Urge Incontinence

So! We are going to round out our series with the third and final type of main urinary incontinence.

Urge incontinence occurs when you have a sudden desire to go to the bathroom due a very quick and powerful bladder contraction. This is sometimes followed by the involuntary loss of urine before you can make it to a toilet. Urge incontinence (UI)  is characterized by the need to go often throughout the day – especially at night (nocturia) – with small amounts of urine actually released. “Frequent” means more than 8x during the day and >2 at night. Enuresis (bed wetting) may also occur.

Urge incontinence is caused by an unstable or overactive bladder whose muscles contract more often than they should. Other names for UI include overactive bladder (OAB), spasmodic bladder, detrusor instability, and irritable bladder. The main difference between urge incontinence and stress and overflow incontinence is the urgent need to use the bathroom quickly and frequently. Both urge and overflow incontinence involve leakage. Stress incontinence occurs during times of high impact physical activity or with increased abdominal pressure. 

Up to 17 - 40% of women and 30% of men may be affected by urge incontinence at some point in their lives. If you are over the age of 65, the likelihood of having UI increases significantly. Although it is normal to note that UI is NOT a normal sign of aging. Other risk factors for developing UI include: 

• Hysterectomy or major pelvic surgery

• Menopause

• Certain medications like diuretics, antidepressants or blood pressure medications

• Certain endocrine disorders (diabetes mellitus) or neurological disorders (MS, stroke)

• Smoking

• Obesity

• Recent pregnancy and childbirth 

• Prostate problems 

Just like with other types of incontinence, UI may be diagnosed by your healthcare provider. It may be a diagnosis of exclusion – since UI is often a symptom of something else. Possible causes include: 

• Recurrent UTIs

• Obstruction of the bladder opening 

• Bladder stones

• Tight pelvic floor muscles

Your healthcare provider may use a urinalysis to rule out infections. They will take a thorough history and possibly perform a pelvic exam. An abdominal ultrasound may be performed. In certain cases, you may receive a cystoscopy to examine your urinary tract or urodynamic testing to show how your system holds and releases urine. 

So how is UI treated? Well, just like other types of continence, you can take steps today to start your journey of relief. The first line of defense includes lifestyle modifications, such as:

• Dietary changes that eliminate bladder irritants (we have a good post on that *here*), including chocolate, caffeine, carbonated beverages, spicy foods, and citrusy foods

• Managing constipation by eating a high fiber diet (so that your body doesn’t have to worry about both types of voiding!)

• Drinking a LOT of water to flush out any irritants you may have (yes this seems counterintuitive)

• Adequate physical activity to help with stress management

• Smoking cessation

• Bladder training (setting times at certain times of the day to void and gradually increasing the times between trip to the bathroom)

• Double voiding at night to help with nocturia (going to the bathroom, doing something else for a few minutes and then going again before you go to bed)

• Physical therapy!!

Other pathways of treatment may include pain medication, nerve therapy and surgery. As with any other type of pelvic floor dysfunction, a multi-modal approach with lots of *tools in the toolbox* is going to work best. Along with time and patience!

But the most important thing to know is that UI (or any type of incontinence) is NOT normal — no matter your age. However you go about it, your pelvic floor PT is here to help!

<3 The Recharged Performance Team

(321) 802-1630

Paige@RechargedPerformanceTherapy.com

Http://www.RechargedPerformanceTherapy.com

References

https://www.healthline.com/health/urge-incontinence

https://my.clevelandclinic.org/health/diseases/22161-urge-incontinence

https://patient.info/womens-health/lower-urinary-tract-symptoms-in-women-luts/urge-incontinence

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/what-is-urge-incontinence