Urinary Incontinence: Types, Causes and Treatment

Urinary incontinence is defined as the involuntary loss of bladder control and it can affect women and men. It is a common pelvic floor dysfunction and can be associated with pelvic floor weakness.

There are different types and causes of urinary incontinence and in this article we describe them.

Types of Urinary Incontinence

There are several types of urinary incontinence:

  • Stress urinary incontinence is when there is increased pressure on the bladder, such as coughing, sneezing, laughing, jumping, or running.
  • Urge urinary incontinence is when you have the sudden urge to urinate that is followed by the involuntary loss of urine.
  • Mixed incontinence is when a person experiences both stress and urge incontinence.

Causes of Urinary Incontinence

There are several causes or reasons that a woman may experience urinary incontinence.

  • Urge incontinence is associated with overactive bladder, where the bladder muscles contract with enough force to override the urethral sphincter (which normally contracts to prevent urine from leaking out). Sometimes, the exact cause of the overactive bladder is not known; however, there are some known risk factors. These include women who have had a C-section or other pelvic surgery, obesity, nerve damage from other conditions like diabetes or stroke, women suffering with a urinary tract infection, and sometimes constipation.
  • For stress incontinence, it is usually related to weak muscles in the pelvic floor or from weak sphincter muscles around the bladder neck, dysfunction in how the sphincter opens and closes. Causes associated with stress incontinence include chronic coughing, obesity, repetitive heavy lifting through exercise or work, and physical changes to the body such as pregnancy and childbirth, menstruation or menopause, and pelvic surgery.

How to Treat Urinary Incontinence

For both types of urinary incontinence, there are multiple treatment options for women. These include medications, behavioral modifications, surgery, and exercise, specifically, Kegel exercises. Kegel exercises, or pelvic floor muscle exercises, are contractions of the muscles that help support the bladder, uterus, and bowels. The pelvic floor muscle groups sit like a sling inside the pelvis going from the pubic bone in front to the tailbone in back. When these muscles are contracted they will tighten around the urethra to reduce or prevent the urine from leaking. To perform the Kegel contraction, think about trying to stop the flow of urine or to not pass gas. It should be performed without contracting, or tightening the muscles in your legs, buttocks, or abdomen. This is an exercise in which no one else should be able to tell that you are contracting the muscles.

Doing Kegel exercises every day can be boring. The Joy On Kehel device makes kegeling fun. Use of the Kehel app and seeing a graph on a personal cell phone screen provides excellent feedback and encourages adherence to an exercise program. The graph records how strongly the muscles contract and how fully they relax. The games included in the app add to the entertainment and using the My Calendar to track progress improves motivation.

Pelvic health physical therapists know that there are no magic pills when it comes to strengthening the pelvic floor muscles to prevent bladder leakage. Exercising those weak muscles is the only way to strengthen them and it can be difficult to motivate patients to perform their exercises every day.

Thanks to the Joy On Kehel that job is now easier than ever.

Authors

Lola Rosenbaum

Doctor of Physical Therapy

Elizabeth Bell

Clinical Specialist in Women’s Health

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