In this blog you will learn about urinary incontinence, causes, symptoms, risk factors, tips to manage the symptoms, and prevention. Do not be embarrassed or afraid to talk about it, Physical Therapy can help you with this issue!

Urinary incontinence is the loss of bladder control and is very common in the elderly population. One out of two women and one out of four men have urinary incontinence according to the Urology Care Foundation. It can affect teenagers, younger adults, males, and females as well. More than 13 million people in the United States have urinary incontinence according to the National Institute of Diabetes and Digestive and Kidney Diseases. Many patients don’t look for help due to feeling embarrassed or for a lack of information.

Types of Urinary Incontinence

Stress Incontinence

Stress Urinary Incontinence is the leaking of urine during any activity that increases abdominal pressure-such as sneezing, coughing, heavy lifting, running, or jumping.

1 in 3 women suffer from stress urinary incontinence according to the Urology Care Foundation.
Stress urinary incontinence will increase with age.

41% of women older than 40 years will develop urinary incontinence and up to 77% of women over 65 already have urinary incontinence according to recent research.

Main Symptom leak with activity

Risk Factors

  • Weak pelvic floor muscles
  • Nerve injury from lower back or pelvic surgeries
  • Pregnancy and childbirth
  • Overweight and Obesity
  • Smoking
  • High impact activities over the years
  • Episiotomy (an incision made between the vaginal opening and the anus during childbirth).
  • Sedentary life
  • Surgery in the vagina or rectum

Urgency Incontinence

Urge incontinence is also called overactive bladder and is a sudden strong urge or need to urinate during the day and night. Urgency incontinence can affect children, young adults, adults, and seniors. It is more common in people over 40 years old and is caused by an abnormal contraction of the bladder.

People with urgency incontinence are often fearful of involuntary leakage or having pain and wake up more than two times at night to urinate.

According to the Urology Care Foundation 30 percent of men and 40 percent of women live with urgency incontinence in the United States.

Main symptom is a sudden urge to urinate

Risk Factors

  • Nerve damaged from the following conditions: Diabetes, Parkinson’s disease, Stroke, Multiple Sclerosis, or Injury.
  • Older age
  • Side effect from a medication
  • Abdominal surgeries such as C-sections, or pelvic surgeries
  • Obesity
  • Enlarged prostate
  • Bladder or prostate Cancer
  • Constipation
  • Urinary tract infections
  • Pelvic floor weakness or tightness
  • Learning behavior (always goes to the bathroom when arriving home. The brain associates the need to go to the bathroom on the way home and the urgency to go).
  • Caffeine and alcohol

How Do you know if you have Urgency Incontinence?

You go to the bathroom more than eight times in 24 hours
You go to the bathroom more than once at night

Mixed Incontinence

The combination of stress incontinence and urgency incontinence is called mixed incontinence.

Main symptom is a combination of leaking and a sudden urge to urinate

Risk Factors

  • Pregnancy
  • Childbirth
  • Pelvic or abdominal surgeries
  • Nerve damage to the lower back
  • Overweight
  • Obesity
  • Smoking

Overflow Urinary Incontinence

The bladder is unable to empty completely. Signs include constant dribbling of urine and the need to go to urinate multiple times during the day. Overflow urinary incontinence is often seen in neurological disorders such as spinal cord injuries, diabetes, and multiple sclerosis. It is more common in men with prostate surgery or prostate problems.

Risk Factors

  • Pelvic or abdominal surgeries
  • Bladder injury

Main Symptom is small urination and frequent dribbling

Functional Incontinence

Unintentional loss of urine for physical and mental conditions where the individual cannot reach the toilet on time.

Main Symptom is unable to move quickly enough to get to the bathroom

Risk Factors

  • Confusion or dementia
  • Difficulty moving due to join pain or stiffness
  • Depression, anxiety, or anger
  • The use of a walker with slow movement
  • Muscle weakness
  • Slow and painful movement

Prevention and Management

Track how much fluids you drink, how much you urinate, and keep track of how often with a diary for three days.

Bladder Diary 

Include in your diary the following questions:

Time Drinks What kind and how much? Trips to the Bathroom How many times and how much urine? Accidental leaks Did you feel a strong urge to urinate? How many times did you wake up at night to go to urinate? What were you doing at the time? (lifting, sneezing, etc.)
Examples:
Between 7 to 8am Coffee 16 oz 4 about 10 oz Yes, a little bit yes 3 lifting

Write down how much fluids you drink during the day, what kind of drinks, how many times you go to the bathroom, how much urine?, any accidental leaks? and how often you go to the bathroom for three days

Lifestyle changes

  • Avoid or reduce coffee, tea, soda, alcohol, artificial sweeteners, or chocolates
  • Maintain a healthy weight
  • Eat more fiber to prevent constipation
  • Stop smoking
  • Schedule Bathroom visits (add 15 minutes more to that time to build resistance to the urges)

Pelvic floor muscle strengthening

Pelvic floor muscle retraining while sitting
  • Tight the pelvic floor muscle when you feel the need to pee
  • Tight the pelvic floor when standing up from a sitting position
Delay Urination
  • As soon as you feel the need to urinate, hold it for five minutes and gradually increase it to 10 minutes until you can hold it for three to four hours.
  • Practice mindfulness breathing while you are holding.

Bladder retraining can take up to 6 to 12 weeks, so just be patient and keep working hard.

Physical therapy can help you to have less leak with the proper mental and physical training according to your needs.

Rule of Thumb: Fluid control: Last glass of water at 6pm

Recommended exercises: Kegel exercises/ Hypopressive exercises/physical therapy

If you are dealing with urinary incontinence or you want to prevent it, call now to find out how Physical Therapy can help you to have less leaks, restore pelvic floor, recover faster, move easier, and effortlessly: 805-203-9940

The information in this blog is for educational and informational purposes only, its content is provided based upon evidence-based medicine, knowledge, and experience as a Doctor of Physical Therapy (DPT).