inkontinence

Urinary incontinence is the involuntary leakage of urine that is sufficient to be troublesome or embarrassing. It is not a disease itself but a symptom that can reflect various underlying conditions. The condition is common in older adults and more prevalent in women, though it can affect people of any age.

The main types are stress urinary incontinence, urge urinary incontinence, mixed incontinence, overflow incontinence, and functional incontinence. Stress incontinence involves leakage with physical activities such as coughing, sneezing, or lifting. Urge incontinence is characterized by a sudden, strong urge to urinate followed by leakage. Mixed combines features of both. Overflow results from incomplete bladder emptying, and functional incontinence arises from cognitive or physical impairments that prevent timely toileting.

Causes and risk factors include weakened pelvic floor muscles after childbirth or menopause, urethral or bladder outlet problems, detrusor (bladder muscle) overactivity, neurological conditions, diabetes, obesity, smoking, and certain medications. Age and sex influence risk, but incontinence is not an inevitable part of aging.

Diagnosis typically begins with medical history and a physical examination, followed by urinalysis to exclude infection or other causes. A bladder diary, post-void residual measurement, and sometimes imaging, urodynamics, or cystoscopy are used in more complex cases to identify the type and underlying cause.

Management combines lifestyle adjustments, pelvic floor exercises, bladder retraining, and scheduled voiding. Treatments include medications such as antimuscarinics or beta-3 agonists for overactive bladder, vaginal devices or pessaries for structural support, bulking agents, and various surgical options (eg, midurethral sling, bladder neck suspension) for persistent stress incontinence. Functional and behavioral therapies remain important components.