as well as the effects of pregnancy, childbirth, and menopause. UI is also more common among older women, although it is not a normal part of the aging process.

Adults may experience one of several types of UI

• Stress incontinence is usually related to a structural issue, such as when the bladder is out of its normal position. Urine leaks can occur during physical movement such as laughing, coughing, exercising, or lifting, or when no movement is occurring.
• Urge incontinence or overactive bladder is usually related to the muscles around the bladder. It occurs when urine leaks at unexpected times, including during sleep. Urge incontinence is most common in older people and may or may not be a sign of a UTI. It is also associated with certain neurological conditions, such as multiple sclerosis.
• Overflow incontinence happens when an overfilled bladder causes uncontrollable leaking of urine. A person with overflow incontinence may feel unable to completely empty the bladder. Causes include tumors, kidney stones, diabetes, and medications. Overflow incontinence is most common in men.
• Functional incontinence is the inability to get to the bathroom in time because of a physical or other type of disability.
• Mixed incontinence occurs when a person experiences more than one type of incontinence. Generally, mixed incontinence refers to a combination of stress and urge incontinence.
• Transient incontinence occurs when urine leakage is caused by a temporary situation such as an infection or new medication. Once the cause is removed, the incontinence goes away.

No, UI is not a normal part of growing older, although it is more common among older people. Talk to a healthcare provider about the following age-related body changes that may cause or aggravate UI:

• Weak or bladder muscles or muscles that are in spasm
• Reduced bladder capacity, weaker urine stream, and the urge to urinate more often
• Thinning and drying of the skin in the vagina or urethra after menopause (women)
• Blockage from an enlarged prostate or the results of prostate surgery (men)

People in the later stages of Alzheimer’s disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. To minimize the chance of accidents, the caregiver can:

• Avoid giving drinks like caffeinated coffee, tea, and sodas, which may increase urination. But don’t limit water.
• Keep pathways clear and the bathroom clutter-free, with a light on at all times.
• Make sure you provide regular bathroom breaks.
• Supply underwear that is easy to get on and off.
• Use absorbent underclothes for trips away from home.

There are different types of incontinence:

• Stress incontinence occurs when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-age women. It may begin around the time of menopause.
• Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
• Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
• Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.

Incontinence can happen for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation. Some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:

• Weak bladder muscles
• Overactive bladder muscles
• Weak pelvic floor muscles
• Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson’s disease
• Blockage from an enlarged prostate in men
• Diseases such as arthritis that may make it difficult to get to the bathroom in time
• Pelvic organ prolapse, which is when pelvic organs (such as the bladder, rectum, or uterus) shift out of their normal place into the vagina. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak.

Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:

• Prostatitis—a painful inflammation of the prostate gland
• Injury, or damage to nerves or muscles from surgery
• An enlarged prostate gland, which can lead to Benign Prostate Hyperplasia (BPH), a condition where the prostate grows as men age.

Bladder problems can disrupt day-to-day life. When people have bladder problems, they may avoid social settings and have a harder time getting tasks done at home or at work. Common bladder problems include urinary tract infections, urinary incontinence, and urinary retention.

Some signs of a bladder problem may include:

• Inability to hold urine or leaking urine
• Needing to urinate more frequently or urgently
• Cloudy urine
• Blood in the urine
• Pain or burning before, during, or after urinating
• Trouble starting or having a weak stream while urinating
• Trouble emptying the bladder

If you experience any of these symptoms, talk to your health care provider.

Treatment for bladder problems may include behavioral and lifestyle changes, exercises, medications, surgery, or a combination of these treatments and others.

The first step in treating incontinence is to see a doctor. He or she will give you a physical exam and take your medical history. The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests. These might include:

• Urine and blood tests
• Tests that measure how well you empty your bladder

In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine. Your family doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.

Today, there are more treatments for urinary incontinence than ever be­fore. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.

Bladder control training may help you get better control of your bladder. Your doctor may suggest you try the following:

• Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating. Making these muscles stronger helps you hold urine in your bladder longer. Learn more about pelvic floor exercises and how to do them.
• Biofeedback uses sensors to make you aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra. Biofeedback can be helpful when learning pelvic muscle exercises.
• Timed voiding may help you control your bladder. In timed voiding, you urinate on a set schedule, for example, every hour. You can slowly extend the time between bathroom trips. When timed voiding is combined with biofeedback and pelvic muscle exercises, you may find it easier to control urge and overflow incontinence.
• Lifestyle changes may help with incontinence. Losing weight, quitting smoking, saying “no” to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation and avoiding lifting heavy objects may help with incontinence. Choosing water instead of other drinks and limiting drinks before bedtime may also help.

