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Causes

By Mayo Clinic staff

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Illustration of the female urinary system Female urinary system
Illustration of the male urinary system Male urinary system

Urinary incontinence isn't a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what's behind your incontinence.

Causes of temporary urinary incontinence
Certain foods, drinks and medications can cause temporary urinary incontinence. A simple change in habits can bring relief.

  • Alcohol. Alcohol acts as a bladder stimulant and a diuretic, which can cause an urgent need to urinate.
  • Overhydration. Taking in a lot of fluids, especially in a short period of time, increases the amount of urine your bladder has to deal with.
  • Dehydration. If you don't consume enough liquid to stay hydrated, your urine can occasionally become very concentrated. This collection of concentrated salts can irritate your bladder and worsen incontinence.
  • Caffeine. Caffeine is a diuretic and a bladder stimulant that can cause a sudden need to urinate.
  • Bladder irritation. Carbonated drinks, tea and coffee — with or without caffeine — artificial sweeteners, corn syrup, and foods and beverages that are high in spice, sugar and acid, such as citrus and tomatoes, can aggravate your bladder.
  • Medications. Heart medications, blood pressure drugs, sedatives, muscle relaxants and other medications may contribute to bladder control problems.

Easily treatable medical conditions also may be responsible for urinary incontinence.

  • Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate. These urges may result in episodes of incontinence, which may be your only warning sign of a urinary tract infection. Other possible signs and symptoms include a burning sensation when you urinate and foul-smelling urine.
  • Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.

Causes of persistent urinary incontinence
Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including:

  • Pregnancy and childbirth. Pregnant women may experience stress incontinence because of hormonal changes and the increased weight of an enlarging uterus. In addition, the stress of a vaginal delivery can weaken muscles needed for bladder control. The changes that occur during childbirth can also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, your bladder, uterus, rectum or small bowel can get pushed down from the usual position and protrude into your vagina. Such protrusions can be associated with incontinence. Incontinence related to childbirth may develop right after delivery or take years to develop.

  • Changes with aging. Aging of the bladder muscle leads to a decrease in the bladder's capacity to store urine and an increase in overactive bladder symptoms. Risk of overactive bladder increases if you have blood vessel disease, so maintaining good overall health — including stopping smoking, treating high blood pressure and keeping your weight within a healthy range — can help curb symptoms of overactive bladder.

    After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. With less estrogen, these tissues may deteriorate, which can aggravate incontinence.

  • Hysterectomy. In women, the bladder and uterus lie close to one another and are supported by the same muscles and ligaments. Any surgery that involves a woman's reproductive system — for example, removal of the uterus (hysterectomy) — runs the risk of damaging the supporting pelvic floor muscles, which can lead to incontinence.
  • Painful bladder syndrome (interstitial cystitis). This rare, chronic condition occasionally causes urinary incontinence, as well as painful and frequent urination.
  • Prostatitis. Loss of bladder control isn't a typical sign of prostatitis, which is inflammation of the prostate gland — a walnut-sized organ located just below the male bladder. Even so, urinary incontinence sometimes occurs with this common condition.
  • Enlarged prostate. In older men, incontinence often stems from enlargement of the prostate gland, a condition also known as benign prostatic hyperplasia (BPH). The prostate begins to enlarge in many men after about age 40.
  • Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. However, more often, incontinence is a side effect of treatments — surgery or radiation — for prostate cancer.
  • Bladder cancer or bladder stones. Incontinence, urinary urgency and burning with urination can be signs and symptoms of bladder cancer or bladder stones. Other signs and symptoms include blood in the urine and pelvic pain.
  • Neurological disorders. Multiple sclerosis, Parkinson's disease, stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.
  • Obstruction. A tumor anywhere along your urinary tract can obstruct the normal flow of urine and cause incontinence, usually overflow incontinence. Urinary stones — hard, stone-like masses that can form in the bladder — may be to blame for urine leakage. Stones can be present in your kidneys, bladder or ureter.
Risk factors Symptoms
References
  1. Urge urinary incontinence/overactive bladder. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/urge-incontinence. Accessed May 16, 2009.
  2. Non-surgical treatment for female stress urinary incontinence. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/non-surgical-treatment-for-female-stress-urinary-incontinence. Accessed May 16, 2009.
  3. DuBeau CE. Treatment of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed May 16, 2009.
  4. Herbruck LF. Stress urinary incontinence: An overview of diagnosis and treatment options. Urology Nursing. 2008;28:186.
  5. Cartwright R, et al. Current management of overactive bladder. Current Opinion in Obstetrics and Gynecology. 2008;20:489.
  6. Urinary incontinence. National Institute on Aging. http://www.nia.nih.gov/HealthInformation/Publications/urinary.htm. Accessed May 16, 2009.
  7. Seeking treatment. National Association for Continence. http://www.nafc.org/seeking-treatment. Accessed May 16, 2009.
  8. Interstitial cystitis/Painful bladder syndrome. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis. Accessed May 16, 2009.
  9. How medications affect your bladder. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/urge-incontinence/medications. Accessed May 16, 2009.
  10. Facts and statistics. National Association for Continence. http://www.nafc.org/media/media-kit/facts-statistics. Accessed May 16, 2009.
  11. Urinary incontinence: What every man should know. National Association for Continence. http://www.nafc.org/bladder-bowel-health/what-is-incontinence/what-every-man-should-know. Accessed May 16, 2009.
  12. What I need to know about prostate problems. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/prostate_ez/#prostatitis. Accessed May 16, 2009.
  13. Urinary incontinence in women. National Association for Continence. http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.htm#evaluation. Accessed May 16, 2009.
  14. Cystoscopy and ureteroscopy. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/cystoscopy. Accessed May 16, 2009.
  15. Peterson JA. Minimize urinary incontinence: Maximize physical activity in women. Urology Nursing. 2008;28:351.
  16. Karsenty G, et al. Botulinum toxin A (Botox) intradetrusor injections in adults with neurogenic detrusor overactivity/neurogenic overactive bladder: A systematic literature review. European Association of Urology. 2008;53:275.
  17. Artificial urinary sphincter. National Association for Continence. http://www.nafc.org/uploads///pdf/educational%20brochures/OnlineAUS.pdf. Accessed May 17, 2009.
  18. Surgery for urinary incontinence. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp166.cfm. Accessed May 17, 2009.
  19. Surgical treatment for female stress urinary incontinence. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/surgical-treatment-for-female-stress-urinary-incontinence. Accessed May 17, 2009.
  20. Khan F, et al. Surgical treatment of stress urinary incontinence in women. http://www.uptodate.com/home/index.html. Accessed May 17, 2009.
  21. Cespedes RD. Is injection therapy for stress urinary incontinence dead? No. Urology. 2009;73:11.
  22. Christofi N, et al. An evidence-based approach to lifestyle interventions in urogynaecology. Menopause International. 2007;13:154.

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June 27, 2009

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