Urinary Incontinence
Urinary incontinence is the inability to control the release of urine from your bladder. Some people experience occasional, minor leaks — or dribbles — of urine. Others wet their clothes frequently.
Stress incontinence. This is loss of urine when exerting pressure — stress — on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
Pelvic floor muscles and connective tissue support the bladder. If these muscles and connective tissue weaken, the bladder can move downward, pushing slightly out of the bottom of the pelvis toward the vagina. As a result, urine can leak during moments of physical stress. Stress incontinence also occurs if the urethra itself is weak.
Urge incontinence/overactive bladder. This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. With urge incontinence, urination is often frequent, including throughout the night.
The 3 main causes of urinary incontinence are
- Pregnancy and childbirth. The stress of a vaginal delivery can weaken muscles and connective tissue needed for bladder control.
- Changes with aging. Aging of the bladder muscle leads to a decrease in the bladder's capacity to store urine and an increase in overactive bladder symptoms.
- Hereditary. The muscles and connective tissue that control the bladder are coded for by genes that are inherited at birth.
Testing often times includes urodynamics. During urodynamics, a tiny catheter is used to fill your bladder slowly with warm water. Pressure in the urethra and bladder is measured continuously during urodynamics. The muscle strength of the pelvic floor is also measure continuously. As the bladder fills and empties, these measurements are used to identify the cause of incontinence and aid in deciding what treatment is optimal.
Treatment for incontinence can range from bladder training and pelvic floor strengthening exercises, to surgery.
Treatment for Urinary Incontinence:
Physical Therapy for Incontinence and OABMidurethral Sling