As you age, you will notice different changes in your mind and body, like memory loss, vision changes and fatigue. A common change in both older men and women that isn’t as openly discussed is changes in bladder function.
With age, the elastic bladder tissue can toughen and become less stretchy, and pelvic floor muscles can weaken. When this happens, problems with bladder emptying and urinary incontinence (leaking urine by accident), can occur.
Incontinence in both men and women
According to the Centers for Disease Control and Prevention (CDC), more than 40% of women older than 65 have urinary incontinence. Women experience unique health events throughout their lives that affect the urinary tract and pelvic floor muscles, such as pregnancy, childbirth and menopause. These events can cause the pelvic floor muscles to become weak or damaged, making it difficult for the bladder to hold urine.
Although men don’t experience these health events, urinary incontinence is still common in men older than 65 and is often related to prostate issues, such as an enlarged prostate or prostate cancer.
Risk factors for incontinence in both men and women include:
- Being overweight
- Previous pelvic surgery or radiation treatments
- Having other medical conditions, such as diabetes, high blood pressure, stroke or a neurological disorder
- Genes that cause weakened pelvic floor muscles
- Experiencing chronic constipation, which exerts pressure on the pelvic structures and strains pelvic floor muscles
- Smoking
- Consuming too much caffeine or alcohol
Types of urinary incontinence and symptoms
Although men and women have different risk factors to experiencing urinary incontinence, both can experience any of the several different types of incontinence. These include:
- Stress incontinence: the most common type of urinary incontinence that involves leaking of urine while coughing, sneezing, laughing, exercising or lifting heavy objects.
- Urge incontinence or overactive bladder: the inability to hold urine long enough to get to the restroom. It’s most common in those with other medical conditions.
- Overflow incontinence: caused by the bladder not being completely emptied when urinating.
- Functional incontinence: when a physical or mental impairment prevents you from urinating on time, such as dementia or severe arthritis.
- Mixed urine incontinence: when two of the above types of incontinence are experienced. It’s common to experience both stress and urge incontinence together.
If you are experiencing incontinence, it’s important to notice when you experience it so you can be diagnosed with the correct type of incontinence.
Non-invasive treatment options for urinary incontinence
Because there are many different types of urinary incontinence and levels of severity, there also are several treatment options. Fortunately, urinary incontinence is treatable and about 80% of people receiving treatment for it can expect symptoms to improve or even be cured.
If you’re experiencing symptoms that are affecting your daily life or causing you to feel stressed or anxious, it’s important to talk to your doctor.
With some cases, symptoms can be improved by making simple lifestyle changes. Your doctor may recommend trying these before attempting other treatment options:
- For stress incontinence, limit the amount of liquids you drink.
- For urge incontinence, avoid caffeine, alcohol or caffeinated beverages.
- Train your bladder by trying to hold the urge to urinate for 10 minutes each time you feel it. The goal is to train your bladder to work up to longer and longer intervals between bathroom breaks.
- Kegels; exercises to train pelvic floor muscles, can strengthen the muscles that control urination. To do these, imagine that you’re trying to stop your urine flow and contract these muscles for five seconds, and then relax for another five.
- If five seconds is too difficult, you can try starting off with a second or two and eventually work up to 10 seconds.
- Aim to do at least three sets of 10 repetitions every day.
Complex cases of urinary incontinence and treatment optionsFor more complex cases, your doctor may recommend other treatment options, such as medications, medical devices or surgery.
There are several medical devices available, some of these include:
- For women, urethral inserts that can be inserted into the vagina to increase pressure on the urethral muscles for added support.
- For men, external catheters help send urine through a tube into a drainage bag.
- Botox injections in the bladder that help the muscles relax.
Although lifestyle changes and medical devices have been proven to be successful, if they are not enough, your doctor may recommend surgical options.
Seeking care
If urinary incontinence is affecting your daily life and controlling your “golden years,” it’s important to talk to your primary care doctor about being referred to a specially trained urologist, which is an expert in diagnosing and treating diseases of the urinary tract. Find a primary care provider or urologist who can help at memorialcare.org/Providers.
Dr. Jennifer Liu, Diplomate of the American Board of Urology, specializes in the treatment of urologic cancers, urinary incontinence and dysfunction, sexual dysfunction and kidney stones.
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