Urinary incontinence is the involuntary leakage of urine. There are four types of urinary incontinence including stress incontinence, urge incontinence, overflow incontinence, and functional incontinence. Depending on which study you read, prevalence ranges greatly depending on type of incontinence and age of the individual. However this affects many, many women throughout the lifespan. Urinary leakage keeps so many women from doing activities they love and can have such a negative impact on confidence. Not to mention the cost of hygiene products (pads) associated with incontinence. 

It’s important to differentiate types of incontinence as they were all treated differently. From a pelvic floor perspective, stress incontinence typically has more to do with coordination of the pelvic floor, while urge incontinence usually stems from overactive pelvic floor muscles. You can imagine how different the treatment would be for both of these. 

Now for a little more on types of incontinence: 

Stress incontinence usually occurs with things like laughing, coughing, jumping or sneezing. Generally things that put more pressure on the pelvic floor or force generated in the abdomen. This doesn’t necessarily mean the pelvic floor muscles are weak, as I have found that in general, it is usually more of a coordination issue. Your diaphragm, deep core muscles, and pelvic floor should all fire together, and if they are not, this can lead to urinary stress incontinence. Things like overconsumption of bladder irritants (fluids that irritate the lining of the bladder), and dehydration can exacerbate this. 

Urge incontinence is when people experience urinary leakage walking to the bathroom, pulling in the driveway of their home, walking through the door into their home, or hear running water. With patients, I often find that the pelvic floor muscles are more tense, affecting the pudendal nerve— a nerve that  courses through the pelvic floor muscles. Similar to stress incontinence, and dehydration and bladder irritants can exacerbate this too. 

Overflow incontinence occurs when the bladder simply becomes too full and urine overflows from within the bladder. Individuals with overflow incontinence can feel the need to urinate, but can often only release a small amount of urine. This can be from neurological causes or an enlarged prostate. 

Lastly, functional incontinence occurs when an individual is unable to make it to the toilet to urinate due to functional reasons, like an inability to walk to the bathroom or unable to remove their clothing to urinate. Helping people improve their functional independence can help treat functional incontinence. 

Treatment options for urinary incontinence include pelvic floor physical therapy, medication, pessaries (you can read about pessaries here), surgery, or a combo of these treatments. 

As you can imagine, an accurate diagnosis is essential for treating incontinence. 

As far as pelvic floor physical therapy for treatment of stress incontinence goes, it usually includes a very thorough examination, lifestyle modification, exercise, constipation management, stress management techniques, and referrals to other providers if needed. The pelvis is a very complex area of the body, and we recommend a lot more than just doing kegels for incontinence.

This is not something that is only experienced by postmenopausal women. Children & adolescents experience urinary incontinence, as well as pregnant and postpartum women. The bad news is that it doesn’t usually go away on its own, and the good news is that there’s treatment. 

If you’re looking for a conservative treatment approach to urinary incontinence, we would love to help you get back to living your best life with confidence at Texas Pelvic Health. To schedule an initial evaluation, call 903-962-2600 or email hello@txpelvichealth.com. You can find more information at www.txpelvichealth.com or on instagram @thepowerfulpelvis.