You likely don’t need a doctor to tell that you have urinary incontinence, but you may not know exactly what it is. Incontinence means a lack of control over urination. If you leak urine when you don’t want to you are incontinent. These “accidents” or “whoops moments” are frustrating and embarrassing and can impact how you live your life. This short article is written to answer your basic questions of “What is urinary incontinence?” and “What does urinary incontinence mean for my health?”
What Does Incontinence Mean?
You don’t need to completely wet your pants with pee to be considered incontinent. The severity of bladder leaks varies greatly from person to person. For some, it is just the occasional little leak that can be dealt with by wearing an absorbent pad. For others, the leaks are more severe. Leaks occur several times per day and require adult diapers. Others are bothered by a feeling that they always have to rush to urinate, requiring them to always know where the closest backroom is.
All of these people must deal with the leaks showing through their clothes, the embarrassing smell, and the uncomfortable wetness. The good news is that for many people incontinence is a treatable condition. It shouldn’t be considered just a natural part of aging. It should be treated as soon as possible to prevent it from getting worse. The key to this is knowing what type of incontinence you have.
Wait, there is more than one type of incontinence?
Yes. There are several types of urinary incontinence. Some are more related to the health of your muscles and others more associated with your nervous system. We’ll discuss a few of the most common types.
- Stress Urinary Incontinence – (SUI) Telling signs include leaking when one coughs, sneezes, laughs, or exercises. These and other activities increase pressure on the bladder. The added pressure (stress on bladder) overcomes weakened muscles holding urine back. The “stress” in stress incontinence doesn’t refer to psychological stress associated with work or family issues. Childbirth affects women’s bladder muscles, but it can also start later in life.
- Urge Urinary Incontinence – If you experience a sudden urge to pee, and find yourself rushing to bathroom, you likely have what’s called overactive bladder. If you don’t make it in time and end up having accidents you have urge urinary incontinence ( urge incontinence or UUI). This condition has more to do with the nerves that control your bladder than the pelvic floor muscles.
- Mixed Incontinence – Like the name sounds, if you have both stress and urge incontinence your doctor will refer to it as mixed incontinence. As many as 85% of people with incontinence this type.
- Overflow Incontinence – Some people don’t feel the urge to urinate, even when their bladder is full, causing their bladder to “overflow” and leak.
- Other types – Less common types of incontinence include functional incontinence and total incontinence. These can be associated with spinal cord injury, fistulas and other medical conditions.
So I have incontinence…. Now what?
The next question you should ask is whether your incontinence can be treated (and potentially cured) or is your only option to simply manage your leaks. The adult diaper industry is happy to provide you with plenty of information on how to manage the bladder problems. You only have to walk into any Walgreens, CVS, or RiteAid store to see entire aisles of shelf-space dedicated to products (i.e. diapers, pads) that simply cover symptoms. True treatments and their benefits depend on the type of incontinence. They vary from simple lifestyle changes to invasive surgical procedures. The most common include:
- Kegel exercises
- Vaginal Weights
- Biofeedback Devices
- Vaginal muscle stimulators
- External muscle stimulators
- Magnetic stimulation
- Surgery with implanted mesh
- Surgery without synthetic material
- Implanted sacral nerve stimulators
- Tibial nerve stimulators
- Dietary changes
- Bladder Training
- Radiofrequency Therapies
- Bulking Agents
This list is likely overwhelming to someone just beginning their search for incontinence treatment. Don’t be discouraged. One benefit of having all these treatment options is that if one solution doesn’t work for you, there is likely an alternative to try. For example, it’s often possible to start with a conservative, low-risk option before (if necessary) moving to a more invasive, higher-risk solution. Let’s consider stress urinary incontinence, the most common type of incontinence, as an example.
Stressed about stress incontinence?
Those with stress incontinence thankfully have multiple options if their symptoms aren’t too severe. These individuals typically benefit from toning their pelvic floor muscles. The simplest way to do this is through Kegel exercises. This approach may be simple, but it’s not always easy. Many women (and men) struggle with contracting the correct muscles. If they are doing them correctly many fail to do them often enough. Seeing a pelvic floor physical therapist may make this easier, but there are challenges with physical therapy.
Various devices train the pelvic floor muscles. They have typically taken the form of vaginally (or anally) inserted electrical probes. Although effective, women (and men) are frequently hesitant to pursue this treatment. In 2019 the FDA cleared a new type of therapy device to treat stress incontinence. Using externally applied stimulation to actively exercise the pelvic floor. The goal is that since it is non-invasive, it promotes patient convenience and comfort, and therefore compliance with treatment. For the most severe cases, it may be necessary for a surgeon to correct the problem with an operation.
You’re not alone
Urinary incontinence can be incredibly bothersome, causing embarrassment and worry. It’s a highly stigmatized medical condition. It’s not something many people are comfortable discussing with their friends or family. Instead, they manage their bladder leaks privately and often fail to seek medical treatment.
There are a number of organizations dedicated to helping those with urinary incontinence. They provide information, resources and support for individuals and families dealing with incontinence. A few favorites are:
- National Association for Continence – Provides education and support for incontinence patients and caregivers
- Simon Foundation for Continence – Their mission is to remove the stigma surrounding incontinence and providing hope for those with incontinence.
- Pelvic Guru – This site helps you locate at pelvic floor physical therapist near you.
Where can I learn about treatment options?
Incontinence is a medical condition, so it makes sense to get input from a medical professional. A number of different types of clinicians can provide guidance and treatment. Consider help from primary care physicians, gynecologists, urologists, urogynecologists, and pelvic floor physical therapists.
If you have stress incontinence and are looking for a comparison of Kegel exercise devices, the article “Best Kegel Devices of 2020” is a great resource. It has been read over 10,000 times. You might also like these other widely read articles and links: