Urinary incontinence is the inability to hold urine inside the bladder voluntarily or to prevent leakage or dribbling.
Urine is stored in the bladder until it is eliminated from the body through a tube called the urethra. Urine flow and leakage are normally controlled by sphincter muscles, which tighten and close around the neck of the bladder and urethra.
When urination begins, bladder muscles contract to squeeze urine out of the bladder and sphincter muscles relax to allow the urine to pass. When urination is completed, the bladder relaxes and the sphincter contracts.
Incontinence affects an estimated 17 million Americans of all ages, although it is more common in women and older adults.
Embarrassment prevents many people from seeking treatment. However, incontinence is a common medical condition and effective treatment is available in the majority of cases.
Stress incontinence is the most common form of incontinence. It occurs when the internal sphincter muscles do not close completely around the bladder neck. Activities such as coughing, sneezing, laughing, or lifting heavy objects apply pressure to a full bladder and cause urine to leak.
Women are more prone to stress incontinence during pregnancy, childbirth, and menopause. Prostate surgery and radiation treatment are the primary causes of stress incontinence in men.
Urge incontinence occurs when an overactive bladder contracts involuntarily and causes urine to leak, sometimes in large amounts. Bladder or prostate infection, bladder cancer, or stone disease can irritate the bladder lining and trigger overactivity.
Neurological conditions such as spinal cord injury, stroke, Parkinson's disease, or multiple sclerosis affect communication between the brain and bladder and cause the bladder to contract inappropriately.
Overflow incontinence occurs when the bladder is allowed to become so full that it simply overflows. When bladder nerves are damaged due to illness or injury, they may not recognize when the bladder is full.
Blockage or narrowing of the bladder outlet by cancer or scar tissue may prevent normal emptying of the bladder. Benign prostatic hyperplasia (an enlarged prostate) can also cause such blockage. For this reason, overflow incontinence is more common in men than in women.
The Department of Urology provides expert evaluation and treatment of all aspects of male and female urinary incontinence. A wide range of treatments is available, including bladder retraining, exercises, biofeedback, medication, and corrective surgery.
Members of the Neurorology and Urinary Incontinence Programs at UPMC are world leaders in the exploration of new and innovative therapies for all types of urinary incontinence.
Exciting research in stress incontinence is under way, in which a patient's own muscle stem cells are used to strengthen the sphincter. The stimulation of the sacral nerve (which controls bladder function) is being evaluated for refractory urinary incontinence.
The Department of Urology is also involved in the evaluation of new drugs under FDA investigation for incontinence treatment.
For patient referral or consultations, contact the Department of Urology at 412-692-4100.
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