Urinary Incontinence: Common but not Normal

There are some body issues that no one really likes to discuss, even with their doctor. Incontinence (leakage), urinary or fecal, is one of those issues. Incontinence affects both men and women, but did you know that it is two times more likely in females than males? The National Association for Continence (NAFC) says 1 in every 4 women over the age of 35 experiences incontinence. Incontinence is common, but that does not mean it is an inevitable part of aging and it does not mean you can’t find relief.

First, let’s review how the bladder functions: your kidneys filter your blood and remove waste/toxins which creates urine. Little tubes, called ureters, take the urine from the kidneys to your bladder where it is stored. As the bladder fills, it stretches. When it reaches a certain level, a message is sent to the brain telling you it’s time to find a bathroom. When you reach the restroom the brain tells the muscles of the bladder to contract (you can’t control this part, it just happens) and your pelvic floor muscles to relax (you can control this part).. If something interrupts the communication process between the brain and bladder or if the muscles of the pelvic floor are weak (or sometimes even tense), leakage can occur. While you cannot control the contraction of your bladder, you can control your pelvic floor muscles. Strengthening these muscles with a specific type of physical therapy can help.

Incontinence is not only a physical problem, but it can affect your personal life. Every patient is unique, but incontinence is usually a bigger issue than needing to wear a pad or change your clothing. Many sufferers experience impacts on their emotional and psychological well-being. A decrease in social activity is also common. Incontinence has also been associated with a 26% increased risk of falls in the elderly population, as reported by the NAFC. Some can lose their balance when experiencing a sudden need to reach the bathroom quickly.

There are many different types of incontinence and they all mean something slightly different. Knowing the various types can help when trying to communicate the problem to your doctor or physical therapist.

  • Stress Incontinence: loss of urine with physical activity/exertion. Often individuals note this leakage is associated with cough, sneeze, laugh, jump, or exercise.
  • Urge Incontinence: loss of urine that is preceded by a strong and sudden need to empty the bladder. With this type of incontinence, you may notice every time you hear running water or pull into your garage after work you feel the need to urinate and can’t make it to the toilet.
  • Overactive Bladder: with overactive bladder symptoms of urgency, urinating frequently, and not feeling like you empty your bladder all the way tend to coincide and one may or may not have leakage along with these symptoms.
  • Mixed Incontinence: this simple means a combination of any of the above listed types of incontinence; most often a combination of stress and urge incontinence.

No matter the factors contributing to your incontinence, you can find relief. It may be embarrassing to discuss with your doctor, but it is important to speak up. Your physician can rule out larger medical conditions, assess if any of your medications are contributing to the problem, and recommend a form of treatment. Ask your doctor about a referral for pelvic floor physical therapy. Return to your beloved social activities and experience less anxiety over incontinence. Have confidence and take back control!

Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic



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