What Is Urinary Incontinence? (video)

Varuna Raizada, MD, a urogynecologist at Scripps Clinic, discusses urinary incontinence, which is a bladder control condition that ranges in severity. Dr. Raizada explains the causes and treatments for this common bladder condition.

Urinary incontinence is a condition that implies more than just leaking urine. It could spring up as something as simple as:

• “I have this constant pressure, this desire to urinate that I just can’t overcome.”
• “I’m using the restroom every hour on the hour.”
• “I’m leaking urine on the way to the restroom.”
• “I can’t even make it to the restroom. I’m having bladder leakage with just lifting or screaming at my kids.”

Words that we often might come across to define this condition would be things like “overactive bladder,” “urgent continence” — implying I have a very strong urge to go, but I can’t make it to the restroom. “Stress incontinence” does not mean mental stress, but more implies physical stress, forces on the body like coughing, sneezing, jumping, laughing, lifting heavy objects that lead to leakage. These are very different ways of describing urinary leakage. Urinary leakage can occur due to different causes.

Urinary leakage can occur starting in your youth. Even young girls sometimes experience it. And it spreads on to the elderly as well. But the most common time for this to show up tends to be in our 30s and 40s. For some women, it is related to childbearing. But there are a lot of women for whom it may have nothing to do with childbearing as well.

The best way to describe causes of urinary leakage would be to think of a bladder as a bag and the opening of a bag. There is a muscle that sits right at the opening of the bag. It’s a little ring of muscle, and that muscle becomes weak or is not adequately closing tightly shut. That leakage will show up as leakage of urine with coughing, sneezing, jumping, laughing and any kind of high impact.

Sudden leakages happen because the nervous system of the bag of the bladder is just not working adequately, or the muscles are rigid and just don’t permit urine to accumulate. That is called overactive bladder, and may show up as constant desire to urinate — called urgency, frequency, using the restroom every hour on the hour, or urge in continence — which means not even making it to the restroom, having leakage even before you actually sit on the commode.

If you are diagnosed with urinary incontinence start off with simple interventions. Pelvic floor physical therapy is a very important treatment strategy. It helps both women who have overactive bladder — which is the urgency, frequency, can’t make it to the restroom in time — as well as stress leakage — which is the coughing, sneezing, jumping, laughing. The idea is not only to strengthen the pelvic floor muscle, but also to help you control those urges. The principle that we use is called biofeedback. A very simple way to describe that would be you’re talking to your bladder, basically reteaching it not to send false messages.

Watch the video on treatments for bladder Incontinence and other pelvic ploor disorders with Dr. Raizada.