Urinary Incontinence: Common Questions, Causes, & Treatment

What is urinary incontinence?

Urinary incontinence means leaking urine, ranging from a few drops to a total emptying of the bladder. In addition, common symptoms include urgent urination, experiencing a higher frequency of urination than is typical for you, waking up from sleep to use the bathroom, painful urination and leaking urine in your sleep.


There are two main types of urinary incontinence: stress urinary incontinence (SUI) and urgency urinary incontinence (UI). Many women experience both types of incontinence. SUI results in leaking urine when you cough, laugh, sneeze or put stress on the bladder through physical activity. UI is a sudden urge to urinate that is difficult to control, often causing you to leak urine in your rush to the bathroom.


How do I know if I have an incontinence problem?

Signs that incontinence has become a significant problem include difficulties completing household chores, exercise or other physical activities without bladder leakage. If you are reluctant to participate in social activities outside your home, travel long distances by car or bus, or go to the movies, concerts or other entertainment venues because of frequent urination, talk to your doctor about your concerns. Many women feel frustrated, ashamed, nervous or down on themselves because they don’t have the bladder control they are used to, but urinary incontinence is a common medical issue that can be treated. Your doctor can recommend a personalized treatment plan beyond just relying on absorbent pads to help you regain control of your bladder.


Why is this happening to me?

There are a variety of causes of urinary incontinence. Urinary tract infections can cause leakage and are treated with antibiotics. Alcohol, caffeine and diuretic medications can cause your body to produce more urine putting stress on your bladder. Pelvic floor disorders, or weakening of the pelvic floor muscles and tissues, can cause not only urinary incontinence but also accidental bowel leakage and pelvic organ prolapse. Constipation is often an issue in women with urinary incontinence, especially in older women. Neuromuscular and anatomical problems are other reasons for urinary incontinence. Your doctor will help determine the cause of your incontinence by reviewing your medical history, asking about your symptoms and performing a physical pelvic exam.


How can I treat urinary incontinence?

Lifestyle changes, bladder training, physical therapy and bladder support devices are the first steps in treating this issue. For women who carry extra weight, losing weight may decrease urine leakage. Managing how much fluid you consume, especially before bedtime, and limiting caffeine and alcohol can also be helpful. Training your bladder and increasing the length of time you can go between trips to the bathroom is another lifestyle adjustment that can decrease urine leakage. Kegel exercises can strengthen the pelvic muscles and are helpful for all types of incontinence. Biofeedback is a training technique that uses sensors to provide feedback regarding how well the pelvic muscles are working. Your doctor may also issue a device known as a pessary to provide support of the vaginal walls to reduce bladder leaks. Medication is another option to decrease the severity of symptoms. Your doctor will personalize a plan that meets your individual needs and lifestyle.


Will I need surgery or a procedure to fix this?

There are surgical procedures that can treat stress urinary incontinence such as slings that help lift and support the urethra. They are made of synthetic materials, animal derived material, or your own tissue. If surgery is not a fit for you, a synthetic substance can be injected into the tissue around the urethra to restrict the opening of the urethra to decrease leakage. If you experience UI, sacral neuromodulation is a treatment option. A thin wire is inserted in the skin of the low back targeted at the nerve that controls your bladder. Similar to acupuncture, percutaneous tibial nerve stimulation is an in-office treatment that sends signals to nerves in the pelvic floor.


How can I prevent urinary incontinence?

To prevent future leakage, you can practice pelvic muscle exercises, more commonly known as Kegels. To find the right muscles, imagine that you have eaten a rich food that has caused you to have gas. The muscle that you use to hold back gas is the one you want to exercise. Engage the pelvic muscles ten times for about 3 seconds each. Try these exercises several times a day and work your way up to 30 Kegels three times a day. Refrain from holding your breath or engaging your stomach, leg, or buttock muscles. Inhale and exhale slowly while counting and try to isolate the pelvic area. You will begin to notice a change in about 4 to 6 weeks. Other ways to prevent incontinence include maintaining normal body weight, avoiding use of cigarettes, caffeine, or artificial sweeteners, treating constipation, and learning how to perform physical activities without excessive straining.


For more information about incontinence, visit the Center for Continence and Prolapse.