General Urology

Incontinence: Urinary Leakage

What Is It?

Urinary leakage (urinary incontinence) is the involuntary leakage of urine, often times without warning. Men, women, and children may experience urinary leakage; however, women are more often affected by this condition.

Symptoms of Urinary Leakage

Urinary leakage may present alone or in combination with urinary urgency (sudden need to urinate), dysuria (painful urination), or urinary frequency.

Urinary leakage is usually a daytime condition, however, some individuals experience nighttime leakage.
In women who have had children vaginally, symptoms of pressure or fullness in the vagina may be present indicating prolapse (protrusion) of the bladder or rectum into the vagina.

Evaluation and Diagnostic Studies

A thorough history and physical examination often points to the type of leakage thus guiding treatment. Urinary incontinence is categorized into three types: stress urinary incontinence, urge urinary incontinence, and mixed urinary incontinence.

Stress urinary incontinence is usually experienced when there is an increase in abdominal exertion or strain such as coughing, sneezing, laughing, or any physical exertion that strains the abdomen. Women are mostly affected by this form of incontinence following vaginal childbirth. Men that have had prostate surgery (usually for prostate cancer) may experience this form of leakage as well.

Urge urinary incontinence is leakage that is accompanied by “urgency” or the strong need to urinate which is not controllable in most cases. Individuals with this form of leakage often experience urinary frequency.

Usually, a thorough physical examination can help determine the cause of leakage. Other tests such as a urodynamic test may be required to help determine the cause of leakage thus help guide treatment recommendations.

Mixed urinary incontinence is a combination of stress and urge urinary incontinence.

Treatment

Treatment for this condition is usually successful and varies from conservative therapy such as dietary modification and biofeedback (exercises that help strengthen the pelvic muscles which prevent leakage).
When conservative measures fail, medications may be used to lessen leakage episodes. These medications work best on urge urinary incontinence.

Outpatient surgery may be required in cases of stress urinary leakage that is not responsive to pelvic muscle exercises. This form of treatment is very effective in controlling urinary leakage.

Urinary incontinence can be a bothersome condition. Fortunately, treatments for this condition are effective and usually result in patient satisfaction.