No one enjoys that feeling of “I have to go… now.” But, for many, urinary incontinence is a daily struggle. Fortunately, there are treatment options available for anyone who is suffering from the condition.
3 Types of Urinary Incontinence
Urinary incontinence is typically categorized into three types: stress, urge, and mixed.
- Stress Incontinence: Leaking that occurs when there’s a change in abdominal pressure, such as laughing, coughing, sneezing or jumping.
- Urge Incontinence: Leaking that occurs after feeling an overwhelming, sudden urge to urinate.
- Mixed: As the name suggested, this is a mix of stress and urge incontinence.
Anatomy of the Bladder
Each type of incontinence results from a different interruption of normal bladder function. As your body creates urine, the bladder stretches and fills. The urethra, the tube that allows urine to leave the body, sits at the bottom of the bladder. The pelvic floor muscles help keep the urethra closed, ensuring that urine stays inside of the bladder.
If the pelvic floor muscles or supporting structures of the bladder are weak, leaking can occur because the muscles aren’t keeping the urethra closed. Alternatively, if irritability of the actual bladder muscle is present, that can lead to urge incontinence; going to the bathroom too soon or too frequently, or experiencing a strong urge.
Who Is Most at Risk for Urinary Incontinence?
It’s estimated that up to 20% of women who have had a vaginal delivery will experience urinary incontinence due to weakening or stretching of the pelvic floor muscles. Reports of female athletes are also arising, which is likely due to abnormal shock absorption during landings or impact activities.
Lifestyle Changes to Ease Symptoms
Sometimes, changing what one drinks or eats can ease the symptoms of urinary incontinence. Beverages that contain caffeine, carbonation, alcohol, or anything that’s highly acidic can be a bladder irritant.
The most common offenders are:
- Coffee
- Caffeinated Teas
- Sodas
- Citrus juices, such as grapefruit or orange juice
- In some people, spicy food
The best thing you can do is stay hydrated with water and progressively consume your fluids throughout the day. Taking in a lot of fluids in one sitting can overwhelm the bladder and lead to strong urges.
If you’re not a fan of plain water, consider adding fruit, cucumber slices, or mint to bring in some flavor. Certain herbal teas are not as acidic, and apple juice can also be a good alternative.
Pelvic Floor Physical Therapy for Urinary Incontinence
There are a wide variety of treatment options available for urinary incontinence, including physical therapy, medication, and surgery. However, the American Urologic Association advocates starting with the most conservative treatment option first, which is physical therapy. Some people choose to take medications while undergoing physical therapy.
Pelvic floor physical therapy focuses on the treatment and strengthening of the pelvic floor muscles. Physical therapists that work in this field are specially trained in the anatomy and function of these muscles.
If you choose to undergo this type of therapy, you will be taught how to contract the pelvic floor muscles — also called Kegel exercises. While this may seem simple, about half of women and men perform these exercises incorrectly on their own. The physical therapist will then develop a personalized strengthening program designed to address the specific kind of incontinence you’re struggling with.
Pelvic floor muscles also work with the abdominal muscles, so the therapy program usually focuses on all of these muscle groups as a unit. Therapists use a biofeedback tool to allow patients to see how strong their contractions are. Biofeedback, a type of therapy that teaches you how to control some of your body’s functions, is helpful because pelvic floor muscles aren’t visible.
How Successful is Physical Therapy?
Typically, patients attend therapy once a week for six to eight weeks. The success rate varies, anywhere from 60-100% improvement in symptoms. Of course, the benefit of physical therapy is that it has no side effects.
In order for treatment to be fully effective, your physical therapist may recommend that you keep a log of when urges or leakage occurs, as well as what you’re eating or drinking and when. Identifying patterns of “cause and effect” can help you make the most out of your time in physical therapy.Â
Don’t Suffer in Silence
The most important thing to remember is that you are not alone. There are solutions available. Many people suffer in silence or accept symptoms as a normal part of being a mom or aging. But there are many easy, inexpensive treatment options that can help.
Don’t hesitate to talk to your primary care doctor or urologist if you’re experiencing urinary incontinence. If you want to try pelvic floor physical therapy, you can always ask your physician for a referral.
The University of Maryland Rehabilitation Network can help. With locations across Maryland, UM Rehabilitation Network experts work together to help people recover from illness or injury — including urinary incontinence. The team at every UM Rehabilitation Network location focuses on providing state-of-the-art treatments designed to allow you to move with ease and get back to everyday activities.
Hear From Our Experts
Listen to Kelly Huestis, Physical Therapist and Clinical Coordinator of the Pelvic Floor Physical Therapy Program at University of Maryland Upper Chesapeake Medical Center and member of the UM Rehabilitation Network, discuss how to treat urinary incontinence on the Live Greater Podcast.
