Maryland General Logo
 
spacer

  home button seperater Medical Services Button seperater seperater seperater seperater

 

Home > Medical Reference > Patient Education

Services at Maryland General

A complete list of inpatient and outpatient healthcare services at MGH.

Urinary incontinence - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of urinary incontinence.

Alternative Names

Incontinence

Highlights:

Types of Urinary Incontinence

Urinary incontinence is generally categorized into the following types:

  • Stress incontinence is caused by activities (coughing, sneezing, laughing, running, or lifting) that apply pressure to a full bladder. Stress incontinence is very common among women, with childbirth and menopause increasing the risk for it. It can also affect men who have had surgical procedures for prostate cancer.
  • Urge incontinence, also called overactive bladder, is marked by a need to urinate frequently. There are many causes of urge incontinence, including medical conditions (benign prostatic hyperplasia, Parkinsonâ ' s disease, multiple sclerosis, stroke, and spinal cord injuries), surgeries (hysterectomy, radical prostatectomy), and infections.
  • Overflow incontinence occurs when the bladder cannot empty completely, which leads to dribbling. Bladder obstruction and inactive bladder muscle can cause overflow incontinence. Risk factors include certain types of medications, benign prostatic hyperplasia, and nerve damage.
  • Functional incontinence is incontinence due to mental or physical disabilities that impair a personâ ' s ability to use or get to the toilet, despite a healthy urinary system.
  • Mixed incontinence. Many people have more than one type of urinary incontinence.

Treatment of Urinary Incontinence

Treatment options for urinary incontinence depend on the type of incontinence and the severity of the condition. Treatments include:

  • Lifestyle Changes. Significant weight gain can weaken pelvic floor muscle tone, leading to urinary incontinence. Losing weight through healthy diet and exercise is important. Regulating the time you drink fluids and avoiding alcohol and caffeine are also helpful.
  • Behavioral Techniques. Pelvic floor exercises (Kegel exercises) can help strengthen the muscles of the pelvic floor that support the bladder and close the sphincter. Bladder training can help patients learn to delay urination.
  • Medications. Drugs, such as oxybutynin (Ditropan) and tolterodine (Detrol), are mainly used to treat urge incontinence.
  • Surgery. Many types of surgical procedures are used to correct anatomical problems that contribute to severe urinary incontinence.

Resources

References

Abed H, Rogers RG. Urinary incontinence and pelvic organ prolapse: diagnosis and treatment for the primary care physician. Med Clin North Am. 2008 Sep;92(5):1273-93, xii.

Albo ME, Richter HE, Brubaker L, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007 May 24;356(21):2143-2155. Epub 2007 May 21.

Burgio KL, Kraus SR, Menefee S, Borello-France D, Corton M, Johnson HW, et al. Behavioral therapy to enable women with urge incontinence to discontinue drug treatment: a randomized trial. Ann Intern Med. 2008 Aug 5;149(3):161-9.

Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: important outcomes for future clinical trials. J Urol. 2008 Nov;180(5):1890-7. Epub 2008 Sep 17.

Epstein BJ, Gums JG, Molina E. Newer agents for the management of overactive bladder. Am Fam Physician. 2006 Dec 15;74(12):2061-8.

Fader M, Cottenden AM, Getliffe K. Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007408.

Gibbs CF, Johnson TM 2nd, Ouslander JG. Office management of geriatric urinary incontinence. Am J Med. 2007 Mar;120(3):211-20.

Hagen S, Stark D, Maher C, Adams E. Conservative management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003882.

Hay-Smith J, Morkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007471.

Herbison GP, Arnold EP. Sacral neuromodulation with implanted devices for urinary storage and voiding dysfunction in adults. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD004202

Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008 Mar 26;299(12):1446-56.

Hunter KF, Glazener CM, Moore KN. Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD001843.

Jahn P, Preuss M, Kernig A, Seifert-HĂĽhmer A, Langer G. Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004997.

Keegan PE, Atiemo K, Cody J, McClinton S, Pickard R. Periurethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD003881.

Kuo HC. Comparison of effectiveness of detrusor, suburothelial and bladder base injections of botulinum toxin a for idiopathic detrusor overactivity. J Urol. 2007 Oct;178(4 Pt 1):1359-63. Epub 2007 Aug 16.

Landefeld CS, Bowers BJ, Feld AD, Hartmann KE, Hoffman E, Ingber MJ, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008 Mar 18;148(6):449-58. Epub 2008 Feb 11.

Lapitan MC, Cody JD, Grant A. Open retropubic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD002912.

Litwin MS, Saigal CS, editors. Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2007; NIH Publication No. 07–5512

MacDonald R, Fink HA, Huckabay C, Monga M, Wilt TJ. Pelvic floor muscle training to improve urinary incontinence after radical prostatectomy: a systematic review of effectiveness. BJU Int. 2007 Jul;100(1):76-81. Epub 2007 Apr 13.

Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004014.

Moore KN, Fader M, Getliffe K. Long-term bladder management by intermittent catheterisation in adults and children. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006008.

Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008 Sep 17;300(11):1311-6.

Rogers RG. Clinical practice. Urinary stress incontinence in women. N Engl J Med. 2008 Mar 6;358(10):1029-36.

Roxburgh C, Cook J, Dublin N. Anticholinergic drugs versus other medications for overactive bladder syndrome in adults. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003190.

Shamliyan TA, Kane RL, Wyman J, Wilt TJ. Systematic review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med. 2008 Mar 18;148(6):459-73. Epub 2008 Feb 11.

Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009 Jan 29;360(5):481-90.

van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, Lycklama á Nijholt AA, Siegel S, Jonas U, et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol. 2007 Nov;178(5):2029-34. Epub 2007 Sep 17.

  • Reviewed last on: 8/4/2009
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
  
 
Physician Directory
seperater
Physician Specialties
seperater
Medical Glossary
seperater
Guide for Patients
seperater
Guide for Visitors
seperater
 
   
 

About Us    ·     Contact Us     ·     Phone Listing     ·     Residency Programs     ·     Site Map     ·     Site Search     ·     Links     ·     FAQs

© 2008 Maryland General Hospital, All Rights Reserved   ·   827 Linden Avenue,   Baltimore, MD 21201   ·   410-225-8000
Commitment to Compliance   ·   Privacy Policy   ·   Terms and Conditions of Use   ·   Disclaimer   ·   JCAHO Public Notice