Urinary Incontinence
What is urinary incontinence (UI)?
Urinary incontinence (UI) is the loss of bladder control, or being unable to control urination. It is a common condition. It can range from being a minor problem to something that greatly affects your daily life. In any case, it can get better with proper treatment.
What are the types of urinary incontinence (UI)?
There are several different types of UI. Each type has different symptoms and causes:
- Stress incontinence happens when stress or pressure on your bladder causes you to leak urine. This could be due to coughing, sneezing, laughing, lifting something heavy, or physical activity. Causes include weak pelvic floor muscles and the bladder being out of its normal position.
- Urge, or urgency, incontinence happens when you have a strong urge (need) to urinate, and some urine leaks out before you can make it to the toilet. It is often related to an overactive bladder. Urge incontinence is most common in older people. It can sometimes be a sign of a urinary tract infection (UTI). It can also happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries.
- Overflow incontinence happens when your bladder doesn't empty all the way. This causes too much urine to stay in your bladder. Your bladder gets too full, and you leak urine. This form of UI is most common in men. Some of the causes include tumors, kidney stones, diabetes, and certain medicines.
- Functional incontinence happens when a physical or mental disability, trouble speaking, or some other problem keeps you from getting to the toilet in time. For example, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer's disease may not realize they need to plan to use the toilet.
- Mixed incontinence means that you have more than one type of incontinence. It's usually a combination of stress and urge incontinence.
- Transient incontinence is urine leakage that is caused by a temporary (transient) situation such as an infection or new medicine. Once the cause is removed, the incontinence goes away.
- Bedwetting refers to urine leakage during sleep. This is most common in children, but adults can also have it.
- Bedwetting is normal for many children. It is more common in boys. Bedwetting is often not considered a health problem, especially when it runs in the family. But if it still happens often at age 5 and older, it may be because of a bladder control problem. This problem could be caused by slow physical development, an illness, making too much urine at night, or another problem. Sometimes there is more than one cause.
- In adults, the causes include some medicines, caffeine, and alcohol. It can also be caused by certain health problems, such as diabetes insipidus, a urinary tract infection (UTI), kidney stones, enlarged prostate (BPH), and sleep apnea.
Who is at risk for urinary incontinence (UI)?
In adults, you are at higher risk of developing UI if you:
- Are female, especially after going through pregnancy, childbirth, and/or menopause
- Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
- Are a man with prostate problems
- Have certain health problems, such as diabetes, obesity, or long-lasting constipation
- Are a smoker
- Have a birth defect that affects the structure of your urinary tract
In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.
How is urinary incontinence (UI) diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms. Your provider may ask you to keep a bladder diary for a few days before your appointment. The bladder diary includes how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
- A physical exam, which can include a rectal exam. Women may also get a pelvic exam.
- Urine and/or blood tests
- Bladder function tests
- Imaging tests
What are the treatments for urinary incontinence (UI)?
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
- Not smoking
- Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.
- Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
- Medical devices, including
- A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.
- For women, a ring or a tampon-like device inserted into the vagina. The devices pushes up against your urethra to help decrease leaks.
- Bulking agents, which are injected into the bladder neck and urethra tissues to thicken them. This helps close your bladder opening so you have less leaking.
- Electrical nerve stimulation, which involves changing your bladder's reflexes using pulses of electricity
- Surgery to support the bladder in its normal position. This may be done with a sling that is attached to the pubic bone.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Chronic Kidney Disease
You have two kidneys, each about the size of your fist. Their main job is to filter your blood. They remove wastes and extra water, which become urine. They also keep the body's chemicals balanced, help control blood pressure, and make hormones.
Chronic kidney disease (CKD) means that your kidneys are damaged and can't filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.
The kidney damage occurs slowly over many years. Many people don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease.
Treatments cannot cure kidney disease, but they may slow kidney disease. They include medicines to lower blood pressure, control blood sugar, and lower cholesterol. CKD may still get worse over time. Sometimes it can lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplantation.
You can take steps to keep your kidneys healthier longer:
- Choose foods with less salt (sodium)
- Control your blood pressure; your health care provider can tell you what your blood pressure should be
- Keep your blood sugar in the target range, if you have diabetes
- Limit the amount of alcohol you drink
- Choose foods that are healthy for your heart: fruits, vegetables, whole grains, and low-fat dairy foods
- Lose weight if you are overweight
- Be physically active
- Don't smoke
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Erectile Dysfunction
Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But it's not a natural part of aging.
Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated.
Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Obesity
Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height.
Obesity happens over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active.
Obesity increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you have obesity, losing even 5 to 10% of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Birth Weight
What is birth weight?
Birth weight is the first weight of your baby, taken just after being born. A low birth weight means that the baby is less than 5 pounds, 8 ounces. A high birth weight means that the baby is more than 8 pounds, 13 ounces.
What can cause low birth weight?
A baby with a low birth weight can be born too small, too early (premature), or both. This can happen for many different reasons. They include:
- Health problems in the pregnant parent
- Taking certain medicines during pregnancy
- Substance use during pregnancy
- Infections during pregnancy
- Being pregnant with multiple babies
- Problems with the placenta, the organ that brings oxygen and nutrients to the baby
- Having small parents
- Genetic conditions in the baby
- Birth defects
What problems can low birth weight cause?
Babies with low birth weight may be more at risk of certain health problems. They include immediate problems, such as:
- Breathing problems
- Infections
- Hypoglycemia (low blood sugar)
- Jaundice
- Trouble keeping warm
There is also a higher risk of longer-term problems, including:
- Delayed motor and social development
- Learning disabilities
- Certain health conditions as an adult, such as heart disease, high blood pressure, diabetes, and obesity
What can cause high birth weight?
Causes of high birth weight can include:
- Having big parents
- Diabetes in the pregnant parent
- Certain genetic conditions
- Too much weight gain during pregnancy
What problems can high birth weight cause?
High birth weight can be a concern because it can make delivery of the baby difficult and raise the risk of birth injuries. The baby is at higher risk of problems with:
- Blood sugar
- Breathing problems
- Jaundice
Can birth weight problems be prevented?
You may be able to prevent some birth weight problems by:
- Getting regular checkups during pregnancy
- Getting the right amount of nutrition and calories during pregnancy
- Controlling your blood sugar if you have diabetes
- Avoiding substance use during pregnancy