Incontinence

Incontinence is the accidental loss of urine. About 15% of women experience this problem at some point. Fortunately, it’s treatable and reversible.

Types of incontinence

  • Stress incontinence – Urine loss caused by pressure on your bladder from activities like coughing, laughing, sneezing or exercising; this is the most common type of incontinence
  • Urge incontinence – Sudden, strong need to urinate, sometimes due to overactive bladder
  • 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 condition (for example, severe rheumatoid arthritis)

Self-assessment quiz

Lifestyle tips

Your doctor might recommend managing symptoms with these habits.

Behavior
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  • Go to the restroom as soon as your bladder is full. Try to empty your bladder completely, but don’t strain your muscles. Instead, stand up or shift position, and then try to urinate again.
  • Use all-cotton or incontinence pads (not menstrual pads) to deal with urine leakage. All-cotton pads are more breathable, which helps prevent skin irritation.
Diet
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  • Limit alcohol, caffeine, coffee, tea, sodas and fruit juice. 
  • Keep a diary to help you find any connections between your diet and your symptoms.
Exercise
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Strengthen your pelvic floor muscles with Kegel exercises and yoga.

Weight management
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Maintain a healthy weight with diet and exercise. Excess weight puts pressure on your bladder.

Manage your health
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  • Check whether any of your medications or supplements list overactive bladder or urinary incontinence as a side effect.
  • Control your blood sugar levels if you have diabetes.
  • Don’t smoke. Nicotine is a bladder irritant, and tobacco can cause urinary tract cancers. Smoking may also make you cough, which can cause bladder leakage.

Treatment options

You don’t have to live with incontinence for the rest of your life. Treatment options include:

  • Biofeedback - Teaches you how to control and strengthen pelvic floor muscles
  • Botox® injections – Block the urge to urinate and enable the bladder hold more urine
  • Oral medications – Block the urge to urinate or help your bladder hold more urine
  • Pelvic floor physical therapy – Strengthens and trains pelvic floor and abdominal muscles to improve bladder control
  • Urethral bulking – Injects a bulking material to the area between the urethra and bladder to prevent urine leaks
Nerve stimulation
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Sacral nerve stimulation uses an implanted device to activate the nerve above your tailbone that controls the bladder. An in-office procedure can check if this controls your symptoms. If it works, a doctor can put the device in your body during a minor surgical procedure. Tibial nerve stimulation uses a thin needle in the doctor’s office to stimulate a nerve on the inside of the ankle, which connects to the sacral nerve and helps control the bladder.

Surgery
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If surgery is your best treatment option, your urogynecologist will recommend the right procedure for you. The most common treatment is a minimally invasive procedure using vaginal tape. It supports the urethra to help prevent urine loss when you cough or move a lot.

Frequently asked questions

What causes incontinence?
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Temporary causes of incontinence include:

  • Acidic or spicy foods
  • Bladder infections
  • Certain medications
  • Constipation (trouble moving your bowels)
  • Pregnancy
  • Too much caffeine

In these cases, lifestyle changes can often relieve symptoms. Other causes of incontinence include:

  • Aging
  • Blockage in the urinary tract, which can lead to kidney damage
  • Menopause
  • Neurological disorders, such as dementia, multiple sclerosis and Parkinson’s disease
  • Pelvic floor disorder, such as pelvic organ prolapse, especially after childbirth
I’m embarrassed. How do I talk to my doctor about this?
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There’s no need to feel embarrassed. Doctors see patients like you often. At your appointment, bring up your concerns in a way that’s 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?”

What if I choose to not treat my incontinence?
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Incontinence may make you start avoiding exercise and social situations. Continual exposure to urine can result in skin rashes and infections. Some incontinence is caused by urinary tract obstructions, which can harm your kidneys if not treated. Bottom line: It’s always a good idea to talk to your doctor.

Contact us

Talk to a care navigator or schedule an appointment at the Women’s Health & Wellness Center.