Urology Care Foundation The Official Foundation of the American Urological Association

Urology Care Foundation The Official Foundation of the American Urological Association


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Bladder Control Problems

Millions of people experience bladder control problems (BCP) and unfortunately many of these people feel like it is simply a part of getting older. The good news is that you are not alone. This is a medical problem and nearly everyone can be helped. The following information should help you discuss this condition with your urologist and understand what treatments are available to you.

What are bladder control problems?

The bladder is a hollow, balloon-shaped organ that is located within the pelvis. It has two major functions: storage and emptying of urine. BCP consist of conditions that affect either function of the bladder. BCP causes a significant amount of problems affecting the quality of life of a person. Among the problems of bladder control are urinary incontinence, frequency and urgency of urination and difficulties emptying the bladder. In general, these problems are related to one or both bladder functions. For example, frequency and urgency are generally related to a bladder that cannot hold the urine to its expected capacity. The expected maximal capacity of the bladder for an adult is about 10 to 15 ounces. Difficulty emptying the bladder involves conditions such as a weak flow of urine, frequent urination and not emptying to completion. The occurrence of BCP increases with aging in both sexes. It should be emphasized, however, that BCP should not be considered "normal" as a majority of aged people do not have BCP.

What are the causes of bladder control problems?

Bladder control is regulated by interaction between the central nervous system (brain and spinal cord) and organs of the lower urinary tract (bladder, urethra, pelvic floor muscles). Therefore, any disease that involves any part of this control mechanism could affect bladder function, and thereby present itself as BCP. For example, patients with diseases that involve the central nervous system, such as neurogenic problems in children, spinal cord injuries, Parkinson's disease, cerebrovascular accidents (strokes) and multiple sclerosis, could have bladder control problems. In addition, trauma, irradiation and other injuries to the lower urinary tract and pelvic organs could potentially cause BCP. Pregnancy and vaginal delivery are considered among the risk factors for BCP. Sometimes extra weight can cause BCP by putting extra pressure on the pelvic floor muscles. However, the majority of people with BCP have no clear symptoms of any neurological diseases or apparent damage to their lower urinary tract system.

How common is BCP?

BCP affects both men and women at all stages of life. In the earlier stages of life BCP may be seen with congenital anomalies involving the nervous system or tissues of the pelvis and lower urinary tract. For example, patients born with spina bifida have significant problems with bladder control. A good portion of bladder function relies on bladder training during the earlier stages of life. Improper or delayed toilet training may be a symptom of BCP during the earlier stages of childhood or later in life.

What are some risk factors for BCP?

Risk factors related to BCP happen around the childbearing ages, when the process of pregnancy and a vaginal delivery can affect bladder control. However, this problem usually goes away in the majority of patients with BCP during pregnancy or immediately after childbirth. The next series of events in life affecting BCP are around the time of menopause for women, and enlargement of the prostate in the fifth and sixth decades of life in men. Enlargement of the prostate gland occurs in the majority of the men living in the western society and may affect bladder function. Menopause can also affect bladder function. The other independent event affecting bladder function is aging and the changes that occur within the tissues of the lower urinary tract and the bladder itself.

Given that the above risk factors could affect almost everyone living in the western society, it is estimated that up to 50 percent of women and 30 percent of men will have bladder control problems during their lifetime.

What can be done for BCP?

Despite the high rate of BCP, it is also known that a small number of patients with BCP seek medical attention. Although not clearly known, it is believe that most people view BCP as tolerable or a normal part of life. Nonetheless, it is clear that effective therapies (both medical and surgical) now exist which could make BCP more bearable for the majority of patients. You should talk with a urologist to learn about what treatment(s) may work best for you.

How can I tell if I may have BCP?

Given the wide range of differences among individuals, it is difficult to draw a certain line between "normal" vs. "abnormal" bladder function. It is generally agreed, however, that any symptoms of the bladder or its control that bother the person or interfere with normal lifestyle should be considered "abnormal." Given this definition, a general rule of thumb is that any aspect of bladder function is bothering a person, they should seek medical care for their BCP. Problems, such as urinary incontinence, difficulty emptying the bladder or other signs of BCP, should not be tolerated and expected as a part of normal living.

The common symptoms of BCP are: leakage of urine resulting from a cough, sneeze or physical activity, or urgency and lack of desired control to hold urination. In addition, symptoms such as frequency of urination (more than eight to ten times per day) or waking up to go to the bathroom more than twice a night, have been considered as "abnormal urinary habits." Given the fact that the symptoms of BCP could signal the presence of other conditions, such as multiple sclerosis and diabetes, attention should be paid to such symptoms.

