Urinary Incontinence

Have you ever leaked urine? If you have, you're not alone: research shows that over 400 million people may be affected by this condition worldwide. Urinary incontinence (UI) is a term that describes involuntary leakage of urine of any amount, and there can be lots of different reasons why it may happen. Both men and women can have UI, but it is more common in women. UI is also more common with increasing age; in 2014, approximately 1 in 4 women in the United States ages 60-69 were impacted.

Two common types of leakage are called stress and urge incontinence. Stress incontinence happens when a sudden increase in pressure within the abdomen places enough stress to overcome the strength or coordination of muscles that help maintain control of the bladder. Those with stress incontinence may experience leaking during activities like sneezing, laughing, jumping, coughing, or running. Many women report that they start to experience this type of leakage after having children and/or as they get older. In addition, athletes participating in activities with higher impact forces like running or jumping may also experience stress UI.

​Urge incontinence happens when there is a sudden, unexpected urge to urinate. Often, those with urge UI are unable to make to the bathroom in time. Normally, the body sends a signal to the brain to let us know that we need to use the bathroom when the bladder is full; with urge incontinence, that signal is abnormally paired with a stimulus so that there is a sudden need to go regardless of how empty the bladder is. This type of leakage can often be triggered by different sights, sounds, or activities: for example, you might feel the sudden need to urinate when you hear water dripping, with the sound of your garage door closing, or when you put your key into the lock of your front door.

Leaking can cause both negative physical and emotional consequences. People with UI may avoid activities they previously enjoyed because of worry that they might leak. In some cases, those who have experienced childbirth may believe that leaking is an unavoidable. Strong evidence indicates that folks of all ages with UI can have significantly higher levels of depression and anxiety compared to those without. Additionally, incontinence may be associated with a higher risk for falls and decline in physical performance in older adults.

However, there are effective treatment options for UI. Physical therapy for pelvic floor muscle training has been shown to reduce leakage episodes, decrease quantity of leakage, and improve quality of life. A physical therapist with training in pelvic health PT can work with you to help figure out why you are leaking and make an individualized plan tailored to your needs in order to address it. Contact HPT to learn more about pelvic health physical therapy for UI today!

Sources:
1. Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 2011;108:1132–8
2. Milsom I, Altman D, Cartwright R, et al. Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal (AI) incontinence. In: Abrams P, Cardozo L, Wagg A, Wein A, eds. Incontinence. 6th ed. Paris: Health Publications Ltd; 2016:17–24
3. Wu JM, Vaughan CP, Goode PS, Redden DT, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol 2014;123: 141-148. doi:10.1097/AOG.0000000000000057
4. Cheng S, Lin D, Hu T, Cao L, et al. Association of urinary incontinence and depression or anxiety: a meta-analysis. Int J Med Res 2020;48(6):1-12
5. Moon S, Chung HS, Kim YJ, Kim SJ, Kwon O, Lee YG, et al. (2021) The impact of urinary incontinence on falls: A systematic review and meta-analysis. PLoS ONE 16(5): e0251711. https://doi.org/10.1371/journal.pone.0251711
6. Corrêa LC de AC, Pirkle CM, Wu YY, Vafaei A, Curcio C-L, Câmara SMA da. Urinary incontinence is associated with physical performance decline in community-dwelling older women: results from the international mobility in aging study. JAH 2019;31(10):1872-1891. doi:10.1177/0898264318799223
7. Cacciari LP, Dumoulin C, Hay-Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication. Braz J Phys Ther 2019;23(2):93-107