A Discussion About Incontinence

Stress incontinence occurs when extra internal abdominal pressure is generated (by exercise, coughing, sneezing) which, in turn, puts extra downward pressure on the bladder. This additional downward pressure can overcome a closed urethra and push urine out during the strain. Coughing, sneezing, laughing, lifting heavy objects, playing tennis, running and jumping are examples of activities that can cause stress incontinence.

Stress incontinence is much more common in women because childbearing often weakens the pelvic muscles. Obesity, smoking, pelvic surgery (including hysterectomy) and menopause are also risk factors.

Stress incontinence is not a condition you have to live with. It can usually be improved and often cured with exercise to strengthen the pelvic floor muscles, use of a pessary (a flexible device that fits into the vagina and supports the bladder and urethra),surgery or sometimes a combination of these therapies. Minimally invasive surgery is now available for treating women with this condition.

Urge incontinence is associated with a strong urge to urinate that cannot be delayed; it is often referred to as overactive bladder. Normally, the bladder muscle contracts when your bladder is full, which signals it's time to urinate. With urge incontinence, the bladder contracts randomly, creating this urge even when the bladder is far from full. This leakage is frustrating because it is unpredictable and the leakage can be large because the bladder may completely empty.

Overactive bladder can be caused by a number of reasons: a temporary problem such as a bladder infection, a major illness such as multiple sclerosis, Parkinson's or diabetes, or poor bladder habits that you can learn to overcome.  Overactive bladder occurs more commonly as we age. 

Like stress incontinence, urge incontinence can be treated through bladder retraining, monitoring your fluid intake (keep your fluid intake around 2 liters), prescription medications and implantable medical devices.

It is important to know that many women are experiencing the same symptoms; you do not have to feel ashamed or embarrassed. Unfortunately, many women do not share their concerns with their healthcare provider but instead adjust their lives to accommodate their bladder.  When women begin limiting their activities, avoiding social situations, they have waited too long. 

Urinary incontinence keeps women from exercise and increases risks for depression and social isolation.  Seek help with any urinary incontinence when you feel it is negatively affecting you, There is help available.