Urinary Incontinence is defined as unexpected loss of urine or loss of bladder control. It is common but does not need to be a consequence of your current stage of life (ie aging, post pelvic surgeries, pregnancy/post-partum). The loss of urine can be just an occasional dribble that may occur with walking, coughing or sneezing, or it can be a larger leak following an urge that can make you feel anxious to leave your home. If you are struggling with an inability to fully control your bladder, don't hesitate to talk with your provider.
Different types of urinary incontinence:
- Stress Incontinence: Type of incontinence that results in a sudden, involuntary loss of urine during activities, such as laughing, sneezing, coughing, lifting or exercising.
- Urge Incontinence: Symptoms are of sudden, intense urge to urinate followed by involuntary leakage. The urge and urinary leakage can be associated with a trigger such as running water, feeling cold, or when you walk into your house. Urge incontinence is associated with overactive bladder (OAB). Symptoms of OAB can include frequent urination during the day (greater than 8 times a day,) and frequent nighttime voiding.
- Overflow Incontinence: This occurs when the bladder is not able to empty completely, resulting in constant or intermittent dribbling of urine during the day/night.
- Functional Incontinence: This is typically the result of physical, mental, or neurological impairments that prevent the person from reaching the toilet in time. Some examples of these impairments can include severe arthritis, cognitive impairments, Parkinson’s, or Multiple Sclerosis.
- Mixed incontinence: When you experience more than one of the above types of urinary incontinence. Usually, it is a combination of stress incontinence and urge incontinence.
Risk factors may include
- Gender – Women tend to have more issues with urinary incontinence. This can be due to many factors including pregnancy, childbirth, menopause and the female anatomy. Men do tend to have an increase in urinary incontinence as they age. This is often related to changes in their prostate glands.
- Age – As we age, we can have changes in our anatomy. Often, the bladder is not able to hold as much urine as it once could. The muscles of the bladder and the urethra (tube that empties the bladder) can lose some strength, and we lose the ability to control our urine.
- Constipation – Issues with constipation can cause an increase in pelvic pressure thus impairing the bladder’s ability to hold and empty urine.
- Weight – If we are carrying extra weight, it can increase the pressure on the bladder and pelvic floor muscles causing some expected leakage of urine with activities.
- Pregnancy and childbirth – Weight, changes in posture as well as hormonal changes that occur during pregnancy can affect the bladder and how the pelvic floor muscles function. Childbirth, especially with vaginal deliveries, can initially lead to weakening of the pelvic floor muscles. In some cases, there can be issues with the pelvic nerves and supportive tissue. This stress may lead to a drop of the bladder, uterus, rectum and/or small intestine into the vagina which may increase your risk of incontinence or other pelvic dysfunctions. These changes can persist after birth, especially if breastfeeding/lactating.
- Family history – Urinary incontinence may be more common if you have/had a close family member that has struggled with urinary incontinence.
- Smoking – Studies have shown that smoking does increase your risk of developing urinary incontinence
- There can be other illnesses/diseases that also can increase your risk of urinary incontinent. Some examples of illnesses/diseases include diabetes, dementia, strokes, cancer/tumors, irritable bowel syndrome (IBS), and frequent bladder infections or kidney issues.
- Abdominal or pelvic surgeries (recent or in the past) – Surgeries particularly in the pelvis, back or abdominal regions lead to development of scar tissue which can impair the muscle’s ability to fire, limit our range of motion, cause inflammation, and possible nerve damage or urinary retention.
When to Seek Care
When the incontinence is affecting your quality of life, it is time to seek medical help. Don’t hesitate to speak with your provider regarding your incontinence. Your health care provider can help determine if the urinary incontinence may be associated with some disease/illness or possible medications, or if appropriate, they can refer you for pelvic floor therapy.
Treatment for urinary incontinence may be as simple as making changes to your diet or lifestyle depending on what type of urinary incontinence you are struggling with.
What to Expect from Pelvic Floor Therapy
Your therapist will perform an evaluation, which may include discussing your past and current symptoms, your medical history, and an examination. The examination can include assessing how well your pelvic floor muscles are functioning. From the evaluation, we will determine the best course of action needed to treat your individual needs. The treatments may include one or more of the following:
- Educate you how to improve your bladder function including modification in your diet (avoiding certain foods that can worsen symptoms, increasing/decreasing fluid intake), changing your activities to help reduce episodes of leaking, and working on how to better empty your bladder and control your urges.
- We will design a home exercise program for you that may include stretching tightened muscles, learning how to relax muscles that are overactive, or strengthening your core or pelvic floor muscles.
- Often, we find that surrounding area (pelvis, back, hips) can impact how your bladder and pelvic floor muscles are functioning. We can address these areas if they are impacting your condition.
- We also have access to modalities that may help to better reduce your symptoms, including biofeedback, electrical stimulation, self-massage/trigger point release.
If you have any concerns with how your bladder functions, know you are not alone. Talking with your provider can help to determine possible reasons for your symptoms. If therapy is an appropriate option, you can get a referral for pelvic floor rehabilitation.
No concerns are too small or too big. We are here to help you gain better control of your symptoms to help you return to a life you can enjoy.