By: By Steve Bond, Pharmacist Incontinence, defined by the involuntary leakage of urine is a common condition affecting up to 30% of Canadians. There are four types of incontinence based on symptoms – Stress, Urge, Overflow and Functional.

1. Stress incontinence occurs when a stressor like a sneeze or cough makes us “pee a little”.
2. Urge incontinence occurs when a person has a strong urgency to go, and leakage occurs. It is sometimes referred to as an overactive bladder (OAB), but you can have an overactive bladder but not incontinence.
3. Overflow incontinence occurs when, due to some obstruction, a person is unable to completely void their full bladder. This can then lead to some leakage.
4. Functional incontinence happens to a person who is unable to get to a restroom due to an external factor such as immobility or dementia, but there is no problem with their urinary tract.

The risk of urinary incontinence increases as we age, but it is not a normal part of aging. Several factors can increase the chances of incontinence. Constipation may cause blockage of the urine outflow. Similarly, an enlargement of the prostate may cause the same. Frequent urinary tract infections can increase the risk. Conditions such as diabetes and congestive heart failure may lead to excessive amounts of urine being formed. Many medications can lead to increased urine output or decreased sensation to void, leading to leakage. The first step in dealing with incontinence is to seek medical help. For many, this can be difficult as it may be embarrassing to speak about. For others, they may be misinformed that incontinence is inevitable. A physical examination, comprehensive medication review and a discussion of urinary schedule may be able to address some of the common causes. There are some conservative treatments that can be attempted. For example, bladder retraining. Much like when a child first learns to be trained, we must sometimes retrain ourselves. A schedule is devised – possibly hourly to start – and the interval between bathroom trips is extended over a few months until it approaches a normal 4-6 hours. Pelvic floor strengthening exercises taught by a knowledgeable health professional such as a registered physiotherapist can improve control. Changing our diet by limiting sugar, caffeine and alcohol may also lessen incontinence. Other modalities include biofeedback, vaginal weight training and electrical stimulation. If these fail, options such as medications or surgery may be an option. Whatever route you and your primary healthcare professional take, know that there is hope for incontinence. Take care of yourselves and each other.