You’re out to dinner with friends, and you’re all laughing about a funny memory. Suddenly, you need to excuse yourself to find the restroom.
Or you’re helping your child move into their new apartment, and after you lift their box full of books, you’re once again looking for the nearest toilet.
Experiences like these are signs of urinary incontinence — a condition where you lose control over your bladder and a small amount of urine leaks out, is a medical problem.
The Basics: Urinary Incontinence 101
When you urinate, the muscles in your bladder tighten, pushing the urine out through a tube called the urethra. Usually, a muscle called the sphincter also tightens so the urine doesn’t leak.
As you get older, that sphincter muscle may weaken, making it less reliable at holding in your urine when you laugh, sneeze, or exercise.
- Stress incontinence: When pressure on your bladder from everyday actions, such as coughing or laughing, causes you to leak urine
- Urge incontinence: When you feel a strong and sudden urge to urinate or the need to urinate often — both of which may cause a urine leak
- Overflow incontinence: When you have frequent but small urine leaks caused by not emptying your bladder completely
- Functional incontinence: When you have a physical or mental impairment that makes it more difficult to get to the toilet in time
- Mixed incontinence: When you have more than one type of urinary incontinence
5 Types of Urinary Incontinence
Urinary incontinence can happen to anyone, but it’s especially common as you age.
While urinary incontinence is a physical problem, it can also affect you emotionally, psychologically, and socially. Normal activities, such as running errands or walking the dog, can cause anxiety, and the desire to stay close to the toilet can keep you from going about your daily life.
But just because urinary incontinence is common, it doesn’t mean you have to live with it.
By talking to your physician, getting diagnosed, and receiving treatment, you can begin to feel like yourself again.
Here’s what you should know about urinary incontinence — and what you can do about it.
Why Do I Have Urinary Incontinence?
Although urinary incontinence can be frustrating and disruptive, it’s not a disease itself. It’s actually a symptom of something else going on in your body, and your treatment may depend on the cause.
Sometimes, urinary incontinence can be temporary, due to a urinary tract infection (UTI), vaginal infection, or constipation. If that’s the case, your urinary incontinence should go away on its own once your urinary system is back to normal.
Other times, urinary incontinence may last longer, and it may be due to:
- Weak or overactive bladder muscles
- Weak pelvic floor muscles
- Nerve damage from diseases, such as diabetes or Parkinson’s disease
- Certain medications
- Prostate problems in men, such as a blockage from an enlarged prostate or prostatitis (inflammation of the prostate gland)
- Pelvic organ prolapse (pelvic organs, like the bladder, shift into the vagina) in women
Urinary incontinence is more common in women because of events such as pregnancy, childbirth, and menopause. This extra stress — along with a shorter urethra (the tube that releases urine from the bladder) — puts women at a higher risk for urine leaks.
Do I Really Need to See a Physician?
Even though many people suffer from urinary incontinence, you may still feel embarrassed about telling your physician. However, your physician is trained to help you treat it, which can prevent potentially embarrassing situations down the road.
In addition to leaking, signs that you may want to talk to your physician about urinary incontinence include:
- Urinating more than eight times a day
- Urinating more than two times a night
- Pressure or muscle spasms in your pelvic area that make you feel like you need to urinate
- Urinating while sleeping
To diagnose urinary incontinence, your physician will give you a physical exam and ask you questions, such as what your symptoms are and if you’re taking any medication. They may ask you to start keeping a journal of when you urinate, when you leak urine, and what activities you were doing at the time.
They may also take a urine or blood sample or perform other tests to see how well you empty your bladder.
Treating Your Urinary Incontinence
Once you know you have urinary incontinence, you can start treating it. Buying protective pads or underwear is a good start, but that won’t treat the underlying issue behind your urinary incontinence.
The good news is that treatment for urinary incontinence can be very simple. It depends on what’s causing it, how much it impacts your life, and what treatment fits your lifestyle. In most cases, your physician will have you try the simplest treatments first and change things up as needed.
Little steps can make a big difference — and they can even make your urinary incontinence go away completely. Some ways you can treat your urinary incontinence at home include:
- Practicing bladder training, which includes setting times to urinate — even if you don’t have to go — and gradually adding time in between trips to help your bladder learn to hold more urine
- Losing weight, which can relieve some pressure on your muscles and bladder
- Avoiding drinks that may make urinary incontinence worse, such as alcohol or drinks with caffeine or carbonation, but still drinking enough water to keep you hydrated
- Quitting smoking, since smoking can make urinary incontinence worse and lead to many other health issues
- Eating more fiber, which may reduce constipation and reduce urinary incontinence problems
- For women, doing Kegel exercises — small muscle contractions in your pelvic area that your physician can teach you how to do
If you’ve tried the at-home route, and your urinary incontinence isn’t improving, you may want to talk to your physician about other options. Medical treatments may include:
- Medications, which can help your bladder empty completely during urination
- Nerve stimulation, which uses mild electric pulses to stimulate the nerves around the bladder, increasing blood flow and strengthening the surrounding muscles
- Biofeedback, which uses a special machine that’s connected to patches that are placed on your skin, allowing you to see how the muscles around your bladder contract on a screen and learn how to control them better
Certain medical treatments are specific to women, including:
- Medications like vaginal creams, rings, or patches that contain estrogen, which can strengthen your muscles and tissues around the urinary system
- Thickening agents, such as collagen, which can be inserted into the tissues around the urinary system to cause them to thicken and keeps the bladder opening closed
- A vaginal pessary, which is a small, ring-shaped device made of plastic or silicone that, once inserted into the vagina, pushes against the wall of the vagina and urethra to support the surrounding muscles
If your urinary incontinence is severe, and no other treatments are working, your physician may recommend surgery. Surgery may be done to:
- Insert stitches to hold your bladder in place
- Insert a catheter (a thin, flexible tube that’s placed in your bladder and drains the urine into a bag outside your body)
- In women, place an artifical piece of mesh or your own tissue underneath your urethra to support it and hold the bladder in place
- In men, remove a blockage from an enlarged prostate
There is much to consider when deciding to have surgery. Surgery can come with complications and may require lifestyle changes, such as changing a catheter bag or restricted activity. Talk to your physician about what options are best to treat your urinary incontinence.
Find the Best Treatment for a Better Life
The constant need to use the bathroom shouldn’t bring you anxiety. You should be able to go out to dinner, take a road trip, or go to your favorite exercise class without worrying about how you’ll get to the nearest bathroom or if you’ll leak urine.
Fortunately, there are plenty of simple treatments that can treat your urinary incontinence. Start small, and allow your body time to adjust to your treatment. If the first treatment you choose doesn’t work, talk to your physician about other options. There are many ways to treat urinary incontinence, and it may take time to find the one that’s best for you.
Urinary incontinence may be a little embarrassing — and sometimes annoying. However, by finding the right treatment, you can go about your daily life without always looking for the nearest bathroom.
Still have questions about urinary incontinence? Call 785-270-4355 to make an appointment with a urologist at Stormont Vail Health’s Urology department or 785-270-4440 to make an appointment with a primary care provider.