Fill out the AUA Symptom Score and share the results with your health care provider.

For more information, see:

Bladder Control Problems: Managing with Products and Devices

Kegel Exercises

Urology Care Foundation brochures:

Bladder Control (Strengthening Your Pelvic Floor Muscles)

Loss of Bladder Control (Urinary Incontinence)

Loss of Bladder Control (Surgery to Treat Urinary Incontinence)

Loss of Bladder Control (Bladder Prolapse)

Overactive Bladder (OAB)

Reviewed: January 2011

Last updated: May 2014

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Bladder Control Problems Glossary
  • bladder: The bladder is a thick muscular balloon-shaped pouch in which urine is stored before being discharged through the urethra.

  • bladder control: The ability to control the timing of urination. Also referred to as continence.

  • bladder training: A behavioral technique that teaches the patient to urinate on a regular schedule and to empty the bladder completely.

  • congenital: Present at birth.

  • continence: The ability to control the timing of urination or a bowel movement.

  • diabetes: A medical disorder of increased blood sugar levels that can cause bladder and kidney problems.

  • frequency: The need to urinate more often than is normal.

  • gene: The basic unit capable of transmitting characteristics from one generation to the next.

  • gland: A mass of cells or an organ that removes substances from the bloodstream and excretes them or secretes them back into the blood with a specific physiological purpose.

  • incontinence: Loss of bladder or bowel control; the accidental loss of urine or feces.

  • ions: Electrically charged atoms.

  • liver: A large, vital organ that secretes bile, stores and filters blood, and takes part in many metabolic functions, for example, the conversion of sugars into glycogen. The liver is reddish-brown, multilobed, and in humans is located in the upper right part of the abdominal cavity.

  • menopause: The time in a woman's life when menstrual periods permanently stop.

  • multiple sclerosis: A serious progressive disease of the central nervous system.

  • neurogenic: Causing or relating to the disorder of nerves.

  • neurologic: Pertaining to the nervous system.

  • neurological: Pertaining to the nervous system.

  • pelvic: Relating to, involving or located in or near the pelvis.

  • pelvic floor muscles: The hammock or sling of muscles in the pelvic floor that normally assists in maintaining continence by supporting the pelvic organs (bladder, uterus and rectum).

  • pelvis: The bowl-shaped bone that supports the spine and holds up the digestive, urinary and reproductive organs. The legs connect to the body at the pelvis.

  • pregnancy: The condition of being pregnant.

  • prostate: A walnut-shaped gland in men that surrounds the urethra at the neck of the bladder. The prostate supplies fluid that goes into semen.

  • radiation: Also referred to as radiotherapy. X-rays or radioactive substances used in treatment of cancer.

  • spina bifida: A condition at birth in which part of the vertebral bodies (or back bones) fail to seal off completely and some part of the spinal cord protrudes through this opening. This condition is often associated with bladder and bowel control problems as well as lack of control of voluntary movement in the lower body.

  • stage: Classification of the progress of a disease.

  • tissue: Group of cells in an organism that are similar in form and function.

  • urethra: A tube that carries urine from the bladder to the outside of the body. In males, the urethra serves as the channel through which semen is ejaculated and it extends from the bladder to the tip of the penis. In females, the urethra is much shorter than in males.

  • urge: Strong desire to urinate.

  • urgency: Strong desire to urinate.

  • urinary: Relating to urine.

  • urinary incontinence: Inability to control urination.

  • urinary incontinence: Involuntary loss of urine associated with a sudden strong urge to urinate.

  • urinary tract: The system that takes wastes from the blood and carries them out of the body in the form of urine. Passageway from the kidneys to the ureters, bladder and urethra.

  • urinate: To release urine from the bladder to the outside. Also referred to as void.

  • urination: The passing of urine.

  • urine: Liquid waste product filtered from the blood by the kidneys, stored in the bladder and expelled from the body through the urethra by the act of urinating (voiding). About 96 percent of which is water and the rest waste products.

  • urologist: A doctor who specializes in diseases of the male and female urinary systems and the male reproductive system. Click here to learn more about urologists. (Download the free Acrobat reader.)

  • vagina: The tube in a woman's body that runs beside the urethra and connects the uterus (womb)to the outside of the body. Sometimes called the birth canal. Sexual intercourse, the outflow of blood during menstruation and the birth of a baby all take place through the vagina.

  • vas: Also referred to as vas deferens. The cordlike structure that carries sperm from the testicle to the urethra.

  • vascular: Having to do with blood vessels.

Bladder Control Problems Anatomical Drawings

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