Urinary incontinence affects 13 million women in the United States and up to 50% of nursing home residents. Incontinence prevalence increases gradually during young adult life and peaks at middle age. Unfortunately, most women who suffer from incontinence do not seek medical advice. There are different types and causes of urinary incontinence, some of which are reversable. Stress incontinence and detrusor overactivity are the most common types in active women.
Women with stress incontinence often lose urine unintentionally with physical exertion such as coughing, sneezing, exercising, or laughing. Stress incontinence is associated with inadequate support to the urethra normally provided by connective tissue of the vagina. Connective tissue weakening may cause hypermobility of the urethra leading to involuntary loss of urine with physical exertion. This form of incontinence can be corrected with vaginal support devices, pelvic muscle exercises, or repositioning surgical treatments.
Detrusor overactivity patients experience a sudden, intense urge to urinate, followed by urinary incontinence. Detrusor overactivity involves either provoked or uncontrolled bladder contractions. Therapies used to treat detrusor overactivity include electrostimulation, acupuncture, biofeedback, and medications. Medication and bladder retraining are the most commonly used modalities. Bladder retraining involves urinating at timed intervals and suppressing the urge symptoms between these voids. Medications that treat detrusor overactivity are generally aimed at reducing inappropriate bladder contractions.
Urinary incontinence does not need to be an accepted part of aging. Although it is not life threatening or painful, it can disrupt quality of life. There are numerous simple, safe and effective treatments available. Ask your provider for information on diagnosis and treatment options.