Take Back Control: Help for Urinary Incontinence

We’ve all seen the TV commercials for adult underwear which make urinary incontinence seem like an inevitable part of aging. While it is common, it’s not something you should suffer in silence because it can often be addressed and improved. 

All too often, patients don’t bring up stress urinary incontinence to their physician because they think nothing can be done or they’re too embarrassed. It’s also sometimes confused with urge incontinence, which is a different but also treatable condition.

Stress Incontinence

This happens when the muscles and tissues that support your bladder and urethra weaken.  Think of it like a leaky faucet – the pressure from activities like coughing or jumping put stress on the bladder and your urethra is unable to stay closed, causing urine to leak out. 

Urge Incontinence

This occurs when you have a sudden, strong urge to urinate and you can't make it to the bathroom in time. It's often caused by an overactive bladder, which contracts too frequently or too strongly or just at the wrong time.

Some people experience a combination of both stress and urge incontinence.  This means they may leak urine when they cough or sneeze, and also when they have a sudden urge to go. 

Treating Incontinence

Both conditions can be treated, but in different ways. Stress incontinence treatments focus on supporting the urethra and reducing pressure on the bladder. Urge incontinence treatments aim to control bladder contractions and improve bladder capacity.

Stress Incontinence options

• Pelvic floor therapy and exercises (Kegels) to strengthen muscles which support the bladder and urethra.
• Pessary device inserted into the vagina to support the urethra and prevent leakage.
• Surgery includes procedures that improve support to the urethra or help bulk the urethra itself.

Urge incontinence options

• Behavioral changes can make a big difference: what you drink, when you drink it and other factors such as stress and identifying triggers. 
• Bladder training to gradually increase the time between urination to increase the bladder's capacity.
• Pelvic floor therapy to improve muscle function.
• Medications (anticholinergics and beta agonists) that block the nerve signals that trigger bladder contractions.
• Sacral nerve stimulation to help regulate bladder function.
• Injection of Botox in the bladder to decrease bladder spasms. 

Lifestyle changes

You can make changes in your everyday life to reduce your risk for incontinence or decrease the severity of your symptoms. These include: 

• Maintain a healthy weight. Excess weight puts extra pressure on your bladder and can worsen incontinence.
• Quit smoking. Smoking weakens the muscles that support your bladder.
• Limit caffeine, carbonation, artificial sweeteners, and alcohol. These may irritate your bladder and increase the frequency of urination.
• Maintain reasonable hydration. If you are too dry, your urine may become an irritant because of the concentration. But if you drink too much, you are going to have to urinate more frequently. While it may seem counterintuitive, drinking plenty of fluids helps reduce constipation and prevents infections by flushing out your bladder.

My take-home message is this: don't suffer in silence. If you're experiencing symptoms of incontinence, please talk to your provider. There’s much we can do to improve or alleviate your symptoms, and help you live a more active and fulfilling life. If you’re unsure where to start, the Pelvic Health Center has resources specifically for this issue. Find out more on our website or call (402) 717-7358.