Besides bladder control training, you may want to talk with your doctor about other ways to help manage incontinence:

• Medicines can help the bladder empty more fully during urination. Other drugs tighten muscles and can lessen leakage.
• Some women find that using an estrogen vaginal cream may help relieve stress or urge incontinence. A low dose of estrogen cream is applied directly to the vaginal walls and urethral tissue.
• A doctor may inject a substance that thickens the area around the urethra to help close the bladder opening. This can reduce stress incontinence in women. This treatment may need to be repeated.
• Some women may be able to use a medical device, such as a urethral insert, a small disposable device inserted into the urethra. A pessary, a stiff ring inserted into the vagina, may help prevent leaking if you have a prolapsed bladder or vagina.
• Nerve stimulation, which sends mild electric current to the nerves around the bladder that help control urination, may be another option.
• Surgery can sometimes improve or cure incontinence if it’s caused by a change in the position of the bladder or blockage due to an enlarged prostate.

Even after treatment, some people still leak urine from time to time. There are bladder control products and other solutions, including adult diapers, furniture pads, urine deodorizing pills, and special skin cleansers that may make leaking urine bother you a little less.

People rarely talk about bladder health, but everyone is affected by it. Located in the lower abdomen, the bladder is a hollow organ, much like a balloon, that stores urine. Urine contains waste and extra fluid left over after the body takes what it needs from what we eat and drink. Each day, adults pass about a quart and a half of urine through the bladder and out of the body.

As people get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less flexible bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken, making it harder to empty the bladder fully and causing urine to leak.

While you can’t control everything that affects your bladder, here are 15 steps you can take to keep it as healthy as possible:

1. Use the bathroom often and when needed. Try to urinate at least once every 3 to 4 hours. Holding urine in your bladder for too long can weaken your bladder muscles and make a bladder infection more likely.
2. Be in a relaxed position while urinating. Relaxing the muscles around the bladder will make it easier to empty the bladder. For women, hovering over the toilet seat may make it hard to relax, so it is best to sit on the toilet seat.
3. Take enough time to fully empty the bladder when urinating. Rushing when you urinate may not allow you to fully empty the bladder. If urine stays in the bladder too long, it can make a bladder infection more likely.
4. Wipe from front to back after using the toilet. Women should wipe from front to back to keep gut bacteria from getting into the urethra. This step is most important after a bowel movement.
5. Urinate after sex. Sexual activity can move bacteria from the bowel or vaginal cavity to the urethral opening. Both women and men should urinate shortly after sex to lower the risk of infection.
6. Do pelvic floor muscle exercises. Pelvic floor exercises, also known as Kegel exercises, help hold urine in the bladder. Daily exercises can strengthen these muscles, which can help keep urine from leaking when you sneeze, cough, lift, laugh, or have a sudden urge to urinate. These exercises also may help avoid infections by strengthening the muscles that help empty the bladder.
7. Wear cotton underwear and loose-fitting clothes. Wearing loose, cotton clothing will help keep the area around the urethra dry. Tight-fitting pants and nylon underwear can trap moisture and help bacteria grow.
8. Exercise regularly. Physical activity can help prevent bladder problems as well as constipation. It can also help maintain a healthy weight.
9. Keep a healthy weight. People who are overweight may be at higher risk for leaking urine. Making healthy food choices and being physically active can help keep a healthy weight.
10. Watch what you eat. Some people with bladder problems find that some foods and drinks, such as sodas, artificial sweeteners, spicy foods, citrus fruits and juices, and tomato-based foods, make bladder problems worse. Changing your diet may help you feel better.
11. Drink enough fluids, especially water. More than half of the human body is made up of water, so it is important that you are drinking enough. How much water you need can vary based on your size, activity level, and where you live. In general, drink enough fluids so that you need to urinate every few hours. Some people need to drink less water because of certain conditions, such as kidney failure or heart disease. Ask your health care provider how much fluid is healthy for you.
12. Limit alcohol and caffeine. For many people, drinking alcohol can make bladder problems worse. Caffeinated drinks (like coffee, tea, and most sodas) can bother the bladder and increase symptoms such as frequent or urgent need to urinate. Cutting down may help.
13. Avoid constipation. Too much stool built up in the colon, called constipation, can put pressure on the bladder and keep it from expanding the way it should. Eating plenty of high-fiber foods like whole grains, vegetables, and fruits), drinking enough water, and being physically active can help prevent this from happening.
14. Quit smoking. Bladder problems are more common among people who smoke. Smoking can also increase the risk for bladder cancer. If you smoke, take steps to quit.
15. Know your medications. Some medications may make it more likely for your bladder to leak urine. Medications that calm your nerves so you can sleep or relax may dull the nerves in the bladder, and you may not feel the urge to go to the bathroom.