The NIDDK would like to thank Catherine Bradley, MD, MSCE, University of Iowa Hospitals & Clinics; Joseph A. Costa, DO, University of Florida Health, Jacksonville
What are bladder control problems?
Bladder control problems are conditions that affect the way a person holds or releases urine. Accidental loss or leaking of urine, called urinary incontinence (UI), is one of the most common bladder control problems. UI is not a disease, but a condition that may be related to another health problem or a life event, such as pregnancy in women or prostate problems in men.
Bladder control problems can be a small annoyance or can greatly affect a person’s quality of life. A person may be too embarrassed or afraid to participate in activities or may be unable to complete his or her normal routine. For example, a person may lose urine while running or coughing. Or, it may be hard to get to a toilet in time.
Bladder control problems are common, and a person’s life may get better with proper treatment. Talk with a health care professional about urine leaks. A doctor can help treat the problem or manage symptoms, including urine odor. Caregivers may find help from a health care professional or a support group. Gynecologists, urologists, and geriatricians—doctors who specialize in the health and care of older adults—often talk to people about bladder control problems. The sooner you get help, the sooner UI may improve.
Do bladder control problems have another name?
Urinary incontinence (UI), urine leakage, and urine loss are other names for a bladder control problem that causes urine to leak. Health care professionals may use the term LUTS, which stands for lower urinary tract symptoms, when speaking about other symptoms you may have with UI.
What are the types of bladder control problems?
The type of UI you have depends partly on the symptoms. The most common bladder control problems include
- Stress incontinence
Stress incontinence occurs when movement—coughing, sneezing, laughing, or physical activity—puts pressure on the bladder and causes urine to leak.
- Urgency Incontinence
Urgency incontinence occurs when someone has a strong urge, or need, to urinate and leaks before getting to a toilet. Health care professionals often refer to urgency incontinence as overactive bladder, which can happen when certain nerves and bladder muscles aren’t working together.
Sometimes a person can have urgency and stress incontinence at the same time, which is also called mixed incontinence.
- Reflex incontinence
Leaking urine without a warning or urge may be reflex incontinence. It often can happen when a person’s bladder nerves are damaged and don’t “talk” to the brain correctly. During reflex incontinence, the bladder can contract, or reflex, at the wrong time, causing urine to leak. Nerve damage from health conditions such as multiple sclerosis , or from trauma such as a spinal cord injury, are among the causes of reflex incontinence. Sometimes it’s also called “unaware” or “unconscious” incontinence.
- Overflow incontinence
Overflow incontinence occurs when the bladder doesn’t empty all the way, causing too much urine to stay in the bladder. With overflow incontinence, urine leaks because the bladder becomes too full.
- Functional incontinence
Functional incontinence occurs when a physical disability or barrier, or a problem speaking or thinking, keeps someone from reaching the toilet in time. For example, a person in a wheelchair may not be able to get to a toilet in time, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer’s disease may not realize they need to plan to use the toilet.
- Temporary incontinence
Temporary, or transient, incontinence lasts a short time due to a passing situation, such as using a certain medicine or having an illness that causes leaking, such as a bad cough from a cold.
Bedwetting, also called nocturnal enuresis, doesn’t only occur in children. Some adults leak during their sleep for a variety of reasons. Certain medicines or drinking caffeine or alcohol at night can make it hard to sleep through the night without leaking urine. In some cases, the bladder can’t hold enough urine overnight. Lifestyle changes often can improve these symptoms.
Some people wet the bed because they don’t produce enough of a certain hormone at night, which could be a sign of diabetes insipidus. Other health problems, such as urinary tract infection, kidney stones, prostate enlargement, or obstructive sleep apnea can cause an adult to wet the bed or urinate frequently at night.
How common are bladder control problems?
Bladder control problems are common. Almost half of all women leak urine at some point in their lives.1 Women are more likely to develop UI during and after pregnancy, childbirth, and menopause . These events, and how the female urinary tract is built, make UI more common in women than men. Still, don’t accept UI as a routine part of being a woman or getting older.
As many as 1 in 3 older men may lose urine by accident.1 A man is more likely to develop UI with age because prostate problems occur more often with age.
Who is more likely to develop bladder control problems?
Factors that make you more likely to develop UI include
- being female.
- being older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
- life events, such as pregnancy, childbirth, and menopause in women and prostate problems in men.
- health problems, such as diabetes, obesity, or long-lasting constipation.
- birth defects. You may have a problem with the structure of your urinary tract.
Your doctor can help find the cause of a bladder control problem and let you know your options for treatment.
You are more likely to have a particular type of UI if a family member has had it, too. For example, bedwetting often runs in families, and children may outgrow it at about the same age their parents did.
What are the complications of bladder control problems?
Leaking urine may cause a person to slow down or stop being physically active. For example, running, jumping, or brisk walking may make UI worse if someone has stress incontinence. Or, perhaps a woman feels that disposable pads or briefs are uncomfortable to move in, so being active may be less fun.
Staying active is important for a person’s overall health and may prevent further bladder control problems. UI may become worse for someone who is not physically active. Physical inactivity can lead to weight gain. People who are overweight or have obesity are more likely to have bladder problems. Getting active may lead to better bladder health.
Let a health care professional know if your bladder control problems are making it difficult for you to be active.
Untreated bladder problems can bring upsetting lifestyle changes. A person may avoid activities he or she once enjoyed. People might stop going to movies, meetings, or religious services because they don’t want to use the restroom in the middle of an activity or have an accident. These changes can lead to depression or social anxiety .
Bladder control problems sometimes cause people to avoid intimacy, because they are worried they may leak urine during sex. Talk with a health care professional if your bladder control problems are getting in the way of your sex life. Gynecologists and urologists regularly talk with people about health problems that interfere with sex. A healthy sex life is part of a healthy life.
Related bladder symptoms and problems
If you have UI, you are more likely to have other bladder symptoms or problems, such as
- urinary frequency
- getting up from sleep to urinate, called nocturia
- difficulty urinating
- trouble emptying your bladder fully, also called urinary retention
- dribbling urine after you think you’ve finished
Working with a health care professional to prevent and treat these related symptoms and problems is important for the health of your bladder and your overall health.