Urinary incontinence occurs when any amount of leakage is present. Even small amounts that feel manageable still count, but people often dismiss them. Incontinence can occur regularly in large amounts, only in certain circumstances, or because of a recent change in your health.
As a nurse, I have worked with patients experiencing both new-onset or short-term incontinence as well as those who have chronic or long-term incontinence. Understanding what causes both, and when the shift from short-term to long-term occurs, can help you manage your care and daily life.
Short-Term Incontinence
While no definitive diagnostic criteria exist for short-term incontinence, it is generally characterized by incontinence that occurs and then resolves completely. People often experience short-term incontinence during a hospital stay or other acute event. Common causes of short-term incontinence can include:
- Urinary Tract Infection (UTI): A UTI, or bladder infection, occurs when bacteria enter the bladder and cause an infection. Symptoms can include a burning sensation when urinating, frequent and urgent urination, pain in the lower abdomen or pelvis, and changes in the color and odor of your urine. Frequent urination, bladder irritation, and/or avoiding urination due to pain can cause short-term incontinence until the infection is treated.
- Vaginal Infections: Vaginal infections, also commonly called vaginitis, such as yeast or bacterial vaginosis, can inflame and irritate the vaginal tissue. This can also irritate the urethra and surrounding area. It can lead to similar symptoms of a UTI, such as burning or pain when urinating. This can lead to short-term incontinence until the infection is treated.
- Constipation: Constipation can be an overlooked cause of changes in bladder control. The rectum and bladder share space in the pelvis. With constipation, the rectum can become distended due to large amounts of stool. As the rectum grows, it puts pressure on the bladder and can cause more frequent urination, leading to incontinence. It is important to address chronic constipation as it can lead to damage to the pelvic floor, which can result in long-term incontinence issues.
- Procedures or surgeries that require catheterization: During surgery or other procedures that require sedation, a nurse or doctor may place a catheter through your urethra into your bladder. This prevents incontinence episodes during surgery. They may leave the catheter in place after the procedure if you have impaired mobility or are not fully awake yet. Depending on how long the catheter stays in place, it can take time to regain normal bladder function after removal. During this transition, you may experience short-term incontinence.
- Medications: Some medications, such as diuretics, antipsychotics, antidepressants, hormone replacement, and sedatives, can cause incontinence. The impact may be short-term as your body adjusts to the medication, or it may last as long as you take it. Discuss any changes in bladder control with your healthcare provider when starting or adjusting medication doses.
- Mobility Changes: Mobility changes can significantly contribute to short-term incontinence. For someone who was previously able to use the restroom alone and then suffers an injury, they may experience functional incontinence if they cannot get to the restroom on their own. This can look like someone who breaks their hip and is recovering from surgery. Or someone who breaks their arm and cannot get their clothing on and off to use the restroom. In many cases, once the person recovers from their injury, they can use the restroom independently and no longer have incontinence episodes.
Long-Term Incontinence
Long-term or chronic incontinence is more common, as it is usually caused by factors that are not easily reversed. It can result from changes to the bladder, pelvic floor muscles, or the connection between the bladder and the brain. Common causes of long-term incontinence can include:
- Multiple Sclerosis (MS): MS causes bladder dysfunction because lesions or plaques in the brain disrupt communication between the bladder and the brain. This can cause symptoms such as frequency, urgency, and urinary retention (when the bladder does not empty on its own). MS can cause chronic or long-term incontinence, although symptom management is still possible.
- Diabetes: Diabetes can cause long-term incontinence through nerve and vascular damage associated with the condition. Elevated blood sugar levels can also cause the body to try to draw out excess water to regulate sugar levels. Incontinence associated with diabetes can become long-term, especially when the condition is not managed.
- Parkinson’s Disease: Parkinson’s is a progressive condition in which specific brain cells become damaged. This damage can lead to loss of bladder control and other bodily functions. Incontinence can develop as the disease progresses and may become long-term.
- Pelvic organ prolapse (POP): POP occurs when pelvic organs, such as the bladder or bowels, drop below their normal position or push into other organs. This can lead to incontinence, which can be intermittent or long-term. Treatment options for POP can minimize incontinence symptoms.
- BPH: benign prostatic hyperplasia (BPH) occurs when the prostate gland enlarges. It can put pressure on the urethra and cause urinary symptoms such as difficulty starting the flow of urine, slow or dribbling urine, incontinence, and other bladder control issues. When BPH is left untreated, it can lead to long-term incontinence.
Management Strategies for Incontinence
Addressing the underlying cause of incontinence is always the first step in managing this condition. Short-term or long-term conditions can cause incontinence, and addressing the cause with a healthcare provider can lead to a better treatment plan. Alongside managing the underlying cause, several strategies can help manage incontinence. These are some of the strategies I use and recommend when working with patients with incontinence:
Bladder Training: Bladder training can help reverse short-term incontinence when the cause has resolved, but urinary symptoms remain. It is also used for people with long-term incontinence to help them better manage symptoms. Bladder training can include scheduled restroom use to help the bladder hold urine longer. The time between urination can be slowly increased over weeks and months. Bladder training can also help people who have urinary retention that leads to leakage by reminding them to empty their bladder at scheduled times before it overfills.
Drinking Fluid throughout the day: Many people tend to avoid or limit fluids when dealing with incontinence. They do this to avoid leaks, especially when they are out of the house. This is not an effective long-term strategy, as it can cause dehydration and other serious outcomes. The goal is to drink fluids evenly throughout the day. This way, the body can function more effectively. Drinking a large amount of fluids at once can cause urge incontinence, so by evenly spacing drinks throughout the day, you can stay hydrated while avoiding the sudden or frequent urge to urinate. Additionally, avoiding fluids that irritate the bladder, such as alcohol and drinks containing caffeine, can lessen symptoms as well.
Pelvic Floor Physical Therapy: Pelvic floor physical therapy helps men and women strengthen and activate the pelvic floor. Pelvic floor muscles support the bladder and affect the ability to hold urine and control urine flow. Pelvic floor physical therapists can work with you to target your specific symptoms and help with both short- and long-term incontinence.
Incontinence Products: Incontinence products are a great way to manage bladder control issues for short- and long-term incontinence. Many product options can help with anything from small leaks to complete bladder loss. The right product depends on how much and how often you leak. For pull-up and brief-style products, measure your hips or waist and choose the right size. Browsing an online product catalog or using resources on the manufacturer’s website can help you choose the right product.
Finding the Right Approach for Short-Term and Long-Term Incontinence
Understanding the cause of incontinence and whether it is short-term or long-term can help you choose the right treatment or management plan. Most causes of short-term incontinence are easier to treat. Whether it’s long-term or short-term, there are still strategies to manage leaks and keep enjoying your life.
