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Frequently Asked Questions About Incontinence and the Bladder

1. What is the difference between overactive bladder and urinary incontinence?

Overactive bladder, though usually grouped with urinary incontinence, is a distinct, even more common condition. The typical symptoms of overactive bladder – urinary urgency, frequency and, sometimes, leakage associated with a strong uncontrollable urge to void – are often referred to as urge incontinence. Urinary incontinence is simply the involuntary escape of urine from the bladder, and is treated differently by urologists.

2. Is it possible to have an overactive bladder without incontinence?

Yes. Most patients with overactive bladder do not have leakage of urine. Instead, they are bothered by urinary frequency and urgency.

3. What is the difference between urge and stress and urinary incontinence?

Urge incontinence is associated with overactive bladder and leakage with a strong desire to void. Urge incontinence is one of the most bothersome urinary symptoms.

Stress incontinence occurs through leakage of urine during coughing, sneezing, lifting, bending or exercise. The "stress" implied is physical, not mental.

Stress incontinence and urge incontinence are treated differently.

4. Can urinary incontinence be indicative of a serious condition?

Yes. Urinary incontinence may be the first symptom of a urinary tract infection, bladder cancer or severe neurologic problems.

5. Can men also develop urinary incontinence?

Yes. Men may also suffer from urinary incontinence. Risk factors include an enlarged prostate causing long-term blockage of the bladder, prostate surgery or radiation treatment. Neurologic disorders may also lead to urinary incontinence in men.

6. Is being overweight a risk factor for incontinence?

Yes. More and more studies are indicating that obesity is associated with urinary incontinence, particularly in women.

7. Is urinary incontinence curable?

Yes. In many cases, urinary incontinence is a curable condition. At times, even if the condition is not cured, the treatments significantly improve the patient's quality of life.

8. Can post-prostatectomy incontinence be successfully treated?

Yes. Currently there are several very good options to treat urinary incontinence after prostate cancer surgery. These include the male sling and the artificial urinary sphincter. The artificial sphincter is considered the gold standard in the treatment of post-prostatectomy incontinence.

9. What are the common tests performed to evaluate urinary incontinence?

A urinalysis, a bladder ultrasound and urodynamics are very common tests performed to evaluate urinary conditions. At times, a cystoscopic examination may also provide valuable information.

10. Can cranberry juice help prevent urinary incontinence?

No. There is no evidence that cranberry juice helps or prevents bladder control problems. Even the claim that cranberry juice prevents urinary tract infections remains unproven.

11. How can I tell when I have a urinary tract infection?

Typical symptoms include urinary frequency, urgency and burning during urination. Some patients also void cloudy or foul-smelling urine. The development of fever and chills is indicative of a more complicated form of urinary tract infection which can affect your kidneys and should be treated immediately.

12. What is a sling surgery?

Sling surgery is used to treat stress (activity-related) urinary incontinence. It consists of a "hammock-like" synthetic or biologic mesh material, which is surgically placed underneath the urethra without tension. This minimally invasive procedure may often be performed as an outpatient procedure. The recovery period is often very short. The success rate has been excellent in most series reported in the medical literature. However, a sling procedure should not be performed for urge urinary incontinence.

13. What is mixed urinary incontinence?

Mixed urinary incontinence is a combination of stress and urge urinary incontinence. The management can be challenging because stress and urge incontinence are treated using very different procedures.

14. What are the causes of urinary retention?

Urinary retention or failure to void can affect men and women. Men are more frequently affected because of prostate problems. Bladder outlet obstruction (blockage) or bladder weakness are the two main possibilities. Bladder weakness or bladder paralysis is often associated with diabetes or neurologic disorders. Urodynamic testing is the most useful test to explain the cause of urinary retention. A cystoscopic examination may also be useful in certain cases.

15. Can pregnancy affect bladder control?

Yes. Many women develop transient (temporary) urinary leakage or bladder control problems during pregnancy. At times, the problem may improve with bladder training and Kegel exercises. Incontinence may be more likely to become a persistent problem in mothers who vaginally deliver multiple or very large babies. When the problem persists and affects the patient's quality of life, treatment is often an option.

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