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Incontinence

What is Incontinence?

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

What are the symptoms?

Other symptoms that may occur along with urinary incontinence include a strong urge to urinate, frequent urination (more often than usual), Nocturia (waking from sleep to urinate), Nocturnal enuresis (leaking urine while sleeping), and Dysuria (painful urination).

Different types of Incontinence

Urinary incontinence in women can be divided into three types:

  1. Stress urinary incontinence (SUI) is leaking urine when coughing, laughing, or sneezing. Leaks also can happen when you walk, run, or exercise.
  2. Urgency urinary incontinence is a sudden strong urge to urinate that is challenging to resist. Women with this type of urinary incontinence may leak urine on the way to the bathroom.
  3. Mixed incontinence is a combination of both SUI and urgency urinary incontinence symptoms.

What causes incontinence?

Some causes may include a urinary tract infection (UTI)—UTIs sometimes cause leakage and can be easily treated with antibiotics. Diuretic medications, caffeine, or alcohol can also cause your body to produce more urine than normal.

Pelvic floor disorders are caused by weakened muscles and tissues of the pelvic floor and symptoms can include urinary incontinence, accidental bowel leakage, and pelvic organ prolapse.

Neuromuscular and anatomical problems can disrupt signals between the brain and bladder, causing the muscles that control those organs to malfunction. Bladder stones or other growths can block the outlet from the bladder into the urethra.

How is incontinence diagnosed?

Incontinence is typically diagnosed using a combination of medical history research and physical exams.

Your gynecologist or other health care professional will ask you to explain your signs and symptoms in detail and you may be asked to fill out a bladder diary for a few days.

A pelvic exam may be performed to check for pelvic organ prolapse and to look for other anatomical problems. This may also include a “cough test.” During a cough test, you’ll be asked to cough with a full bladder to see if urine leaks. A pad test may be done, in which you wear a pad that absorbs leaked urine. The pad is weighed to determine amount of leakage. A test to measure the support of the urethra may also be done. Sometimes, imaging tests and bladder function tests will be taken if more information is needed.

How is it treated?

It’s likely that your gynecologist will first recommend nonsurgical treatment. This can include lifestyle changes, bladder training, physical therapy, and using certain bladder support devices. Lifestyle changes that can help reduce incontinence include losing weight, managing fluid intake including monitoring or cutting out caffeinated and alcoholic beverages, and training your bladder by controlling urges and increasing time span between bathroom breaks until it’s back to normal. Certain physical therapies including kegel exercises and biofeedback machines can also help to control the affected muscles.

For urgency urinary incontinence, the treatment may involve medication. Medications help control muscle spasms and bladder contractions while relaxing the bladder, allowing it to store more urine.

Surgery is required to help certain types of incontinence using electrical nerve therapies and acupuncture-like nerve stimulation designed to send signals to the bladder and pelvic floor. Other surgical remedies include slings and other structures designed to provide support and hold the urethra in place. Often, several treatments used at once produce the most effective remedy.

Who is affected?

It’s important to remember that while incontinence is common in older women, age is not the determining factor. Pregnancy also plays a large role. A large baby, an episiotomy, or a difficult birth can weaken the pelvic floor.

The issue at hand involves the muscles and tissue, which can be repaired with the right care. Remember that it’s not normal to have to rush to the bathroom or get up several times in the middle of the night.

If you think you may suffer from incontinence, or have questions about treatments or diagnosis, reach out to your gynecologist today and get the relief you’ve been missing.