Incontinence Q & A
What is incontinence?
Incontinence is the medical term anytime there is a leakage of bodily fluids. The most common is urinary incontinence or bladder leakage.
Are there different types of urinary incontinence?
Yes. There are three:
- Stress incontinence
- Urge incontinence
- Mixed incontinence
What is the difference?
Stress incontinence is marked by the leakage of urine after coughing, sneezing, laughing, jumping or pressure on the pelvis. It is due to structural problems of the uterus pelvic floor bladder and urethra.
Urge incontinence is usually a neurological problem and shows a severe urge to urinate with no time to find a bathroom. This is where the person feels they have to go and if they don’t find a toilet within a few moments they will leak, sometimes quite a lot.
Mixed incontinence is a combination of the two and is the most common type of incontinence.
Are there risk factors?
Yes. The risk factors lead to different types of incontinence. For stress incontinence, a genetically weak pelvic floor is a risk factor. Certain women inherit poor quality collagen, which makes the tissues thin. Another is pregnancy and vaginal delivery. In fact it is common to have stress leakage after birth and during breastfeeding. Age is a very large component as well. As estrogen levels go down in postmenopausal women these tissues thin out and become weak as they need estrogen to maintain strengths.
Urge incontinence is often the side product of other diseases such as diabetes due to the impact on the nerves that control the bladder. As urge incontinence is mainly a nerve problem, anything that affects nerves will affect voiding and this also includes aging.
Mixed is a combination of the two so some structural and some neurological problems are present.
Is there any testing?
It is extremely important that a person that has leakage is tested properly. It begins with making sure there are no old infections, then urodynamics is performed. This is a test where sterile water is placed in the bladder while the patient has electrical measuring devices placed. While the patient voids, it is possible to read the electrical impulses and determine how much of which type of incontinence is present. Sometimes a bladder ultrasound is done as well to look at all of the structures.
Are there treatments?
There are very successful treatments ranging from physical therapy to drug therapy to surgery. Each treatment is carefully designed for a patients unique problem after undergoing all the testing. Several options are then presented, and the patient and providers work as a team.