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Urinary Incontinence

What is urinary incontinence?

Urinary Incontinence (UI) is the loss of urine control. Symptoms can vary from slight leakage of urine, to not having any control, or feeling strong urges to urinate. The problem can be short or long-term, and is often caused by other health issues, such as bladder infections. UI is not a normal part of aging, but is more common in older people.

Types of Urinary Incontinence:

  • Stress Incontinence—The most common form of incontinence. It occurs when movements such as exercise, coughing, sneezing, laughing, and lifting heavy objects put pressure on the bladder.
  • Urge Incontinence—When the need to urinate comes on very quickly. Often, not being able to get to a restroom in time. It may be a sign that conditions, like diabetes, stroke, dementia, Parkinson's disease, urinary tract infections, or an overactive bladder need attention.
  • Functional Incontinence—When you have urine control, but can't get to a restroom in time. Sometimes due to conditions, such as arthritis, that make it hard to move.
  • Overflow Incontinence—Small amounts of urine leak due to an over-filled bladder. It may feel like you can't fully empty your bladder.
  • Mixed Incontinence—Having more than one type of urinary incontinence.

Causes of Urinary Incontinence in older adults

  • Issues related to certain diseases or medicines
  • Menopause
  • Aging
  • Urinary tract infection
  • An enlarged prostate or treatment of a prostate problem
  • Stool build-up in the bowels
  • Obesity
  • Spinal cord injuries, diabetes, Parkinson's disease, and multiple sclerosis
  • Overactive bladder

Symptoms

  • Pain when filling the bladder or urinating
  • Stream of urine gets weaker and weaker
  • Urinating more often
  • Needing to rush to the restroom or not making it in time
  • Abnormal urination or changes related to stroke, spinal cord injury, or multiple sclerosis
  • Consistent urine leakage
  • Frequent bladder infections

Getting Diagnosed

If you're experiencing any symptoms, talk to your doctor about urinary incontinence. They may refer you to a urologist or urogynecologist that specializes in urinary tract diseases.

Types of Treatments

  1. Behavioral Therapies to Regain Bladder Control
    • Bladder Training—Teaches you to resist the urge to over-empty your bladder by going to the bathroom too often.
    • Toilet Scheduling—Using a routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder every 2 to 4 hours to prevent leaking.
  2. Pelvic Muscle Rehab to Prevent Leakage
    • Kegel Exercises—Pelvic exercises can strengthen the bladder muscles to improve, and even prevent, urinary incontinence. Women should perform them 30 to 80 times daily for at least 8 weeks.
    • Biofeedback—Learning how to relax and control stress can help you control your pelvic muscles and body functions. Best results when practiced with Kegel exercises.
    • Vaginal Weight Training—Tighten vaginal muscles using small weights held within the vagina for 15 minutes, twice a day, for 4 to 6 weeks.
    • Electrical Stimulation Therapy—Mild electrical pulses stimulate muscle contractions in the pelvis. Combine with Kegel exercises for best results.

Other Treatments

  • Medicine
  • Surgery
  • Diet changes
  • Adult incontinence products (diapers and pads)

Blue Cross Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. The joint enterprise is a Medicare-approved Part D Sponsor. Enrollment in Blue MedicareRx (PDP) depends on contract renewal.

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Last Updated: 01/01/2021

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