Urinary incontinence is the loss of voluntary bladder control that can cause leakage of urine. It can be temporary or last for a long time. There are four types of long-term or permanent incontinence:

• Stress incontinence — The most common type. Leakage occurs when there is extra pressure on the bladder. Triggers may include laughing, sneezing, lifting heavy objects, or exercise.
• Urge incontinence — Known as overactive bladder; a loss of bladder control following a strong urge to urinate. The bladder is unable to hold urine long enough to make it to a restroom.
• Overflow incontinence — The bladder will not empty, so urine builds up and the bladder overflows.
• Functional incontinence — There is normal bladder control, but the toilet can’t be reached in time.

People may have just one or a combination of these types.

• Medication
• Constipation
• Infection
• Muscle weakness
• Restricted mobility
• Obesity
• Endocrinological disorders such as diabetes

• Stress incontinence may be caused by:
  • Weakening of muscles that suspend the bladder
  • Weakening of muscles that control urine flow
  • Obesity
• Urge incontinence may be caused or worsened by:
  • Urinary tract infection
  • Diabetes type 1 and type 2
  • Bladder irritation such as a stone or a tumor
  • Drugs such as hypnotics or diuretics
  • Caffeine
  • Alcohol
  • Nerve damage due to:
    • Spinal cord injury
    • Stroke
    • Multiple sclerosis
    • Parkinson's disease
  • Constipation
  • Excessive fluid intake
• Overflow incontinence may be caused or worsened by:
  • A bladder that is blocked, such as by a scar in the urethra
  • Fecal impaction
  • Drugs such as antidepressants, hypnotics, antipsychotics, antihistamines, or calcium channel blockers
  • Vitamin B12 deficiency
  • Weak bladder muscles
  • Nerve damage due to:
    • Surgery
    • Diabetes
    • Spinal cord injuries
    • Other factors
• Functional incontinence may be caused by:
  • Medical conditions that make it difficult to move like severe arthritis
  • Drugs that cause confusion or sedation

• Childbirth—History of multiple pregnancies or vaginal deliveries
• Urinary tract infection
• Obesity
• Chronic lung disease
• Urethritis
• Previous hysterectomy or urethral surgery
• Pelvic organ prolapse
• Depression
• Dementia, including Alzheimer’s disease
• Menopause
• Diabetes
• Stroke
• Multiple sclerosis
• Spinal cord injury or disease
• Use of certain substances such as caffeine, alcohol
• Use of certain medications, such as cholinergic agents or alpha-agonists

• Blood tests
• Urine tests

• Stress test
• Urodynamic tests

• Ultrasound
• Cystoscopy

• Comprehensive evaluation
• Myofascial release (internal & external)
• Trigger point release (internal & external)
• Joint mobilization
• Massage
• Patient education
• Heat and ice
• Ultrasound
• Therapeutic exercise for the pelvic floor musculature
• Core strengthening
• Activity modification
• Postural education
• Stretching
• Relaxation techniques
• Biofeedback (internal & external)
• Electrical stimulation (internal & external)
• Muscle re-education
• Bladder and bowel retraining and patterning
• Fluid and food intake management
• Cardiovascular training
• Kegel instruction

• If advised by your doctor, do exercises to strengthen your pelvic floor muscles, such as Kegel exercises. This is especially important if you are pregnant.
• Reduce your intake of substances that lead to incontinence such as caffeine, alcohol, and certain drugs.
• Lose weight, if needed.
• Eat a healthy diet to avoid constipation.

• Urology Care Foundation

http://www.urologyhealth.org

• National Institute of Diabetes and Digestive and Kidney Diseases

http://www.niddk.nih.gov

• Health Canada

http://www.hc-sc.gc.ca

• Women's Health Matters

http://www.womenshealthmatters.ca

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