What is urinary incontinence?
Urinary incontinence is a symptom, not a disease. Everyday habits, underlying medical conditions, or physical problems can cause it. Working with a healthcare provider is important in determining the cause of your incontinence and devising a treatment plan to restore your quality of life.
Urinary incontinence refers to an inability to manage or control urine leakage. Incontinence can be small and sporadic or heavy and frequent. Regardless of frequency and volume, female incontinence is a common and, most often, an embarrassing problem.
Urine leakage in women can be mild, occurring during a cough or a sneeze. Or, it may be severe, causing a sudden and strong urge to urinate that prevents you from getting to the toilet in time.
Though leakage of urine occurs more often as you get older, urinary incontinence isn’t just a consequence of aging. If urinary incontinence affects your daily activities and quality of life, don’t hesitate to contact Dr. Aliabadi. Simple lifestyle changes or medical treatment can help manage symptoms or even stop urinary incontinence.
Types of urinary incontinence
Continence issues can range from mild to severe, from a small leak here and there to loss of bladder control. Urinary incontinence generally falls into one of the following categories:
- Overflow incontinence
A slow, minor urine leakage after urinating. It can occur when the urethra is blocked or when the bladder muscles fail to void (empty) the bladder entirely.
- Urge incontinence
Also known as an overactive or spastic bladder, urge incontinence is a type of incontinence that results from an immediate, strong urge to urinate.
This happens when a muscle spasm contracting the bladder overpowers the sphincter muscles that regulate the flow of urine through the urethra.
- Stress urinary incontinence
This is one of the most common types of urinary incontinence in women. When discussing stress and bladder control, we’re referring to physical stress.
During urinary incontinence, weak pelvic muscles let small amounts of urine escape when pressure is applied, such as by coughing, sneezing, laughing, exercising, or lifting something heavy.
- Functional incontinence
A physical or mental impairment keeps you from making it to the toilet in time. For example, with severe arthritis, you may be unable to unbutton your pants quickly enough.
- Mixed incontinence
You experience more than one type of urinary incontinence.
Symptoms of urinary incontinence
Women with urinary incontinence can experience symptoms beyond the loss of urine. It’s important to note which symptoms are affecting you so that you can relay the information to Dr. Aliabadi. Some symptoms include:
- Frequency – Urinating more often than normal
- Urgency – The urge to urinate, even if the bladder is empty
- Feelings of pressure or discomfort in the lower abdomen
- Dysuria – Pain or burning while urinating
- Nocturia – The need to get out of bed to urinate several times a night
- Dysfunctional voiding (Enuresis) – Urinating the bed while asleep
Causes of urinary incontinence
Many different medical conditions may cause urinary incontinence. Some conditions are easy to treat, while others may require intensive intervention or have long-lasting effects.
Urinary incontinence in women is often associated with pregnancy due to hormonal changes and the increased weight of the baby. Some other underlying physical medical conditions include:
- Childbirth and pelvic support issues
Anything that can weaken the muscles needed for bladder control and those of the pelvic floor can impact continence. For example, vaginal delivery, hysterectomy, and uterine prolapse can weaken muscles and damage nerves and supportive tissues of the pelvic floor resulting in incontinence.
- Aging and menopause
Aging reduces bladder muscle capacity and increases involuntary contractions. In women, menopause decreases estrogen, which can deteriorate the bladder and urethra lining, further aggravating incontinence.
- Prostate conditions
In older men, urinary incontinence is often linked to an enlarged prostate (benign prostatic hyperplasia) or untreated prostate cancer, which can cause stress or urge incontinence.
- Obstructions and abnormal growths
Tumors or growths (like polyps or bladder stones) in the urinary tract can obstruct urine flow and lead to overflow incontinence. Abnormalities, such as a urinary fistula or bladder prolapse, can also result in leakage.
- Neurological and neuromuscular disorders
Conditions like multiple sclerosis, Parkinson’s disease, or spinal injuries can disrupt nerve signals involved in the urethral muscles and bladder control, contributing to urinary incontinence.
Not all incontinence is long-term. Some causes are temporary, and incontinence ends when the cause is addressed. For example, vaginal infections, irritation, medications like diuretics, constipation, restricted mobility, and urinary tract infections (UTIs) can all cause urine to leak out when you don’t want it to.
Diagnosing urinary incontinence
Because urinary incontinence could be the result of a variety of very different medical conditions, diagnosing the cause can be tricky. If you’re having difficulty controlling your bladder during the day or night, make an appointment with Dr. Aliabadi.
