The Top Questions about Incontinence

Incontinence is involuntary leakage of urine, often when you laugh, sneeze, or cough.

Incontinence is a common experience for women, and many women may consider it as something they must learn to live with. Although it is often talked about as a normal part of aging or postpartum life, if it starts to interfere with daily activities, effective treatments and management options are available.

Michelle Chin, MD, is a urogynecologist and minimally invasive surgical provider with Rochester Regional Health who works with women who deal with incontinence. She shares some of the common questions she hears and discusses ways women can manage, improve, or find support for incontinence.

What causes incontinence?

There are two types of incontinence: stress incontinence and urge incontinence.

Stress incontinence stems from pressure within the abdominal cavity such as laughing, coughing, sneezing, or lifting. That pressure can cause leakage due to the loss of support of the bladder neck and urethra from either weakened vaginal connective tissue or pelvic floor muscles. This typically happens with women who have had pelvic floor injury during pregnancy and childbirth.

Urge incontinence occurs when the bladder muscles contract involuntarily, often before the bladder is completely full. This can lead to an unexpected and strong need to urinate frequently, which can feel uncontrollable. This can also be related to weak or contracted pelvic floor muscles, but also what you eat or drink.

“A lot of patients come in with a mix of both types of incontinence,” Dr. Chin said. “We try to parse out which is the most bothersome and then focus on helping with that.”

How can I stop my incontinence?

Incontinence can be managed in a variety of ways, depending on a person’s symptoms, goals and preferences, from lifestyle changes such as exercise to surgical options.

One of the simplest changes is considering what you eat or drink. Drinking more water and less caffeine can reduce your need to urinate as frequently.

Retraining your bladder by using methods like timed voiding can help to reduce the frequency and urgency of urinating, as well.

Pelvic physical therapy can lengthen and strengthen your pelvic floor, helping to support not only your bladder, but also your uterus and rectum.

Using a device like a pessary can help support the pelvic floor and any organs that may be prolapsing.

Your provider may prescribe medications such as anticholinergics or beta-3 agonists, which help to reduce involuntary muscle activity.

In some cases, OBGYN providers may offer neuromodulation such as posterior tibial nerve stimulation. This treatment consists of 12 sessions, during which the tibial nerve is stimulated using a tiny needle to block abnormal nerve signals being sent to the bladder and reduce involuntary muscle movements.

If a patient does have a prolapse that needs to be repaired, our urogynecology physicians are highly trained and experienced in minimally invasive surgical techniques to ensure you are in the hospital for recovery as little as possible.

“We tailor each surgery to the unique needs of each patient,” Dr. Chin said. “We take into account their current activity level, which organ is prolapsing and how severe the prolapse is, surgical history, and other factors to ensure their procedure and recovery are as smooth as possible.”

Can incontinence be a sign of something more serious?

There are some patients who experience incontinence as a sign of other health conditions. In less common circumstances, patients who have frequently have an urgent need to urinate may have diabetes.

Occasionally women may have an organ partially prolapse out of their vagina, but this can be fixed with minimally invasive surgery. While concerning and uncomfortable, Dr. Chin wants to reassure patients that this is not a life-threatening concern.

“Women might be afraid that incontinence is linked to serious conditions like bladder cancer, but that is not the case,” Dr. Chin said.

What can I do to prevent incontinence in the future?

Pelvic physical therapy helps to maintain a healthy pelvic floor. With a physical therapist personalizing the right stretches and exercises for you, you should be able to prevent future incontinence issues.

OBGYN providers suggest resources through Voices for PFD by the American Urogynecologic Society and YourPelvicFloor.org for other commonly asked questions about incontinence.