One of the most common urological problems is urinary incontinence (UI), the loss of control over urination, which affects millions of women. In some instances it’s as minor a problem as losing a few drops of urine while running or coughing. In other cases, women may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms.
Women experience UI twice as often as men. For some women, the risk of public embarrassment keeps them from enjoying activities with family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference.
But both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging. Older women experience UI more often than younger women.
Yet incontinence is not inevitable with age. UI is a medical problem. Your doctor or nurse can help you find a solution. No single treatment works for everyone, but many women can find improvement without surgery.
Causes of urinary incontinence
Incontinence stems from problems with muscles and nerves that help to hold or release urine. The body stores urine-water and wastes removed by the kidneys-in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.
During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body.
Incontinence will occur if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. Urine may escape with less pressure than usual if the muscles are damaged, causing a change in the position of the bladder. Obesity, which is associated with increased abdominal pressure, can worsen incontinence. Fortunately, weight loss can reduce its severity.