Urinary incontinence

Urinary incontinence is any accidental or involuntary loss of urine. It is common, especially with age and after childbirth, and though often not talked about, it is usually very treatable. It comes in patterns that point to the cause. Stress incontinence — leaking with coughing, laughing, lifting or exercise — reflects weakened pelvic-floor muscles or support, common after pregnancy and childbirth and around menopause. Urge incontinence — a sudden, intense need to urinate that is hard to defer, often with frequency and night-time trips — reflects an overactive bladder. The two often coexist (mixed incontinence). In men, incontinence is frequently linked to prostate enlargement or prostate surgery. Overflow incontinence — a constant dribble from a bladder that never fully empties — can occur with an obstruction (such as prostate enlargement) or a nerve problem. Temporary incontinence can come from a urinary infection, constipation, certain medicines, or simply too much caffeine or fluid. Because the treatments differ — pelvic-floor exercises, bladder training, medicines, treating the prostate or an infection — identifying the type and cause is the key step, and most people can be significantly helped.

• Weak pelvic-floor muscles (stress incontinence) — leaking with coughing, exercise; common after childbirth and around menopause.
• Overactive bladder (urge incontinence) — sudden strong urges hard to hold.
• Prostate enlargement or prostate surgery — a common cause in men.
• Bladder obstruction (overflow incontinence) — a bladder that never empties fully.
• Urinary tract infection — can cause temporary incontinence.
• Constipation, certain medicines, caffeine or excess fluids.
• Nerve conditions — affecting bladder control.

The type of incontinence is worked out mainly from the pattern and a clinical assessment, but a few tests help. A urinalysis and, if needed, a urine culture check for infection or blood. In men, prostate assessment (including PSA where appropriate) is relevant when enlargement is suspected. Sometimes the bladder is checked to see whether it empties fully. A bladder diary — recording drinks, urination and leaks — is often more useful than any blood test for pinpointing the pattern. Mediora.AI can flag a urinary infection or, in men, a raised PSA from your results that may relate to the incontinence; the assessment of type and cause belongs with your doctor.