Simply defined, urinary incontinence is a term used to describe urine leakage or a loss of bladder control. According to the National Association for Continence, more than 25 million Americans experience bladder leakage every day.
Although men aren’t immune to the condition, women who have been through childbirth are more likely to experience urinary incontinence, especially those who’ve delivered vaginally.
“We believe this is related to the stretching and tearing of tissues that support the pelvis during pregnancy and delivery,” says Joan Blomquist, MD, chief of the division of urogynecology at GBMC. “Other risk factors include genetics, chronic constipation, chronic cough, obesity and smoking.”
The chances of developing incontinence also increase with age.
Types of incontinenceThere are two main types of incontinence with varying symptoms for each.
“Stress incontinence is urine leakage when you do something physical — coughing, sneezing or activities like jumping or jogging,” Dr. Blomquist explains. “When coughing or another force transmits pressure to the bladder, the urethra is supposed to close to keep urine in. If the closing mechanism isn't working properly, urine can leak out.”
Symptoms may occur occasionally during a bad cold or vigorous exercise, or frequently during walking or other light movement.
The second common form is called urge incontinence, sometimes referred to as overactive bladder. A strong, sudden urge to urinate is the main symptom.
“This occurs because the bladder muscle contracts or spasms without warning,” Dr. Blomquist continues. “Some women notice certain triggers such as a change in temperature or the sound of running water. Many women with urge incontinence go to the bathroom frequently and may have to get up several times at night to urinate.”
The effects of incontinenceAlthough urinary incontinence is a physical ailment, it can affect patients’ emotional and mental health as well, and it can greatly impact their quality of life.
“Women who have leakage are frequently embarrassed about the situation and may avoid social activities they used to enjoy,” Dr. Blomquist points out. “They may avoid intimate relationships as well. If leakage occurs with exercise, they may stop working out, which can have negative impacts on their overall health. Incontinence pads can be quite expensive, creating a financial burden for some women. For others, the skin around the vaginal opening can get irritated from chronic leakage.”
What you can doIf you’re experiencing urinary incontinence, the most important thing to know is that support is available.
“The first step is to talk to your healthcare provider,” Dr. Blomquist urges. “A primary care physician or gynecologist can help with initial suggestions, or they might recommend you see a specialist such as a urogynecologist or urologist. There are a lot of treatment options; don’t be afraid to ask for help.”
Lifestyle modifications like losing weight, quitting smoking and avoiding foods and beverages that irritate the bladder (like coffee, chocolate and spicy food) can help to get symptoms under control. Kegel exercises to strengthen the pelvic floor or a pessary device that lifts the bladder and applies compression to the urethra may also help relieve some symptoms. In extreme cases, surgery may be indicated.
“Other treatments include medication, Botox injections into the bladder and overstimulation of the nerve that goes to the bladder,” Dr. Blomquist adds. “We offer all available options at GBMC. This allows us to tailor treatment to each patient depending on the type of incontinence, any other medical issues they may have, and their own personal preferences as to what works best with their lifestyle.”