Urology Expert Forum
Unable to keep control of bladder
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Unable to keep control of bladder

I am a 40 year old female and having problems both at night and during the day.  I have problems every night and having to wear diapers.  Now I am having lots of troubles during the day.  What can I do?  Wearing diapers during the day is embarrassing but also being wet is embarrasing.
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Dear Nancy,
There are different kinds of urinary incontinence, and from your brief note it is difficult to know what your problem is.  
Urinary incontinence can be generally due to bladder abnormalities or due to problems in the urethra and urethral sphincter (the valve-like mechanism in the urethra which controls the flow of urine from the bladder out).  Each category has its sub-groups.  As a whole the problem could be neurologic, structural, or a combination of both.
The different types are: urge incontinence, stress incontinence, unconscious incontinence, continuous leakage, nocturnal (night time) incontinence, overflow incontinence and post void dribbling.    
Another cause could be due to a fistula which is an abnormal tract formed from the bladder or urethra to the outside, allowing for continuous flow of urine without any control by the individual.  These may happen after pelvic/gynecologic surgery or radiation therapy. Furthermore, an abnormally placed ureter (ectopic ureter) could be a potential cause.
Some of these may be treated with medications and others with surgery. Suffice it to say that you must be seen by a urologist for an evaluation.

This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

Sincerely,
HFHS M.D.-BE



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