Keeping a bladder diary of your symptoms, noting the time of day and amount of urine you leaked or voided, can be helpful. If you experienced a leak, write down what you were doing at that time. You’ll also want to take note of your liquid intake and any medications you’re using.
After hearing about your symptoms and discussing your medical history, Dr. Aliabadi may conduct a pelvic physical exam to check for physical abnormalities or any other possible causes of your incontinence. In some cases, testing may be recommended. Including:
- Stress test
Your doctor will have you cough with a full bladder to observe any leakage.
- Postvoid residual volume test
After urinating, an ultrasound or a catheter can measure the amount of liquid left in the bladder.
- Dye test
A special dye is injected into your bladder, and you are asked to wear a sanitary pad. The amount of dye leaked onto the pad can help diagnose the severity of your incontinence.
- Cystoscopy
A narrow, flexible tube is inserted into your urethra. The lens at the end provides a better look at your urinary tract and bladder.
- Urodynamic testing
Catheters are inserted into the bladder and sometimes the rectum to measure bladder pressure and capacity while it is filled, followed by assessing urine flow during voiding.
Urinary incontinence treatment options
Depending on the cause of your condition, you may have several options to treat your urinary incontinence.
Some cases of urinary incontinence can clear up with a few lifestyle changes. These include:
- Drinking less fluid, especially caffeinated drinks
- Quitting smoking
- Losing excessive weight (for overweight women)
- Avoiding constipation through diet changes and supplements
- Treating stressors such as chronic coughing
You can also talk to your OB-GYN about therapeutic and medical interventions, such as:
Physical therapy
Physical therapy for urinary incontinence can include several different strategies. For example, you may be asked to change your fluid intake and practice pelvic floor exercises, such as Kegel exercises, to strengthen your pelvic floor muscles.
Your physical therapist will also show you bladder training techniques to reduce the frequency of the urge to urinate to normal levels (about every 4 hours during the day and between 4-8 hours at night). Your therapist may employ a technique called biofeedback to teach you how to monitor your body’s natural signals.
Medication
If overactive bladder muscles cause urinary incontinence, some medications can help keep the muscular contractions under control. Botox injections are sometimes used for bladder control problems.
Bulking agents
Bulking agents are substances injected into the tissues surrounding the urethra. They can add support and bulk to the tissue and shrink the urethral opening, which helps stop the flow of urine.
Pessary devices
A pessary is a small, doughnut-shaped device that is inserted into your vagina to help provide support for prolapsed pelvic tissue and organs. Some devices can put pressure on the urethra, aiding in the prevention of leaks. A pessary is a good choice for women who may not be good candidates for surgery.
Non-invasive treatments
Laser treatments, like MonaLisa Touch, can help strengthen your vaginal walls and pelvic floor muscles to reduce urine leaks.
Surgery
Several procedures can improve urinary incontinence. Dr. Aliabadi can discuss the options that are right for you based on the cause of your condition, your age, and your overall health.
Consider Dr. Aliabadi for your health concerns
Dr. Aliabadi isn’t only an expert OB/GYN but is knowledgeable in all aspects of women’s health and well-being, including urinary health and bladder control concerns. Dr. Aliabadi and her caring, supportive staff are available to support you through menopause, childbirth, infertility, or even just routine gynecological care.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Urinary Incontinence FAQs
What are the risk factors for urinary incontinence?
Certain factors can increase your risk of developing urinary incontinence, such as age and gender, as older women who have undergone menopause are more likely to experience urine leakage. Smoking, obesity, and some medications can also play a role.
What are incontinence medications?
Urinary incontinence drugs work to calm an overactive bladder and can include Oxybutynin, Fesoterodine, Mirabegron, Alpha-blockers, or topical estrogen. Medications are often a second-line treatment used only if other therapies are not working.
How do you stop urine leaking during physical activity?
Leaking urine during physical activity is not uncommon for women, especially postpartum women. Strengthening your pelvic floor, emptying your bladder before exercise, and consulting with your doctor can help reduce leakage. Wearing incontinence products during exercise can also help minimize issues from leaks.
Sources:
Urinary Incontinence. https://medlineplus.gov/urinaryincontinence.html
Definition & Facts for Bladder Control Problems (Urinary Incontinence). https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/definition-facts
Urinary Incontinence. https://www.womenshealth.gov/a-z-topics/urinary-incontinence
Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.