Urinary incontinence is defined as the involuntary loss of urine which the patient describes as being “wet”. Urinary control is maintained by an intact nervous system which directs the muscles and sphincters of the pelvis. If there is compromise of the nervous system (neurologic disease such as Parkinson’s, Alzheimer’s, Diabetes, etc.) or the muscles/sphincters (trauma, surgery, radiation, infection) then urinary control may be adversely affected.
In addition to the above, there are general causes of incontinence which often vary by gender particularly as men/women age. In men, there may be overflow incontinence in which the bladder is blocked often by an enlarged prostate. In women, there may be stress incontinence, caused by laxity of the pelvic muscles which occurs with age and is often accentuated as a result of childbirth.
Both men and women suffer from urgency incontinence (i.e., getting to the bathroom in time). This occurs as the bladder becomes fibrotic (less compliant) with age. As a result of this, older adults can’t postpone urinating and void more frequently that younger people. The same is true for older people whose bladder awakens them at night and often interferes with what had been ‘normal’ sleep habits.
There is treatment available for all forms of incontinence and urinary urgency and frequency. These run the gamut from behavioral therapy, timed voiding, medication and surgical procedures.