Incontinencia Urinaria

Written by the doctors and editors at UpToDate

What is urinary incontinence? — “Urinary incontinence” is the term doctors use when a person leaks urine or loses bladder control. Incontinence is a very common problem, but it is not a normal part of aging. If you have urinary incontinence, you do not have to “just live with it.” There are treatments and things you can do on your own to stop or reduce urine leaks.

What are the symptoms of urinary incontinence? — There are different types of urinary incontinence. Each causes different symptoms. In men, the 4 main types are:

  • Stress incontinence – Men with stress incontinence leak urine when they laugh, cough, sneeze or do anything that “stresses” the belly. Some men get this type of incontinence after having surgery for prostate disease.
  • Urgency incontinence – Men with urgency incontinence feel a strong need to urinate all of a sudden. Urgency incontinence is also known as urge incontinence. Often the “urge” is so strong that they can’t make it to the bathroom in time. (If you have these sudden urges but do not leak urine, you might have an “overactive bladder.” That can also be treated.)
  • Mixed incontinence – Men with mixed incontinence have symptoms of both stress and urgency incontinence.
  • Incontinence caused by incomplete bladder emptying – Some men cannot fully empty their bladder when they urinate. This can happen if they have a condition called “benign prostatic hyperplasia,” which makes the prostate grow larger than normal. An enlarged prostate can block the flow of urine.

Is there anything I can do on my own to feel better? — Yes. Here are some steps that can help reduce urine leaks:

  • Reduce the amount of liquid you drink, especially a few hours before bed.
  • Cut down on any foods or drinks that make your symptoms worse. Some people find that alcohol, caffeine, or spicy or acidic foods irritate the bladder.
  • Lose weight, if you are overweight.
  • If you have diabetes, keep your blood sugar as close to normal as possible.
  • If you take medicines called diuretics, keep in mind that these medicines increase the need to urinate. Try to plan ahead and take them when you know you will be near a bathroom for a few hours. If you keep having problems with leaking because of diuretics, ask your doctor if you can take a lower dose or switch to a different medicine.

These techniques can also help with bladder control:

  • Bladder retraining –During bladder retraining, you “train” yourself to go to the bathroom only at scheduled times. For instance, you might decide that you will go every hour. In that case, you would make yourself go every hour, even if you didn’t feel the need to go. You would also try to wait until a whole hour had passed even if you needed to go sooner. Then, once you got used to going every hour, you would try to wait longer than an hour between bathroom visits. Over time, you might be able to “retrain” your bladder to wait 3 or 4 hours between bathroom visits.
  • Pelvic muscle exercises – Pelvic muscle exercises strengthen the muscles that control the flow of urine. When done right, these exercises can help. But people often do them wrong. Ask your doctor or nurse how to do them right.

Should I see my doctor or nurse? — Yes. Your doctor or nurse can find out what might be causing your incontinence. He or she can also suggest ways to help the problem.

Ask your doctor or nurse if any of the medicines you take could be causing your symptoms. Some medicines can cause incontinence or make symptoms worse.

How is incontinence treated? — Your treatment options depend on what type of incontinence you have. Some of the treatment options include:

  • Medicines to relax the bladder – These medicines can help with urgency incontinence.
  • Medicines to improve urine flow – These medicines can help with incontinence related to an enlarged prostate.
  • Surgery to (figure 1):
  • Repair the tissues that support the bladder or hold it in place
  • Improve the flow of urine, for example by removing part of the prostate gland
  • Repair the muscles that control urine flow
  • Electrical stimulation of the nerves that relax the bladder
  • Devices, such as:
  • A “condom catheter,” which fits over the penis like a condom and collects urine into a bag that is strapped to the leg
  • A penis clamp, which squeezes the penis to keep urine from leaking out (this can be used only for a certain amount of time)

What will my life be like? — Many men with incontinence can recover bladder control or at least reduce the amount of leakage they have. The key is to speak up about it to your doctor or nurse. Then work with him or her to find a treatment or therapy that helps you. Sometimes it takes a few tries before you find a solution, but the effort is worth it.


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