Stress Urinary Incontinence
Today, I want to talk about a specific type of bladder leakage called Stress Urinary Incontinence. One in 3 women will experience bladder leakage at some point in their lifetime and although it is common, it is not normal. Let me reiterate that…
Bladder leakage is not normal. Not when you exercise. Not when you sneeze. Not after you have had a baby. Not when you laugh. Not when you are post-menopausal. Not when you lift. Bladder leakage is never normal. It is a sign of dysfunction in our core support system.
Stress incontinence happens when physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. Stress urinary incontinence is often a result of weakness or poor recruitment patterns of the pelvic floor muscles.
With stress incontinence you may experience urine leakage when you:
- Stand up
- Get out of a car
- Lift something heavy
- Have sex
Amount of leakage can vary from a few drops to a complete emptying of bladder. Some people experience the bladder leakage with many different activities and for others it is limited to a single activity type.
Treatment for Stress Urinary Incontinence
Stress urinary incontinence is probably one of the most common things that I see here at my practice. The good news is that it respond really well to conservative treatment and simple changes that you can make in your daily routine.
Contrary to what the Poise commercials want us to believe, the treatment for stress incontinence is not buying the latest, greatest absorbent pad or diaper. Instead, most people report a significant improvement in their leakage with training for their pelvic floor muscles. Many times stress incontinence is a result of weak pelvic floor muscles.
Not sure if your pelvic floor muscles are weak? See if you can stop the flow of urine mid stream. When you contract your pelvic floor muscles (AKA Kegel exercise) you should be able to get the stream to stop completely. If you can’t, then this is a sign that your pelvic floor muscles may be weak.
Word of caution… do not repetitively start and stop your flow of urine as a exercise. This can mess up the normal mechanisms for completely emptying your bladder.
One of the tips I tell people to do if they are having leakage with a cough or sneeze is what we called “The Knack.” It is a little precontraction of the pelvic floor to brace for the load of that is going come from the pressure of the cough or sneeze. If you have warning that a cough or a sneeze is going to happen then stop where you are and contract your pelvic floor to brace for the load.
If you are experiencing stress incontinence, know that you are not alone and there are things that you can do to make a difference. Partnering with a pelvic physical therapist can be a great option. They can help you identify your pelvic floor muscles and come up with a rehabilitation program specific to your individual needs and goals.
So you leak urine sometimes. That much has been established fairly easily. What you don’t know is what type of urinary incontinence you have. Determining what type of incontinence you have can put you on the right road to recovery. Below are the symptoms of the 3 most common types of urinary leakage: urge urinary incontinence, stress urinary incontinence, and mixed urinary incontinence.
URGE URINARY INCONTINENCE (Otherwise known as “The gotta go’s, oops I went”)
- Frequent strong, sudden urge to urinate
- Regularly going to the bathroom 8 or more times in a 24 hour period
- Getting up 2 or more times during the night to go to the bathroom
- Leaking all of a sudden for no good reason
- Knowing where all the good bathrooms in town are and how long it takes to get there, because you never know when you will have to go “just in case”
- Limiting the amount of fluid you drink so there is less urine to leak
- Once you pull in the driveway or put the key in the lock it is a mad dash to get to the bathroom
Even if you do not leak in these situations, but you still experience them, you may have overactive bladder.
STRESS URINARY INCONTINENCE (Otherwise known as “pee pee when you hee hee”)
- Losing urine with physical activities such as lifting or exercising
- Losing urine when you cough, laugh, or sneeze
- Losing urine when you stand up or sit down
- Experiencing most or all of the symptoms of overactive bladder and stress urinary incontinence