Urinary incontinence screening

Urinary incontinence is the loss of bladder control. The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence, also called overactive bladder.

Incontinence can happen when the bladder muscles suddenly tighten and the sphincter muscles are not strong enough to pinch the urethra shut. This causes a sudden, strong urge to urinate that you may not be able to control. Pressure caused by laughing, sneezing, or exercising can cause you to leak urine. Urinary incontinence may also happen if there is a problem with the nerves that control the bladder muscles and urethra. Urinary incontinence can mean you leak a small amount of urine or release a lot of urine all at once.

Who is at risk

Women are more likely than men to have urinary incontinence. In addition:

• Pregnancy
• Menopause
• Overweight
• Constipation
• Nerve damage
• Surgery
• Certain medications
• Caffeine
• Urinary tract or bladder infection

Symptoms

• Having a strong urge to urinate
• Urinating more often than what is usual for you
• Waking from sleep to urinate
• Painful urination
• Leaking urine while sleeping

What you can do

• If you have stress incontinence, Kegel exercises to strengthen your pelvic floor muscles may help.
• Losing weight.
• Changing your eating habits.
• Quitting smoking.
• Treating constipation.

Preventive service at no cost

Primary care doctors screen with short questionnaires to identify symptoms of urinary incontinence. Refer women for further evaluation and treatment if indicated.

Why screening is important

Many women are reluctant to discuss urinary incontinence with their health care providers, and the condition is often overlooked. Early treatment may prevent worsening symptoms, improve quality of life, and reduce the chances of more complex and costly treatment.

What the screening is

Your doctor or nurse will ask you about your symptoms and medical history during your well woman exam.

Treatment

• 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.

Additional tips

Don’t drink less. You need fluids, especially water, for good health.

Resources

• Bladder Control Problems