Bladder Issues and Adult Urinary Incontinence (AUI)

Accidents Happen

If you have trouble holding your urine until you get to the toilet, the problem could be adult urinary incontinence. Adult urinary incontinence affects twice as many women as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract are all factors that can contribute to urinary incontinence. Although older women experience urinary incontinence more often than younger women, urinary incontinence is not an inevitable part of aging.

The body stores urine—water and wastes removed by the kidneys—in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body.

The pelvic floor muscles and the urethral sphincter are two structures that help keep urine in the bladder.

The pelvic floor muscles support the vagina, urethra and other organs in the pelvis. When the pelvic floor muscles are strong, the urethra and bladder cannot move out of place. This helps keep the urethra closed, so urine cannot leak from the bladder.

The urethral sphincter is a band of muscles around the urethra. When these muscles are strong, they squeeze tightly and keep urine in the bladder. When you want to urinate you can relax these muscles.

Adult urinary incontinence in women usually occurs because of problems with pelvic floor muscles—which can be damaged during childbirth—or problems with the urethral sphincter.

Stress incontinence and urge incontinence are the two most common types of incontinence in women. When these two conditions occur together, doctors may use the term "mixed incontinence."

  • Stress Incontinence—If coughing, laughing, sneezing, or other movements that put pressure on the bladder cause you to leak urine, you may have stress incontinence.
  • Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence. It is the most common form of incontinence in women and is treatable.
  • Urge Incontinence—If you lose urine for no apparent reason while suddenly feeling the need or urge to urinate, you may have urge incontinence. The most common cause of urge incontinence is inappropriate bladder contractions.

Many women who experience stress or urge urinary incontinence suffer in silence for years, until the situation becomes unbearable. Some mistakenly believe that urinary incontinence is a normal part of the aging process, but this is not true. Others don’t realize that urinary incontinence is treatable and often curable at all ages1.

If you experience adult urinary incontinence, it is understandable if you feel a little embarrassed about discussing your symptoms with anyone, even a health care professional. However, adult urinary incontinence is a very common problem that doctors are used to hearing their patients talk about. Focus on getting the proper diagnosis and treatment that can lead to alleviated or minimized symptoms1.

1. NIH Publication No. 044132. September 2004.
Available at: "http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/
Accessed: November 30, 2005.



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