Q. This is embarrassing to discuss with anyone, so I thought I’d write to you about it. I’m having bladder-control problems. What can I do?

About 10 percent of men and women over the age of 65 have trouble with bladder control. This is known officially as “urinary incontinence.” Women suffer from this more than men.

During urination, muscles in the bladder contract, forcing urine into the urethra, a tube that carries urine out of the body. At the same time, muscles surrounding the urethra relax and let the urine pass. If the bladder muscles contract or the muscles surrounding the urethra relax without warning, the result is incontinence.

Short-term incontinence is caused by infections, constipation and some medicines. If the problem persists, it might be caused by weak bladder muscles, overactive bladder muscles, blockage from an enlarged prostate or damage to nerves that control the bladder from diseases such as multiple sclerosis or Parkinson’s.

In most cases, urinary incontinence can be treated and controlled, if not cured. Someone suffering from a bladder control problem should refer to an expert. Physicians see this problem all the time, so there is no need to be embarrassed.

The physician will typically do a number of tests on the urine, blood and bladder. The patient may be asked to keep a daily chart tracking their urination.

There are several different types of urinary incontinence. If urine leaks when sneezing, coughing, laughing or putting pressure on the bladder in other ways, this is called “stress incontinence.” When someone is unable to hold urine, this is called “urge incontinence.” When small amounts of urine leak from a bladder that is always full, this is called “overflow incontinence.” Many older people who have normal bladder control but have difficulty getting to the bathroom in time, have “functional incontinence.”

But, don’t despair: There are many ways to treat urinary incontinence. The method just depends upon the type of problem.

You can train your bladder with exercises and biofeedback. You can also chart your urination and then empty your bladder before leakage occurs.

Physicians have a plethora of other tools and treatments, as well. There are urethral plugs and vaginal inserts for women with stress incontinence. There are medicines that relax muscles, helping the bladder to empty more fully during urination. Others tighten muscles in the bladder and urethra to cut down on leakage.

Surgery can improve or cure incontinence. This procedure is usually performed if there has been a change in the position of the bladder or if there is a blockage due to an enlarged prostate. Common surgery for stress incontinence involves pulling the bladder up and securing it. When stress incontinence is serious, the surgeon may use a wide sling. This holds up the bladder and narrows the urethra to prevent leakage.

Even if treatment is not fully successful, management of incontinence has been proven to make people feel more relaxed and comfortable about the problem.

With experience as a freelance writer and publicist for major pharmaceutical companies, such as Eli Lilly, Johnson & Johnson, Merck and Pfizer, Fred Cicetti is now a New Jersey-based columnist writing about a variety of senior health issues. His opinions and views do not necessarily reflect those of Therapy Times or Valley Forge Publishing Group. Questions or comments can be directed to editorial@TherapyTimes.com.

All Rights Reserved © 2006 by Fred Cicetti