What is Urinary Incontinence?
Urinary incontinence is the accidental leakage of urine. The severity of the leakage ranges from a few drops with a big sneeze, to soaking one’s pants on the way to the restroom.
This diagnosis is further classified in different categories and symptoms:
1. Stress Urinary Incontinence (SUI)
The accidental leakage of urine during exertion such a coughing, sneezing, laughing, jumping, or exercising.
2. Urge Urinary Incontinence (UUI)
Urgency to urinate followed by leaking of urine.
3. Mixed Urinary Incontinence
The presence of both SUI and UUI.
Other symptoms that may accompany urinary incontinence include:
- Urinating frequently (more than 6-8 times per day)
- Getting up out of bed to urinate more than 1 time per night
- Presence of liquid in underclothing
- Bladder pressure
- Bladder pain
- Low back pain
- Presence of pelvic organ prolapse
- Fecal incontinence
Causes of Urinary Incontinence Symptoms
These symptoms may affect people of all ages and genders. Women, or people with vaginas, often experience urinary incontinence during pregnancy and after delivery. Hormone changes, including declining levels of estrogen are often associated with urinary incontinence.
The natural aging process, loss of muscle mass, and loss of coordination of pelvic floor muscles often result in urinary incontinence as well. Additional causes can include secondary effects of abdominal or pelvic surgery, cancer treatment such as chemotherapy or radiation, obesity, chronic bearing down, chronic constipation, smoking, and illness.
Can Men Experience Urinary Incontinence Symptoms?
Men may experience urinary incontinence following prostate cancer treatments such as prostatectomy, chemotherapy, or radiation. Enlarged prostate, obesity, and smoking are all risk factors for UI as well. Men may also experience urinary incontinence associated with hormone changes, as well as declining muscle mass and pelvic floor muscle coordination.
Urinary incontinence an also be caused or exacerbated by consuming foods and drinks that irritate the bladder. This irritation can lead to urinary urgency and incontinence. Some foods and drinks that are known to irritate the bladder include:
- Spicy foods
- Carbonated beverages
- Artificial sweeteners
- Sugary food and drinks
Pelvic Floor and Incontinence: What To Know
While urinary incontinence can have many causes, the pelvic floor muscles (PFM) are often found to not be functioning in an optimal way in those with signs and symptoms of UI.
The pelvic floor muscles support the bladder and rectum in all people, and the vagina and uterus in women. This group of muscles consists of 2 layers of muscles (superficial and deep), connected by fascia above, between, and below them.
The pelvic floor muscles form a sling from the pubic bone, laterally to the bones of the pelvic girdle that you sit upon, and posteriorly to the tail bone. These muscles must be both strong and flexible to support the pelvic organs and provide closure around the urethra and anus.
Co-ordination of the muscles is required for them to relax to allow for passage of urine and feces out of the body, yet they must be able to contract forcefully during exertion such as a big sneeze.
Many times, the pelvic floor muscles are found to be underactive or weak in those who are experiencing urinary incontinence. The good news is that they can be strengthened and retrained with the help of a pelvic floor physical therapist.
What Should You Do If You Experience Incontinence Symptoms?
If you experience any of these symptoms it is important to see your physician. Additional testing may be required, and a referral to a urologist, urogynecologist, and pelvic health physical therapist may be indicated. The good news is that most forms of urinary incontinence are curable using a combination of pelvic floor stretches with our without weights as well as other forms of therapy, and you do not have to live with the symptoms.
Pelvic physical therapy is a front-line treatment to address weakness or poor coordination of the pelvic floor muscles that may be contributing to urinary incontinence. This noninvasive treatment is helpful for people of all ages and genders.