Do you look for a table closest to the restroom? Are you turning down invitations to go out because of a potential urge to use the restroom? Do you wear a pad all the time? If so, you’re probably struggling with urge incontinence. More than 33 million people in the U.S. have some form of urinary incontinence. And in many cases, early intervention can decrease or even eliminate those annoying bladder leaks.
What is urge incontinence?
People who have urge incontinence experience a sudden need to urinate and cannot control the flow of urine, even if the bladder isn’t full. This disorder can lead to involuntary accidents, as well as frequent urination, also called “overactive bladder.”
In a healthy urinary system, urine travels from the kidneys to the bladder, where a relaxed bladder expands to store the urine. At the bottom of the bladder, the urethral sphincter stays closed (kind of like a spigot) until the bladder squeezes. As your bladder fills, your brain sends a signal for the bladder to contract and the sphincter muscles to relax, resulting in urination.
Urge incontinence mixes up these signals, causing bladder spasms. These unwanted bladder spasms create an urgency to urinate even if your bladder isn’t full. Because the bladder doesn’t store a normal amount of urine and can squeeze without adequate warning, you are running to the bathroom more frequently or even worse, wetting your pants. If left untreated, these symptoms will worsen over time.
What causes urge incontinence?
Although there are several conditions that exacerbate urge incontinence, it’s difficult to determine why the brain and bladder are not communicating correctly. The misfiring of the nerves could be due to some of these risk factors:
an enlarged prostate.
How is urge incontinence different from other types of incontinence?
Although the general definition of incontinence is losing control over your urine flow, there are a few different types of incontinence.
Stress urinary incontinence (SUI) results from physically weak or stretched out pelvic floor muscles (which includes the urethral sphincter), rather than faulty nerve messaging as with urge incontinence. The muscles that control the bladder outlet cannot keep it closed when put under pressure. So instead of staying closed, a weakened urethral sphincter leaks urine under the stress of a sneeze, cough, or laugh.
Mixed incontinence is a combination of SUI and urge incontinence, so people experience urgency and stress-induced bladder leakage.
Many people suffer in silence with urge incontinence. Research shows that as few as 1 in 5 people with urinary incontinence seek treatment. One barrier to getting treatment is education about the solutions. Strong pelvic floor muscles, including the urethral sphincter, are key to controlling urination for all types of incontinence, and there are a variety of treatments that target the health of the bladder and its surrounding muscles.
Pelvic floor exercises address the strength of pelvic floor muscles. This network of layered muscles supports the pelvic organs, including the bladder and its related mechanisms. Kegel exercises are used to tighten and strengthen these muscles, building a better support system for the pelvic organs, and potentially allowing one to make it to the toilet when urgency is felt.
Bladder training is a conservative treatment that uses a urination schedule. Patients go to the bathroom at set times, even if they don’t feel like it. Gradually, the time increments between voiding increase, teaching the bladder to suppress unnecessary contractions.
Medication can help control bladder spasms. Some drugs work by blocking the messages telling your bladder to squeeze. Others cause your bladder to relax, calming its overactive tendencies. Medications can take weeks, or even months to work, and side effects include constipation, dry mouth, nausea, and dizziness.
Injections of Botox can relax the bladder so it doesn’t squeeze or spasm prematurely, and may be covered by Medicare. Repeated injections are needed every few months.
Electrical stimulation (e-stim) gently delivers electrical impulses. There are a few different types:
Pelvic floor e-stim gently contracts your pelvic floor muscles, essentially doing the above-mentioned pelvic floor exercises, Kegels, for you. Consistent use aims to tighten and strengthen your pelvic floor, which better supports your bladder.
Percutaneous tibial nerve stimulation (PTNS) uses e-stim to reach the nerve that controls urination. During an office visit, a clinician uses a needle connected to an electrical device to deliver gentle impulses to the tibial nerve, which runs up your leg and connects to nerves surrounding the bladder. Multiple sessions are needed.
Sacral neuromodulation therapy (InterStim) requires an implanted device. This small device, usually placed under the skin near the hip, sends impulses to the sacral nerve to help control bladder contractions.
Are there any over-the-counter treatments?
Pelvic floor exercises for strengthening has long been the first line of treatment for incontinence. However, doing Kegel exercises effectively is challenging because you cannot see if you’re contracting the correct muscles in the pelvic floor. Some e-stim devices are over-the-counter. ELITONE is the first e-stim device that is non-invasive (other devices use vaginal probes). It does your Kegels for you, longer and stronger than you can achieve on your own. ELITONE, which has been cleared by the FDA to treat SUI, tones the pelvic floor muscles and sends e-stim signals for both stress and urge incontinence.
You can make a difference in your struggle with incontinence. Make an appointment with your doctor, and before the appointment, try keeping a simple diary of urination frequency and any accidents. The more you communicate with your clinician about your incontinence symptoms, the sooner you’ll be on the path to leak-free living.