By Carol Jacobs, PT, DPT

Urinary incontinence is the involuntary leakage of urine in any amount–from just a couple drops to the full bladder. Although it can affect both women and men, women are twice as likely to experience urinary incontinence due to a number of factors, including pregnancy and childbirth, menopause, and the anatomy of the female urogenital tract. Approximately 25 to 45% of women will experience incontinence at some point in their lives, but regardless of whether a woman is prenatal, postpartum or in menopause, it should not be considered a normal part of pregnancy or aging. While less common in men, various prostate conditions and aging increase their risk as well. Factors that increase the risk of incontinence for both women and men are obesity, smoking, and various respiratory conditions that cause increased coughing or sneezing. Many people quietly just put up with incontinence because it is often thought that there is nothing that can be done about it, but in fact, urinary incontinence is quite treatable!

The three most common types of incontinence are stress incontinence, urge incontinence, and mixed incontinence.

You may be experiencing stress incontinence if you experience

• Bladder leakage when you cough, sneeze, or laugh
• Bladder leakage with physical activity-running, jumping, lifting, or even an increased rate of breathing and walking!

Stress incontinence occurs when physical activity causes the bladder to leak, and the pelvic floor muscles cannot withstand the demands of increased physical activity.

Another type of incontinence, urge incontinence, is a strong urge to urinate, seemingly ‘out of the blue.’ Having an overactive bladder can contribute to urge incontinence, and you may be experiencing urge incontinence or an overactive bladder if you

• Urinate frequently, more than 6-8 times a day
• Urinate a normal amount then ‘have to go’ shortly afterward, and then it’s just a few drops
• Wake up more than 2 times a night to urinate
• Feel like you will barely make it to the bathroom
• Feel a strong, sudden urge to urinate when you hear running water such as when doing dishes or turning on the shower

Mixed incontinence is a combination of stress and urge incontinence; there is involuntary leakage with physical activity accompanied by frequent urges to urinate. It is considered a more severe type of incontinence because it can make an individual feel as though he/she is going to the bathroom all the time.

Physical Therapy treatment of urinary incontinence involves determining the type of incontinence an individual is experiencing and evaluating the pelvic floor muscles to determine the appropriate strengthening or relaxation home exercise program. Treatment also may incorporate bladder habit retraining and further evaluation when appropriate to determine if there are other health conditions, such as pelvic organ prolapse or overactive bladder, or lifestyle choices that contribute to incontinence. As you progress in your treatment, you will learn to engage the pelvic floor muscles with increased physical activity such as lifting and squatting. Throughout the process of treating incontinence, you will learn about the pelvic floor muscles, their role in bladder and overall physical health, and healthy bladder habits.

If you find that you are avoiding physical activity, looking for the bathroom in every location, or avoiding experiences and outings for fear of not having a bathroom nearby, incontinence is starting to narrow the scope of your world. If you are experiencing incontinence, even if it is mild or occasional, it is important to address it with physical therapy treatment early on. Incontinence that starts out as a mild inconvenience can slowly get worse without notice until you find that you are drinking less water to decrease urination and becoming dehydrated in the process or that you are wearing pads and disposable incontinence briefs-a temporary and costly ‘solution’ that can lead to skin irritation and increase your risk of urinary tract infections. To begin treatment, discuss your bladder leakage with your physician, physician’s assistant or nurse practitioner to determine whether physical therapy referral is appropriate for you. If it is, call us here at Lucas Therapies to schedule an initial evaluation-we are here to help you! Physical therapy treatment of incontinence can eliminate incontinence in most people or significantly decrease it to manageable levels. In the process you learn healthy bladder habits and exercises that keep you dry after treatment ends!

Sources

Voices for PFD

Urinary Incontinence in Women Statistics