Incontinence

An estimated 25-33% of Americans suffer from urinary incontinence, however, incontinence affects twice as many women as men. This is because reproductive health events unique to women, like pregnancy, childbirth, and menopause, affect the bladder, urethra, and other muscles that support these organs.

Urinary incontinence can happen to women at any age, but it is more common in older women likely due to the hormonal changes that occur during menopause. In fact, more than 4 in 10 women 65 and older have urinary incontinence. Although it is more common as you age, urinary incontinence is not a normal part of aging, and it can be treated.

What is Urinary Incontinence?

Urinary incontinence is the loss of bladder control, or leaking urine. To understand the condition, it’s important to first understand the urinary system and how it works. 

Urine is made by the kidneys and stored in the bladder. The bladder has muscles that tighten when you need to urinate. When the bladder muscles tighten, urine is forced out of your bladder through a tube called the urethra. At the same time, sphincter muscles around the urethra relax to let the urine out of your body.

When the bladder muscles suddenly tighten and the sphincter muscles are not strong enough to pinch the urethra shut, incontinence can occur. This causes a sudden, strong urge to urinate that you may not be able to control. 

The condition can range in severity. For some, pressure caused by laughing, coughing, sneezing, or exercising can cause them to leak urine. Urinary incontinence may also happen if there is a problem with the nerves that control the bladder muscles and urethra. Urinary incontinence can mean you leak a small amount of urine or release a lot of urine all at once.

Types of Urinary Incontinence

There are four types of urinary incontinence, however, the two the most commonly affect women are: 

  • Stress Urinary Incontinence (SUI): This is the most common type of incontinence. It is also the most common type of incontinence that affects younger women. The trademark symptom of SUI is leaking when you are active. Everyday actions that use the pelvic floor muscles, such as coughing, sneezing, or laughing, can cause you to leak urine. It is often attributed to weak pelvic floor muscles which put pressure on the bladder and urethra by making them work harder. 
  • Urge Incontinence (UI): A group of urinary symptoms of which the most common is the sudden, uncontrolled need or urge to urinate. Urine leakage usually happens after a strong, sudden urge to urinate and before you can get to a bathroom. Some women with urge incontinence are able to get to a bathroom in time but feel the urge to urinate more than eight times a day. They also do not urinate much once they get to the bathroom. This may sometimes also be called “overactive bladder.”

Many women with urinary incontinence have both stress and urge incontinence. This is called “mixed” incontinence.

Causes and Risk Factors

Chronic incontinence that worsens over time is caused by muscle weakness in the urinary tract, damage, a malfunction in the urinary tract, or a malfunction in the nerves that control urination. 

Acute incontinence, however, is temporary. This type may be caused by a urinary tract infection, medication side effects, constipation, bladder stones, or vaginal childbirth. 

There are risk factors that may increase one’s risk of developing urinary incontinence such as gender, age, pregnancy, weight, smoking, and other diseases like kidney disease, diabetes, neurological diseases, and spinal injuries can all affect nerves controlling urination resulting in urinary incontinence.

Diagnosis and Treatment

More than half of those experiencing urinary incontinence fail to seek treatment despite that the condition often affects one’s daily activities. 

If you are experiencing an involuntary loss of urine, consult with a healthcare provider. Your gynecologist may first recommend nonsurgical treatment such as lifestyle changes, bladder training, physical therapy, and using certain bladder support devices. For urgency urinary incontinence, the treatment may involve medication. Surgery may help certain types of incontinence. Often, several treatments are used together for the best effect.

Request an Appointment

The physicians, nurses, and medical staff at Raleigh OB/GYN offer a comprehensive list of gynecological and obstetric services to the women of the Raleigh, NC area. If you have questions about incontinence, call our office at (919) 876-8225 to make an appointment.