In men, it may indicate an enlarged prostate or other prostate problems. You should tell your doctor about any incontinence problems as soon as possible because it may be a sign of a more serious condition. With the help of your physician, you will be able to explore the causes and available treatment options.

Urinary incontinence is a common condition, becoming even more common as a person ages. In fact, at least one in 10 people age 65 or older experiences some form of urinary incontinence.

Many people suffer needlessly in silence. They are too embarrassed to consult with their doctors and get the help they would like and need. Some people think that the condition is an inevitable part of aging and that they can only manage the consequences of the disorder rather than explore the possible causes and the treatment options available. The treatment may be as simple as taking antibiotics to control an infection or learning exercises to strengthen the muscles that control the flow of urine.

An article in the December 16, 1998, issue of The Journal of the American Medical Association reports on the success of treating urge incontinence (see "Types of Urinary Incontinence") in women by teaching them muscle control and exercise techniques along with relaxation techniques. The researchers used biofeedback to help the women identify the correct muscles to exercise.

The study compared this group of women with women who were given a common medication for incontinence. The study found that these new skills, learned with the help of biofeedback, were more effective than medication (reducing the episodes of incontinence by 81 percent when compared with no treatment). Both biofeedback and medication were more effective than no treatment, which demonstrates the importance of getting treatment for incontinence.

Types of Urinary Incontinence:

(A person may have more than one type)

• Stress incontinence — Incontinence caused by pressure on the bladder from coughing, sneezing, laughing, lifting something heavy, or moving too quickly.

• Urge incontinence — Occurs when a person is aware of the need to urinate but can't control the urge and make it to the toilet soon enough.

• Overflow incontinence — Happens when the bladder is constantly full (from the inability to urinate normally or some blockage) and small amounts of urine escape.

Diagnosis:

• Urinary incontinence is easily diagnosed and is often treatable, depending on its cause. It is important for the patient and the patient's family to be open and honest with their physician about this condition.

• It is helpful to keep a record of your urinary habits and when you experience incontinence. This will help you and your physician learn which substances and situations may be contributing to your incontinence. Record how often you experience incontinence, any activity that precedes it (for example, it happens after standing quickly, laughing, exercising, etc), how much urine leaks (very little or a lot at once), if there is any warning before it happens, if it wakes you up at night, and whether incontinence follows ingesting any particular drinks, foods or medications.

Treatment:

Effective treatment depends on identifying the cause of urinary incontinence. The important thing is to see your doctor as soon as possible for an evaluation.

For More Information:

• National Institute on Aging
  NIA Information Center P.O. Box 8057
  Gaithersburg, MD 20898-8057
  (800) 222-2225
  (800) 222-4225 (TTY)
  http://www.nih.gov/nia/
  E-mail: niainfor@access.digex.net

• National Kidney and Urologic Diseases Information Clearinghouse
  3 Information Way
  Bethesda, MD 20892-3580
  http://www.niddk.nih.gov/health/kidney/nkudic.htm
  E-mail: nkudic@info.niddk.nih.gov

Additional Sources: American Medical Association Complete Guide to Women's Health, Agency for Health Care Policy and Research

Brian Pace, M.A., Writer
Richard M. Glass, M.D., Editor
Jeff Molter, Director of Science News

(JAMA. 1998; 280:2054)