Urinary Incontinence: Types, Causes, and Treatment Options

Key Points

• Urinary incontinence affects millions of women but is not a normal part of aging

• Stress incontinence occurs during physical activities like laughing, sneezing, or exercising

• Urge incontinence involves sudden, intense urges to urinate that are hard to control

• Lifestyle changes, pelvic floor exercises, and medical treatments can significantly improve symptoms

• Professional evaluation, including urodynamic testing, helps identify the best treatment approach

• Nashville Gynecology Center offers comprehensive bladder symptom evaluation and personalized treatment plans
  

Understanding Urinary Incontinence

Let's talk about something that affects way more women than you might think: bladder leaks. If you've ever sneezed and worried about whether you made it through unscathed, or if you've mapped out every bathroom between your house and the grocery store, you're definitely not alone.

Urinary incontinence is the involuntary loss of urine, and while it's super common (affecting about 1 in 3 women at some point), it's not something you just have to live with. The good news? There are real solutions that can get you back to living your life without constantly worrying about your bladder.

At Nashville Gynecology Center, we understand how frustrating and embarrassing bladder issues can be. That's why we're breaking down everything you need to know about the different types of incontinence and what you can do about them.

The Two Main Types: Stress vs. Urge Incontinence

What Is Stress Incontinence?

Stress incontinence happens when physical movement or activity puts pressure on your bladder. We're talking about things like:

• Coughing or sneezing

• Laughing (yes, even at your favorite comedy)

• Exercising or lifting something heavy

• Jumping or running

• Even standing up sometimes

This type of incontinence occurs when the muscles and tissues that support your bladder and urethra become weakened. Think of it like a trampoline that's lost some of its spring. When pressure hits, things don't stay in place like they used to.

Common causes of stress incontinence include:

Pregnancy and childbirth are huge factors since they can stretch and weaken pelvic floor muscles. Menopause also plays a role because lower estrogen levels can weaken tissues in the urethra and bladder area. Other contributors include chronic coughing, obesity, and previous pelvic surgeries.

What Is Urge Incontinence?

Urge incontinence is a different beast entirely. This is when you get a sudden, intense urge to pee, and you might not make it to the bathroom in time. Some women describe it as their bladder having a mind of its own.

With urge incontinence, your bladder muscle contracts when it shouldn't, even if your bladder isn't full. You might experience:

• A sudden, overwhelming need to urinate

• Leaking on the way to the bathroom

• Needing to pee frequently throughout the day (more than 8 times)

• Waking up multiple times at night to use the bathroom

What triggers urge incontinence?

Sometimes it's your bladder being overly sensitive or your brain and bladder not communicating properly. Certain triggers can set it off, like hearing running water, putting your key in the door when you get home, or even just thinking about needing to go. Conditions like urinary tract infections, neurological disorders, or bladder irritants can also contribute.

Mixed Incontinence: When You Have Both

Here's where it gets complicated. Some women experience both stress and urge incontinence at the same time. This is called mixed incontinence, and it means you might leak during exercise AND have those urgent "gotta go right now" moments. Treatment usually focuses on whichever type is bothering you most.

What Causes Bladder Control Problems?

Understanding why incontinence happens can help you figure out the best way to address it. Here are some of the most common culprits:

Pregnancy and Childbirth

Growing a baby puts a ton of pressure on your pelvic floor, and vaginal delivery can stretch or damage those muscles and nerves. The more pregnancies you've had, the higher your risk.

Aging and Menopause

As we get older, our bladder muscles can weaken. Plus, menopause brings hormonal changes that affect the tissues around the bladder and urethra, making them thinner and less elastic.

Weight and Lifestyle Factors

Extra weight puts additional pressure on your bladder and surrounding muscles. Smoking can lead to chronic coughing, which repeatedly stresses the pelvic floor. Certain foods and drinks like caffeine, alcohol, spicy foods, and artificial sweeteners can irritate your bladder too.

Medical Conditions

Diabetes, neurological conditions like multiple sclerosis or Parkinson's disease, and chronic urinary tract infections can all contribute to incontinence. Some medications can also affect bladder control.

Conservative Treatment Options You Can Try at Home

Before jumping straight to medical procedures, there are several things you can try on your own:

Pelvic Floor Exercises (Kegels)

These are like push-ups for your pelvic muscles. When done correctly and consistently, they can significantly strengthen the muscles that control urination. The trick is making sure you're doing them right. Many women accidentally engage the wrong muscles.

Bladder Training

This involves scheduling bathroom trips and gradually increasing the time between them. You're basically retraining your bladder to hold more and respond to your schedule instead of calling the shots.

Lifestyle Modifications

Losing even 5-10% of your body weight can make a big difference. Cutting back on bladder irritants like coffee, soda, and alcohol helps too. Staying hydrated is important, but try to spread your fluid intake throughout the day rather than guzzling a bunch at once.

