Incontinence

Incontinence Quiz

Think you have Incontinence? Take our assessment to find out more.
Incontinence is the involuntary loss of urine. It can happen occasionally or frequently, significantly affecting a woman’s quality of life. Incontinence can be a chronic condition that results from any number of factors, including weakened pelvic floor muscles due to childbirth, aging or other medical conditions.

There are four main types of incontinence:
  • Stress incontinence: Urine loss due to increased abdominal pressure caused by coughing, laughing, sneezing or exercising (This is the most common type.)
  • Urge incontinence: Uncontrolled loss of urine due to sudden and strong urge to urinate
  • Overflow incontinence: Constant dribbling due to an inability to empty the bladder completely
  • Functional incontinence: Inability to make it to the toilet in time due to a mental or physical barrier (for example, severe rheumatoid arthritis)
Behavior:
  • Don’t delay a trip to the bathroom once your bladder is full. Make sure you have a place to go and can excuse yourself in social situations.
  • Once in the bathroom, make sure to empty your bladder completely. Instead of straining muscles, stand up or shift position, then sit down and urinate again.

Diet:
  • Reduce or remove bladder irritants from your diet. Common irritants include alcohol, coffee and other sources of caffeine, carbonated beverages, fruit juices, and vinegar. Try keeping a bladder journal.

Exercise:
  • Recent research indicates yoga can be an effective treatment for urinary incontinence, especially poses and breathwork designed to strengthen and bring awareness to the pelvic floor region.
  • Kegels reduce or prevent incontinence by strengthening the pelvic floor.

Lifestyle Factors:
  • If you’re overweight, try to get down to a healthy weight with diet and exercise. Excess weight can put pressure on your bladder and make emptying your bladder more difficult.
  • If you’re a smoker, please quit. This is one of the most positive steps you can take to improve your overall health. Nicotine is a bladder irritant, and tobacco is a urinary tract carcinogen. Smoking may also cause you to cough, which in turn can trigger involuntary loss of urine.
  • If you have diabetes, work toward having your blood sugars under good control.

Medical:
  • Make a list of medications or supplements you are taking and check to see whether any of them list incontinence as a side effect.
Most cases of incontinence can be cured or controlled with treatment. Depending on the reasons for your incontinence, treatment may include targeted exercises, medication, biofeedback, special incontinence devices, minor office procedures or surgery.

In many cases, the cause of incontinence is easily identifiable and the course of treatment or recommended life adjustment is minor. Sometimes, however, there can be cause-and-effect scenarios and related health issues that play into incontinence. Incontinence is not a condition you have to suffer with for the rest of your life. Our urogynecologists are specially trained to unravel the complex reasons for incontinence. Whatever the reason for your incontinence, we can help find the treatment that’s best for you.
Treatments for Incontinence:
  • Medication: Oral medicines can block the urge to urinate or can enable the bladder to hold more urine.
  • Kegel exercises (pelvic floor physical therapy): Kegels are one type of exercise designed to prevent, reduce or eliminate incontinence. You can strengthen the muscles of the pelvic floor with a simple squeeze-and-release movement. Other times, more specialized treatment of muscle function is necessary to train the pelvic floor and abdominal muscles to work together to improve urinary function. Pelvic floor therapists are specially trained in these treatments.
  • Sacral nerve stimulation: An implanted device is used to stimulate the sacral nerve, just above the tailbone. This activates the nerves that control the bladder.
  • Tibial nerve stimulation: Using a small needle (similar to those used for acupuncture) in the office, the tibial nerve is stimulated on the inside of the ankle to help activate the nerves that control the bladder.
  • Botox® bladder muscle injections: Using a camera to look into the bladder in the office, Botox (botulinum toxin) is then injected into the bladder to block the urge to urinate and enable the bladder to hold more urine.
  • Urethral bulking: Using a camera to look into the bladder, a bulking material is injected into the area between the urethra and bladder to prevent accidental urine leakage.
  • Surgery for incontinence: There are multiple types of surgery that can be used to support a urethra and prevent accidental urine leakage when you cough or move vigorously. This most commonly includes a minimally invasive surgery using a tension-free vaginal tape, but can also involve other procedures using your own tissues. Your surgeon would help you decide what the right procedure is for you.

How common is urinary incontinence?
Very common. Approximately 15% of women will deal with the involuntary loss of urine at some point in their life.

Shouldn’t I expect incontinence at my age?
Aging can be one cause of incontinence. But incontinence can occur at any age, and at any age, most causes of incontinence are treatable and reversible.

I’m embarrassed. How can I bring this up at my annual appointment?
Incontinence is a common condition—you aren’t alone. Your provider is used to hearing concerns about incontinence from other women. At your appointment, try bringing it up in a way that’s most comfortable to you. Try using words like, “I’m concerned because there have been several times when I couldn’t control my bladder. What do you recommend?” or “I think I use the restroom too frequently. Is there a way to treat that?” While this can be a very personal and embarrassing subject to talk about, remember that providers are professionals and hear similar concerns all the time from their patients. If you don’t have a provider or don’t know who to talk to, call our Care Navigator and they will set you up with the right provider to help you determine treatment options and next steps.

What causes incontinence?
There are many causes of incontinence, some of which are temporary: bladder infections, constipation, excessive caffeine, acidic or spicy foods, pregnancy and certain medications.

Other causes are less temporary, including: age; menopause; pelvic floor disorder; pelvic floor injury due to childbirth; and neurological disorders like dementia, multiple sclerosis and Parkinson’s disease.

What is the most common cause of incontinence?
The most common causes of incontinence are weakened pelvic muscles and/or an overactive bladder, both of which can usually be treated and improved—but which tend to worsen over time if left untreated.

What’s the difference between incontinence and overactive bladder?
An overactive bladder can cause urge incontinence, or the involuntary loss of urine due to a sudden and unexpected contraction of the bladder muscles. Common symptoms of overactive bladder include frequent trips to the bathroom, overwhelming urges to urinate and inability to get to a toilet in time.

What happens if I choose not to treat my incontinence?
While some causes of incontinence, such as bladder irritation or constipation, may resolve with lifestyle changes, other causes can be more serious, such as an obstruction in the urinary tract, which can cause urine to back up and harm the kidneys. Regardless of the cause, incontinence can lead to lack of exercise and fewer social engagements, and continual exposure to urine can result in skin rashes and infections. Bottom line: It’s always a good idea to have chronic incontinence evaluated by a qualified health care provider.

What can I do to prevent incontinence?
No one can predict who will become incontinent. But maintaining a healthy weight and good overall health are good ways to reduce your risk. In addition, exercising pelvic muscles on a regular basis—and especially during and after pregnancy—can help keep pelvic muscles strong and reduce the likelihood of stress incontinence.