Bladder control issues can significantly affect an older adult’s quality of life, limiting socializing, affecting mobility, and causing discomfort. While it's a common concern, especially for seniors, bladder problems are not a normal part of aging and are often treatable. If you or a loved one is experiencing loss of bladder control, the good news is there are several treatment options for people experiencing urinary incontinence. With the help of your primary care doctor, you can feel more empowered to take control and seek the help you need.

The urinary tract is your body's drainage system and handles removing waste in the form of urine. Here's a quick overview of how it works:¹

• Kidneys: Filter waste from the blood.
• Ureters: Tubes that carry liquid waste from the kidneys to the bladder.
• Bladder: Stores urine until it's time to empty.
• Internal sphincter: A muscle that keeps urine in the bladder until you're ready to urinate.
• Urethra: The tube that carries urine out of the body.

Urinary incontinence is the involuntary loss of bladder control. While common, it's important to remember that it's not a normal part of aging and there are ways to improve or even resolve the issue. According to the National Association for Continence, over 33 million Americans suffer from some type of incontinence.²

Incontinence occurs when the bladder suddenly contracts or the sphincter muscles are weakened. Several factors can contribute to this, including:³

• Pregnancy, childbirth, and menopause: These hormonal shifts can weaken pelvic floor muscles in women.
• Enlarged prostate: This can cause incontinence in men.

Other contributing factors could be constipation, nerve damage, caffeine, alcohol, medications, infections, and excess weight.³

Understanding the type of incontinence you experience is crucial for effective treatment. Here are the most common types:⁴

• Stress incontinence: Leakage occurs during physical activities like coughing, laughing, or exercising.
• Urge incontinence: A sudden, intense urge to urinate, often followed by leakage before reaching the bathroom.
• Overflow incontinence: Frequent or constant dribbling of urine due to a full bladder that doesn't empty completely.
• Functional incontinence: Difficulty reaching the toilet in time due to physical or mental limitations.
• Mixed incontinence: A combination of two or more types, typically stress and urge incontinence.

Fortunately, incontinence is treatable. While there isn't a one-size-fits-all solution, several effective strategies can help. For example:⁴

• Pelvic floor training (Kegel exercises): Strengthening these muscles can improve bladder control.
• Timed or double voiding: Urinating on a schedule can help retrain your bladder. Also, urinating the trying again moments later to make sure the bladder is empty is referred to as double voiding.
• Delayed urination: Practicing holding off urination when you feel the urge can strengthen bladder control.

Simple lifestyle adjustments can also make a difference:⁴

• Weight management: Losing weight, if needed, can reduce pressure on the pelvic floor.
• Quit smoking and limit alcohol: Smoking is linked to increased incontinence episodes, and alcohol can worsen leakage.
• Healthy diet and caffeine limitation: Fiber-rich foods can prevent constipation, which can exacerbate incontinence. Limiting caffeine may also help.
• Hydration: Staying hydrated by drinking water promotes good bladder health by diluting urine and preventing kidney stones. Not drinking enough water can cause dehydration, which can encourage bacteria growth. - BROWN
• If changing your habits or lifestyle doesn’t seem to improve your condition, talk to your doctor about other treatment options. Your doctor may recommend:
• Medications: Various medications can help manage incontinence.⁵
• Devices: A pessary is a silicone ring that is inserted into the vagina to support the urethra, which helps prevent urine leakage in women.⁶
• Nerve stimulation: Electrodes stimulate and strengthen pelvic floor muscles.⁵
• Injections: Thickening agents can be injected around the urethra, the hollow tube that releases urine from the body. This can reduce stress incontinence, but it is not a permanent solution and may need to be repeated.⁶
• Biofeedback: A technique that uses electronic devices to monitor and provide real-time feedback. This helps you learn to control bladder and urethral muscles.⁶
• Catheterization: A thin tube is inserted to drain the bladder.⁶
• Surgery: Sling procedures or bladder neck suspension may be considered in some cases.⁵

Talking to your doctor is the first step towards regaining bladder control. Before visiting your primary care doctor, think about ways to get the most from your visit. To prepare for your appointment:

• Medication list: Bring a list of all medications, including vitamins and supplements.
• Symptom log: Record your symptoms and any questions you have.
• Support person or notebook: Bring someone to help you remember information or take notes.

Your doctor may also ask you to keep a bladder diary to track patterns.

Remember, urinary incontinence is treatable. By understanding the causes, types, and treatment options, you can take proactive steps to improve your bladder control and reclaim your comfort and confidence. Don't hesitate to reach out to your healthcare provider for support and guidance.

Content contained on this page is for informational purposes only and does not constitute medical advice. Consult your health care provider before beginning any new fitness or dietary plan. References provided are for informational purposes only and do not constitute endorsement of any websites or other sources. Should you have any health-related questions, you should contact your health care provider.

• The Urinary Tract & How It Works, National Institute of Diabetes and Digestive and Kidney Diseases, last accessed April 11, 2025, https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-how-it-works.
• Urinary Incontinence: Causes And Treatment, National Association for Continence, last accessed April 11, 2025, https://nafc.org/urinary-incontinence.
• Urinary Incontinence, Cleveland Clinic, last accessed Feb 20, 2025, http://my.clevelandclinic.org/services/ob-gyn-womens-health/diseases-conditions/urinary-incontinence.
• Urinary Incontinence in Older Adults, National Institute on Aging, last accessed February 20, 2025, https://nia.nih.gov/health/urinary-incontinence-older-adults.
• Urinary Incontinence, Cleveland Clinic, last accessed April 11, 2025, https://my.clevelandclinic.org/health/diseases/17596-urinary-incontinence#symptoms-and-causes.
• Urinary Incontinence Diagnosis & Treatment, Mayo Clinic, last accessed February 20, 2025, https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/diagnosis-treatment/drc-20352814.

Managing incontinence requires different treatment methods and lifestyle decisions, from setting reminders to starting new exercise plans or therapies. When managing the practical, everyday challenges, think about the following to feel prepared and confident about living without worry.⁶

• Skincare: Keep the area clean and dry to prevent irritation.
• Absorbent pads: Use pads to protect clothing and manage leakage.
• Extra clothes: Keep a spare set of clothes handy.
• Bathroom planning: Locate restrooms in advance when in unfamiliar places.