If a cough, laugh or sneeze makes you unexpectedly leak, you may be dealing with urinary incontinence, or leaky bladder. Two doctors help us break down urinary incontinence — what it is, the different types and how it’s treated.
What is urinary incontinence?
“Urinary incontinence happens when a person loses control of their bladder,” explains James Daucher, MD, a urogynecologist who specializes in treating pelvic floor disorders in women at Geisinger. “It can range from a slight leaking of urine when you cough or sneeze to urges so sudden, you can’t make it to the bathroom in time.”
While it’s a common issue that can affect anyone, it’s most common in women — but not just older women. “Urinary incontinence is common for those who have given birth and those with a family history of incontinence, so young women can be impacted, too,” says Vani Dandolu, MD, urogynecologist at Geisinger.
“Urinary incontinence is not a disease,” explains Dr. Dandolu. “It’s a symptom of other factors such as pregnancy, childbirth, urinary tract issues, age, weight or diet.”
The good news? You don’t have to just live with it. “A specialist, such as a urogynecologist or a urologist, can help you pinpoint the type of urinary incontinence you’re experiencing and help you lessen — or even put an end to — your symptoms,” says Dr. Daucher.
Types of urinary incontinence
There are 5 main types of urinary incontinence:
1. Temporary incontinence
“Temporary incontinence is caused by foods or drinks that act as diuretics and make you ‘go’ more,” explains Dr. Dandolu. “The bladder struggles to keep up, and you may unintentionally urinate. But this isn’t permanent and should stop once the offending foods or drinks have left your system.”
Carbonated beverages, alcohol, large doses of vitamin C, caffeine, artificial sweeteners and spicy, sugary or acidic foods can all cause temporary incontinence.
2. Stress incontinence
Stress incontinence occurs when the pelvic floor muscles (the muscles that help control urine flow) weaken from physical stressors.
“Stress incontinence is often caused by pregnancy, giving birth, muscle strain or having a hysterectomy,” explains Dr. Daucher. “All of these conditions can put stress on the bladder and the muscles that support it. After these muscles become weakened, movements like coughing, exercising and laughing can cause urine leakage.”
3. Urgency incontinence (overactive bladder)
Urgency incontinence, also known as overactive bladder, stems from an issue with bladder muscle contractions. If bladder contractions aren’t in sync, or if they spasm, urine can slip out. Urgency incontinence means you may just get just a few seconds’ notice, or none at all, before you start urinating.
Urgency incontinence can be caused by conditions such as multiple sclerosis (MS), Parkinson’s disease, urinary tract infections or an enlarged prostate in men. If you experience urgency incontinence, your doctor may prescribe medication that can help control bladder spasms.
4. Overflow incontinence
Overflow incontinence is often known as “dribbling” and happens when the bladder is unable to completely empty.
“Overflow incontinence is caused by obstructions or narrowing of the urinary tract. While it’s rare in women, overflow incontinence can be caused by pregnancy and birth, as well as an enlarged prostate gland in men,” says Dr. Dandolu.
5. Mixed incontinence
As its name suggests, mixed incontinence is a mixture of stress, urgency and overflow incontinence. Any combination of these types can be classified as mixed incontinence. Typically, most people with mixed incontinence have stress and urgency incontinence.
Treatment for urinary incontinence
Treatment for urinary incontinence will depend on the specific symptoms you’re experiencing. “This is why it’s so important to talk with your doctor or specialist,” adds Dr. Daucher. “He or she can create a personalized treatment plan to help you overcome the uncomfortable symptoms.”
Treatment options may include:
- Lifestyle changes, like quitting smoking or changing your diet
- Maintaining a healthy weight
- Bladder training
- Electronic nerve stimulation to help treat overactive bladder
- Supportive inserts, such as vaginal pessaries, which help prevent urine leakage in women
- Medications, like those to control an overactive bladder
- Pelvic floor exercises (such as Kegels) to strengthen the muscles that control urination
- Surgery to help better support your urethra or treat a pelvic organ prolapse
Overcoming urinary incontinence
If your urinary incontinence is persistent and affecting your daily life, you don’t have to face it alone. Talk with your doctor about seeing a urogynecologist or urologist who can help you find the best treatment to improve your symptoms.