Urination Disorders in Adults: Causes, Diagnosis, and Treatment Options

Urinary incontinence is not a normal result of aging, and it shouldn’t be treated as a disease. It is a sign of a urination disorder, a condition that impacts many adults across Europe, particularly women. Despite its frequency, it remains underreported, often due to embarrassment or the false belief that there’s no solution. Fortunately, most cases can be treated or significantly improved.

What causes urination disorders?

Healthy urination relies on coordination between the brain, spinal cord, bladder, and pelvic muscles. Disruptions in this system can be caused by:

• side effects of certain medications,
• bladder infections or inflammation,
• weakened pelvic floor muscles (especially after childbirth),
• hormonal changes, such as menopause,
• or a failure of the bladder’s closure mechanism.

Main types of urinary incontinence

• Stress incontinence: leakage caused by pressure on the bladder, such as from laughing, sneezing, or lifting.
• Urge incontinence: sudden, intense urge to urinate due to an overactive bladder muscle.
• Overflow incontinence: leakage caused by a bladder that doesn’t empty completely, often due to blockage or muscle weakness.
• Urinary retention: difficulty emptying the bladder completely or requiring frequent, small voids.
• High-frequency urination: needing to urinate more often than usual, including during the night, sometimes with very small amounts each time.

How is incontinence diagnosed?

A thorough medical assessment helps determine the right approach. This often includes:

Urinalysis

Checks for infections, blood, or other irregularities in the urine.

Post-void residual measurement

Determines how much urine remains in the bladder after urination, using a catheter or ultrasound.

Cystoscopy

A visual inspection of the bladder using a thin, lighted tube to identify structural issues.

Stress testing

Performed to see if leakage occurs during physical activity or with a full bladder.

Urodynamic tests

Evaluate how well the bladder and urethra function, including bladder pressure and flow rates.

Can urinary incontinence be treated?

Yes - most forms of urinary incontinence are manageable with proper care. Treatment options include:

Behavioral therapy

Customized training programs help strengthen pelvic muscles and improve bladder control. Bladder retraining, fluid management, and toilet scheduling are also part of this therapy.

Medications

Certain drugs help calm an overactive bladder or improve bladder capacity. Adjustments may also be needed if current medications are contributing to symptoms.

Bulking agents

Injectable substances placed near the urethra can help close it more effectively. These procedures are often done in outpatient settings and can offer noticeable improvement.

Surgical options

Surgery may be recommended to reinforce the bladder or support weakened pelvic structures, especially in women.

Laparoscopic bladder suspension

This minimally invasive procedure lifts and supports the bladder using small abdominal incisions, leading to shorter recovery times and less postoperative discomfort.

Sacral nerve stimulation

This outpatient procedure uses a device to stimulate nerves that control the bladder. After an initial test phase, the device can be permanently implanted under the skin.