Urinary Incontinence

Urinary incontinence simply means leaking urine. Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.

Millions of women experience it each year. Some women may lose a few drops of urine while coughing, sneezing, laughing, during exercise and even during sexual activity. Others may feel a strong, sudden urge to urinate but may leak a large amount of urine before reaching the bathroom. Some women experience a combination of both of these. There are also other types of incontinence, which you can learn more about below.

Types of Urinary Incontinence

There are three main types of urinary incontinence:

Stress Incontinence

When pressure on the bladder increases, and the muscles around it are weak, some urine can come out. This weakness can happen as a result of pregnancy, childbirth and hormonal changes during menopause. You may have a leak when you’re coughing, laughing, sneezing, walking, running, exercising or having sex.

Urgency Incontinence or Overactive Bladder

A sudden strong urge to urinate that is hard to stop. Women with this type of urinary incontinence may leak urine on the way to the bathroom. If you have an overactive bladder, it means that you have symptoms of urgency and frequency that may or may not include incontinence.

Mixed Incontinence

Many women have symptoms of both stress and urgency incontinence. This is the most commonly seen incontinence pattern in women.

In addition to these three types, there are also several, less common types:

Functional Incontinence

Functional incontinence happens as a result of mental or physical disabilities keep a person from getting to the toilet, despite a healthy urinary system. For instance, individuals with Alzheimer’s disease may simply forget to urinate. People with injuries, or those that are wheelchair bound, may not be able to make it to the bathroom on time. This can lead to urinary leakage.

Overflow Incontinence

Overflow incontinence occurs when the bladder can’t empty completely. As it continues to fill, it reaches the point where it can hold no more urine. This leads to an eventual leak. Bladder obstruction, an inactive or weak bladder muscle, spinal injuries or diabetes can cause overflow incontinence.

Sensory Irritative Incontinence

Sensory irritative incontinence occurs due to chronic or acute bladder irritation. This can be cause by urinary tract infections or vaginal atrophy, as seen in women who have gone through menopause.

Bypass Incontinence

Bypass incontinence occurs in individuals with urinary tract fistulae. Urine can freely flow from the bladder through a hole leading directly into the bladder. The result is chronic, continuous urinary leakage.

Symptoms of Urinary Incontinence

It is common for several symptoms to occur along with urinary incontinence:

• Urgency — Having a strong urge to urinate
• Frequency — Urinating more often than what is usual for you
• Nocturia — Waking from sleep to urinate
• Dysuria — Painful urination
• Nocturnal enuresis — Leaking urine while sleeping

Diagnosing Urinary Incontinence

Many of our physicians offer testing for urinary incontinence right in the office, called urodynamics. This refers to a group of tests that are performed to assess function of the urinary tract by measuring urine storage and evacuation. The purpose of urodynamic testing is to make a diagnosis so a treatment can be designed for you.

Causes

Many things can cause urinary incontinence. These can include:

• Urinary tract infection — Urinary tract infections can cause leakage, which usually goes away when they’re treated with antibiotics.
• Diuretic medications, caffeine, or alcohol — Incontinence may be a side effect of substances that cause your body to make more urine.
• Pelvic floor disorders — These disorders are caused by weakening of the muscles and tissues of the pelvic floor and accidental bowel leakage, and pelvic organ prolapse.
• Constipation — Long-term constipation often is present in women with urinary incontinence, especially in older women.
• Neuromuscular problems — When something disrupts the nerve signals from the brain to the bladder, the muscles that control those organs can malfunction, allowing urine to leak.
• Anatomical problems — The outlet of the bladder into the urethra can become blocked by bladder stones or other growths

Due to the risk of public embarrassment, many women alter their lifestyles, choosing not to participate in the things they normally enjoy. Many women also choose to ignore their symptoms and refuse to discuss incontinence with their providers. Regardless of your type of incontinence, our doctors can quickly investigate, diagnose and treat it with care and compassion.

Treatments

No single treatment is available to treat all types of incontinence. While surgery is warranted in some patients, many patients never require surgery. Doctors also prescribe many conservative therapies. These include pelvic floor physical therapy (Kegel exercises), control of medical conditions, weight loss, medications and pessaries (a device you put in the vagina to support the pelvic organs).