Effective Treatments Exist for Adult Incontinence

For toddlers, diapers are OK. But for adults, losing urine can mean anything from inconvenience to utter embarrassment.

Called incontinence, the problem of involuntary loss of bladder control hits countless people, whether young or old, men or women. Yet many are too shy to seek help or think it's an unavoidable part of growing older.

"I wouldn't say it's normal for it to happen," says Jeffry Huffman, M.D., urologist at the University of Southern California (USC). "But should doctors intervene? It depends on each person and how it affects their lifestyle." There are times when it can signify disease, Huffman says.

For example, if it is accompanied by blood in the urine, people should go to the doctor to get tests to rule out potentially serious conditions. It also may point to neurological problems or metabolic disorders. Incontinence comes in two types, Huffman explains.

The first is known as stress incontinence, and it is the most common. Women often experience it after pregnancy, when muscles in their pelvis become weakened. People with stress incontinence find they unexpectedly leak urine when they sneeze or exert force in some way.

The other type is urge incontinence. That means that people have urine leakage occurring as soon as they get a slight urge to go to the bathroom. The feeling may overwhelming, as the bladder muscle tightens uncontrollably at the wrong time.

"This is usually because of an infection," Huffman says. "There is usually some bladder pain associated withit." In the case of infection, patients are treated with antibiotics. But these contractions also can stem from bladder irritability after surgery or interstitial cystitis, a chronic inflammatory condition of the bladder wall. Sometimes they are caused by problems with the nervous system.

Doctors today have good treatments for most cases of incontinence, Huffman says. Often problems are solved by a simple surgical procedure in which surgeons lift and suspend the bladder. It can be a minimally invasive procedure in which patients can leave the hospital the same day or the next, he says.

Some doctors use implants near the opening of the bladder, Huffman says. And some patients do well with medications such as bladder relaxants. Others opt for exercises to strengthen the pelvic muscles.

Finally, in those whose incontinence is caused by surgical procedures or radiation from cancer treatment, surgeons may implant artificial sphincters to help restore control. For persistent cases, doctors may perform studies on pressure in the bladder, how much urine flows out of it and stays in it, and patients' neuromuscular function.

"Incontinence is a very common problem, and many people ignore it," Huffman says. "But it is treatable."