The accidental loss of urine is urinary incontinence. The two main forms of this condition are stress incontinence and urge incontinence. In many cases, incontinence is caused by weak pelvic floor muscles, often the result of childbirth or estrogen loss during menopause. Obesity, medications, and urinary tract infections also contribute to the problem. Many women experience both types of incontinence.
Two Types of Urinary Incontinence
Stress incontinence occurs when one sneezes, coughs, laughs, walks, or lifts objects. It can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles cannot properly support your bladder, the bladder drops down and pushes against the vagina. When you cannot tighten the muscles that close off the urethra, urine may leak out.
Urge incontinence is a loss of urine accompanied by a strong and abrupt desire to empty the bladder. This type of incontinence may be caused by irritation of the bladder, emotional stress, or brain conditions such as a stroke, but many times, no cause is known.
For years, urinary incontinence was thought to be untreatable. Thanks to recent medical advancements, however, we now have the tools to accurately diagnose and effectively treat this common problem. The first step in dealing with this condition is to talk with your family doctor, gynecologist, nurse practitioner, physician’s assistant, or nurse. Your health care professional will consider your symptoms, family history, and other factors when formulating a diagnosis for you.
You may have to keep track of what you drink, how much you drink, how much you urinate and leak, and how often you urinate and leak for 3-4 days to see if any patterns develop. Your doctor will examine you and may do some simple tests to determine if there is a cause for your incontinence.
Urodynamic testing is one of the best methods for accurately diagnosing urinary incontinence. Advanced testing may include one or more of these studies:
- Cystometrogram: measures bladder muscle contractions during filling
- Urethral pressure profile: measures the pressure inside the urethra
- Leak point pressure study: measures the effectiveness of the urethral closure mechanism
- Flow rate study: measures the force of urinary stream
For stress incontinence, some treatment options include doing Kegel exercises to strengthen the pelvic floor muscles and improve stress incontinence; using a pessary, a removable device to put pressure on the urethra; medications; and surgery.
For urge incontinence, some treatment options could include behavioral therapy that include pelvic muscle rehabilitation using biofeedback; electrical stimulation; bladder training; and medications.
If you experience urinary incontinence, please discuss your diagnosis and treatment options with your gynecologist or primary care doctor.