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What to Know About Urinary Incontinence, From a Urologist

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If you’re leaking a little when sneezing or constantly feeling the sudden urge to use the bathroom, you might be experiencing urinary incontinence — and the silent stigma surrounding it. A lot of people tend to brush it off, saying, “It’s normal,” or “Just live with it.” But the reality is that seeking medical guidance for urinary incontinence can help improve your quality of life. 

 

What Is Urinary Incontinence?

Urinary incontinence is the loss of bladder control, and it’s common in adults. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong that you don't get to the bathroom in time.

It occurs more often as people get older but isn’t an inevitable consequence of aging; it’s more so a symptom caused by everyday habits, underlying medical conditions or physical problems.

Dr. Daniel Hoffman , an AdventHealth board-certified urologist with fellowship training in female pelvic medicine and reconstructive surgery, shares more on urinary incontinence.

 

Types of Urinary Incontinence

“There are two main types of urinary incontinence,” explains Dr. Hoffman, “Urge and stress. Urge continence could be caused by another underlying, treatable condition, and stress incontinence could be caused by physical problems or big changes, like pregnancy.”

 

Urge Urinary Incontinence

Certain drinks, foods and medications may increase water and salt expelled from the body — stimulating your bladder and increasing your volume of urine. “This would include alcohol, caffeine, carbonated drinks, artificial sweeteners, chocolate, foods high in spice as well as sugar or acid, and heart and blood pressure medications,” says Dr. Hoffman.

Temporary urge incontinence can also be caused by another underlying, easily treatable condition, such as constipation or a urinary tract infection. Enlarged prostate: this is especially common in older men, and known as benign prostatic hyperplasia

 

Stress Urinary Incontinence

Dr. Hoffman explains, “When a patient has had a more major physical change or issue, such as pregnancy or childbirth, they can have what’s known as persistent stress urinary incontinence.” Other factors that may cause this would be:

  • Age: as we get older, the bladder can have a decreased capacity to store urine
  • Hysterectomy: some damage may be done to the supporting pelvic floor muscles
  • Menopause: when women begin producing less estrogen, tissues can deteriorate
  • Prostate cancer: incontinence can be a side effect of treatments for prostate cancer

 

Diagnosing Urinary Incontinence

“When a patient is experiencing frequency and urgency, visiting a urologist is the first step in managing the discomfort. At the first visit, we take an extensive medical history of each patient,” Dr. Hoffman explains.

The urologist will ask about specific symptoms, such as when leaking occurs, when it’s most bothersome, how often the bladder is being emptied and if there are any modifiable behaviors that could be contributing to the symptoms.

From there, a few simple in-office tests are performed. “Depending on the patient’s history and symptoms, sometimes a urinalysis is done to rule out a bladder infection,” says. Dr. Hoffman.

 

Preventing Urinary Incontinence

Urinary incontinence is not always preventable, but to decrease your risk, you can:

  • Avoid bladder irritants, such as caffeine, alcohol and acidic foods
  • Maintain a healthy weight
  • Practice pelvic floor exercises
  • Prevent or treat constipation
  • Quit smoking

And while incontinence can occur in anyone, Dr. Hoffman outlines some of the more common risk factors associated with this issue:

Gender

Women are more likely to experience stress incontinence due to pregnancy, childbirth and menopause, while men with prostate gland problems are at increased risk of urge and overflow incontinence.

Age

As you grow older, your bladder and urethra muscles lose their strength, increasing the chance of involuntary urine release.

Weight

Extra weight puts pressure on your bladder and surrounding muscles, weakening the muscles and allowing urine to leak out when sneezing or coughing.

 

Health History

Smoking tobacco may increase your risk of urinary incontinence, as well as if you have a history of other diseases, such as neurological diseases or diabetes.

Family History

If a close family has urinary incontinence, your risk of developing the condition is higher.

 

Seeking Help From a Urologist

“If lifestyle changes and physical therapy haven’t relieved symptoms, medications can also help with urgency incontinence,” says Dr. Hoffman. 

Additionally, nerve modulation can help retrain the way the bladder and brain communicate, reducing overactive bladder and urgency incontinence. Nerve modulation can be done through an office procedure similar to acupuncture (called percutaneous nerve stimulation), or through an implantable pacemaker for the bladder (called sacral neuromodulation). 

If you’ve been experiencing symptoms of urinary incontinence, our team is here to help. Learn more about our urology care or make an appointment with Dr. Hoffman to discuss your options in managing urinary incontinence.

 

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