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Urinary incontinence happens when you lose bladder control or you leak urine involuntarily. It affects between 9 and 13 million people of all ages in the United States. The majority are women, and it is most common among elderly women. The more times a woman has given birth, the more her risk of urinary incontinence goes up. Smoking is also a risk factor.
Most of these women have stress incontinence, where you leak urine when you laugh, cough, sneeze, or exercise. Another type is urge incontinence, when you may have to "go" suddenly and can't hold the urine in. Some women have both types. Some people may experience temporary incontinence.
Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Your health care provider will give you a physical examination and ask questions about any past prostate problems, pregnancy, or hysterectomy, your pattern of urinating, when your urine leakage occurs, and whether you strain or have discomfort when urinating. You may be asked to cough vigorously to see if it causes urine loss, a sign of stress incontinence.
Your health care provider may suggest urine tests to find any infection, urinary stones, diabetes, and other underlying causes. A pelvic ultrasound may be done to look at your bladder, kidneys, and urethra.
Treatment can help more than 80% of people with urinary incontinence. Exercise and behavioral therapies are most successful. Common treatments include:
Several drugs are available to help with urge incontinence, including:
Other options for urge incontinence that hasn't responded to medication include:
Surgery may help women with stress incontinence and men with an enlarged prostate. Other options include catheters, urethral plugs, condom catheters, vaginal slings, and absorbent pads or underwear.
Complementary and Alternative Therapies
Alternative therapies include Kegel exercises, biofeedback, acupuncture, hypnosis, and herbal therapies. Yoga may help as well. Always tell your health care provider about the herbs and supplements you are using.
Nutrition and Supplements
Chondroitin sulfate -- One study suggested that chondroitin sulfate helped with symptoms or urge incontinence and overactive bladder as well as the medication Detrol. More studies are needed to know whether it really works. Avoid chondroitin sulfate if you are allergic to shellfish or have asthma. Chondroitin sulfate can increase the risk of bleeding, especially if you take blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix). Pregnant or breastfeeding women should not take chondroitin sulfate. Men with prostate cancer should ask their doctor before taking chondroitin.
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted. Speak to your doctor about any herbal therapies you are considering using.
St. John's wort (Hypericum perforatum), for symptoms of urinary incontinence. One laboratory study suggested St. John's wort has the potential to help with urinary incontinence, but it hasn't been tested for that in humans. St. John's wort can interfere with many medications. Check with your health care provider before taking St. John's wort if you are taking prescription medications. St. John's wort can affect mood, so people with a history of psychiatric illness should ask their doctors before taking it. Don't take St. John's wort if you are trying to become pregnant.
Some of the most common remedies used for urinary incontinence are listed below. Usually, the dose is 3 - 5 pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms get better.
Acupuncture may help, depending on what's causing the incontinence. Acupuncture may also strengthen the urinary system. In one study, women who received 4 weekly bladder acupuncture treatments had significant improvement in symptoms of urinary incontinence compared to women who received placebo treatments.
Exercise and behavioral therapy can help many people get rid of their symptoms. You have to stick with the changes for them to work, so it may help to have support from a loved one and close monitoring by your health care provider.
If you are pregnant, consult with your health care provider before taking any medication. For men, regular prostate examinations can find problems early.
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Review Date: 4/16/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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