Would you pass the trampoline test?
When asked if they have incontinence, many women say, “No, I just leak when I sneeze, laugh, or exercise.” However, these women DO have urinary incontinence. The definition of incontinence is simply the lack of control over urination. Bladder incontinence is a common condition, affecting 1 in 3 women over 30 years old, and 1 in 2 women over the age of 50. Symptoms often begin after childbirth, when the pelvic floor is stretched or damaged. Left untreated, incontinence can worsen, affecting many areas of a woman’s life. Research shows that women who have incontinence are more likely to struggle with mental health, sexual health, and social issues.
Types of incontinence
Now that you know the basic definition of incontinence, let’s take a look at the types of incontinence that affect women.
Stress urinary incontinence (SUI) is urine leakage with increased abdominal pressure. This pressure pushes down on pelvic floor muscles, applying stress to muscles that are too weak to keep the bladder closed. The pelvic floor consists of layered muscles that act like a hammock to support your bladder, vagina, and rectum. Sneezing, coughing, or exercise can trigger this increase in abdominal pressure, and 82% of women with incontinence have some degree of stress incontinence. Conservative treatments focus on strengthening the pelvic floor muscles.
Urge urinary incontinence (UUI) is a sudden and strong desire to urinate, accompanied by bladder leakage. If you can get to the toilet before leaking, the condition is called “overactive bladder.” The cause of UUI is complex and addresses how the nervous system controls the bladder. Treatment often involves medication or stimulation to calm the bladder. Learn more about UUI. Learn more about a UUI Study we are currently conducting.
Mixed incontinence (MI) describes when a woman has both stress and urge incontinence symptoms.
Overflow incontinence occurs when the bladder literally overflows because it’s full but no message is sent to the brain to tell the women to urinate. In some cases, the bladder also has difficultly fully emptying. There are various causes that require a range of medical treatments.
Nocturia is incontinence at night and often requires waking up multiple times, interrupting sleep. Learn more here.
QUIZ: How BAD is Your Incontinence?
How severe are your stress incontinence symptoms?
If you’ve done the research on the definition of incontinence and the different types, you’ve probably determined you have SUI (including mixed incontinence), which is the most common among the types of incontinence. Stress incontinence usually develops when the pelvic floor muscles are weakened or stretched, so treatment often is focused on strengthening the pelvic floor. SUI symptoms vary in severity but are often categorized as mild, moderate, or severe. Regardless of the severity, you should consider treatment together with a healthcare professional. Early intervention increases the success of the treatment.
Mild. You experience occasional light leakage with vigorous exercise, coughing, laughing, or sneezing. It’s usually a surprise when it happens, but you may wear an absorbent pad “just in case.”
Moderate. Your bladder leakage ranges from a few times a week to every day. You most likely wear an absorbent pad.
Severe. You leak multiple times per day, sometimes from simple movements, such as standing up, walking, or bending over. You probably use multiple pads per day. In addition to incontinence, you may have notable pelvic organ prolapse (i.e., when pelvic organs drop into or below the vagina).
Stress incontinence treatments
Mild stress incontinence
- Behavior modification. Changing your behavior involves altering your daily routine, including increasing your toilet visits and modifying when and how much fluid you drink. This method doesn’t solve any underlying problems, so your condition may worsen.
- Pelvic floor muscle training. Also known as Kegel exercises, this training strengthens the pelvic floor muscles, which in turn decreases bladder leakage. Kegels work well if performed correctly and consistently, however, studies show that women struggle to do them effectively.
- Biofeedback. This treatment is used to sense whether a woman is performing Kegels properly. The treatment requires the insertion of a vaginal probe. Studies show that biofeedback increases success with muscle training, but it is invasive.
- Weighted Kegel balls. These devices are placed in the vagina and provide additional resistance when performing muscle training. Kegel balls are less convenient than basic Kegel exercises, plus there’s a risk of infection.
- Surface stimulation. ELITONE allows women to tone the pelvic floor with muscle stimulation. Unlike many other treatment options, ELITONE doesn’t require vaginal insertion and can be used while going about everyday activities.
Moderate stress incontinence
- Surface stimulation (see above)
- Weighted Kegel balls (see above)
- Vaginal stimulation. A device is inserted vaginally to deliver muscle stimulation to the pelvic floor muscles. Treatment occurs over multiple weeks. Many women don’t tolerate the invasive nature of this treatment.
- Pessaries. These removable devices are placed in the vagina and press against the urethra, squeezing it closed to prevent leakage. This treatment can be a good alternative to surgery, but it doesn’t address the underlying cause. Side effects include infection and odor.
Severe stress incontinence
Surgery is an invasive option that should be considered a last resort. The most common surgery is a sling procedure where the surgeon tacks the ends of a sling (usually mesh or tape) to other tissues, and the sling physically lifts the bladder neck. Recently, there have been reports of severe complications with the products used in incontinence surgeries.
You don’t have to live with bladder leaks. Now that you’ve learned the actual definition of incontinence, the different types of incontinence, and the many treatment options, take the next step and talk to your health professional about a solution that’s right for you. Check out how to find the right doctor and what to expect at your initial appointment.