Sarah loves to spend time with her friends talking about her grandchildren and going to exercise classes with neighbors. But she’s started to have a problem that keeps her from getting out. It’s embarrassing, but lately Sarah hasn’t been able to get to the bathroom before she wets her pants. She doesn’t know what’s happening, but the problem is keeping Sarah at home.
Sarah may have a problem with bladder control called urinary incontinence (the accidental leakage of urine). While it may happen to anyone, urinary incontinence is more common in older people. Women are more likely than men to be incontinent. If this problem is happening to you, there is help. Incontinence can often be cured or controlled. Talk to your healthcare provider  about what you can do.
Incontinence can happen for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation , and some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:
The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. Incontinence typically occurs if the muscles relax without warning.
The first step in treating incontinence is to see a doctor.  He or she will give you a physical exam and take your medical history. The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests . These might include:
In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine. Your family doctor may also send you to an urologist, a doctor who specializes in urinary tract problems.
There are different types of incontinence:
Today, there are more treatments for urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.
Bladder control training may help you get better control of your bladder. Your doctor may suggest you try the following:
Here is a brief description of Kegel exercises that help tighten your pelvic floor muscles.
Women—Locate your pelvic muscles by stopping the flow of urine midstream. Empty your bladder, lie down, squeeze and hold these muscles for a count of three, then relax them for a count of three. Do this 10 times. Your goal is to do at least three sets of 10 each day.
Men—Identify your pelvic floor muscles by stopping the flow of urine in midstream. Empty your bladder, and then lie on your back with knees apart and bent. Squeeze your pelvic muscles for a count of three and relax for a count of three. Work up to doing 10 of these exercises three times a day.
If you are having symptoms of leaking or often need to rush to the bathroom, talk to your healthcare provider. It’s best to treat this problem in the early stages when the exercises are most helpful. For more information about Kegel exercises, please see the National Institute of Diabetes and Digestive and Kidney Diseases website at www2.niddk.nih.gov .
Besides bladder control training, you may want to talk to your doctor about other ways to help manage incontinence:
Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:
Over time, BPH can cause serious problems. Treating BPH early may reduce your chance of having urinary tract infections, incontinence, and bladder and kidney stones.
Incontinence and Alzheimer’s Disease
People in the later stages of Alzheimer’s disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet.
To minimize the chance of accidents, the caregiver can:
For more information about Alzheimer’s disease, visit the Alzheimer’s Disease Education and Referral (ADEAR) Center website at www.nia.nih.gov/alzheimers , call 1-800-438-4380 (toll-free), or email email@example.com .
Here are some helpful resources:
National Association for Continence
P.O. Box 1019
Charleston, SC 29402-1019
National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892-3580
National Library of Medicine
Simon Foundation for Continence
P.O. Box 815
Wilmette, IL 60091
For more information on health and aging, contact:
Visit www.nihseniorhealth.gov , a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health and wellness information for older adults. Special features make it simple to use. For example, you can click on a button to make the type larger.
National Institute on Aging
National Institutes of Health
NIH...Turning Discovery Into Health®
U.S. Department of Health and Human Services