Timed Voiding

Going to the bathroom on a regular schedule (every 2-3 hours, for example) can prevent your bladder from getting too full and reduce urgency.

When to Seek Professional Evaluation

If home remedies aren't cutting it, or if incontinence is affecting your quality of life, it's time to talk to a specialist. At Nashville Gynecology Center, we offer comprehensive bladder symptom evaluation and treatment to get to the root of your issues.

Our team, led by Dr. Larry D. Gurley, takes a personalized approach to understanding your specific situation. We don't believe in one-size-fits-all solutions because every woman's body and circumstances are different.

Urodynamic Testing: Getting Real Answers

Sometimes we need more detailed information about how your bladder is functioning. That's where urodynamics comes in. This specialized testing measures how well your bladder, sphincters, and urethra are storing and releasing urine.

Urodynamic testing can help us:

• Determine exactly what type of incontinence you have

• Identify the underlying cause of your symptoms

• Rule out other bladder conditions

• Create the most effective treatment plan for you

The testing is done right in our office, and while it might sound intimidating, most patients find it's not as bad as they expected. Think of it as giving us a detailed roadmap of what's happening with your bladder so we can fix it properly.

Medical Treatment Options

Based on your evaluation, we might recommend:

Medications

For urge incontinence, medications can help calm an overactive bladder and reduce those sudden urges. These work by relaxing the bladder muscle so it can hold more urine.

Pessary Devices

A pessary is a small device inserted into the vagina that supports the bladder and urethra. It can be especially helpful for stress incontinence.

Hormone Therapy

For postmenopausal women, topical estrogen therapy can help strengthen the tissues around the urethra and improve symptoms.

Minimally Invasive Procedures

Depending on your situation, we might discuss options like bladder botox injections for overactive bladder, urethral bulking agents, or surgical procedures to provide support to the urethra.

Our gynecology services are designed to offer you the full range of options, from the most conservative approaches to advanced treatments when needed.

Living Your Best Life Without Bladder Worries

Here's the bottom line: you don't have to accept incontinence as your new normal. Whether you're dealing with occasional leaks during your workout class or more significant bladder control issues, there are solutions that can help.

The first step is understanding what type of incontinence you have and what's causing it. From there, we can create a treatment plan that fits your lifestyle and goals. Some women find relief with simple pelvic floor exercises and lifestyle changes. Others need a combination approach with medications or procedures.

What matters most is that you don't have to suffer in silence or plan your whole life around bathroom locations.

Ready to Take Control of Your Bladder Health?

If you're tired of dealing with bladder leaks and ready to explore your options, we're here to help. Nashville Gynecology Center is conveniently located in midtown Nashville:

Nashville Gynecology Center
300 20th Avenue North, Suite 102

Nashville, TN 37203
Phone: (615) 284-1500
Fax: (615) 432-2007

Call us at (615) 284-1500 to schedule your bladder symptom evaluation. You can also learn more about our philosophy and what makes our practice different, or take a virtual office tour to see our welcoming environment.

Don't let incontinence keep you from enjoying life. Let's work together to find the solution that's right for you.

FAQs About Urinary Incontinence

Is urinary incontinence a normal part of getting older?

No! While incontinence becomes more common as we age, it's not an inevitable part of aging. Many effective treatments are available, and you don't have to just accept it as your reality. The changes that come with aging and menopause can contribute to incontinence, but that doesn't mean you can't do something about it.

How do I know if I have stress or urge incontinence?

Stress incontinence happens during physical activities like laughing, sneezing, exercising, or lifting. Urge incontinence involves a sudden, overwhelming need to urinate that you can't control. If you leak when you cough, it's likely stress incontinence. If you're rushing to the bathroom and sometimes don't make it, that's urge incontinence. A professional evaluation can give you a definitive answer.

Can Kegel exercises really help with incontinence?

Absolutely! When done correctly and consistently, pelvic floor exercises can significantly improve stress incontinence and sometimes help with urge incontinence too. The key is doing them properly. About 70% of women do Kegels incorrectly at first. Working with a specialist to make sure you're engaging the right muscles makes a huge difference.

Will drinking less water help my incontinence?

Actually, this can backfire. Drinking too little water can concentrate your urine, which irritates your bladder and can make symptoms worse. The goal is to drink a moderate amount (about 6-8 glasses a day) and spread it throughout the day rather than drinking a lot at once.

How long does it take to see improvement with treatment?

It depends on the treatment approach. Lifestyle changes and pelvic floor exercises usually take 6-12 weeks of consistent effort to show results. Medications might work within a few weeks. Procedures or surgeries can provide more immediate relief. Your doctor can give you a better timeline based on your specific treatment plan.

Is surgery the only option for severe incontinence?

Not at all. Surgery is just one option, and we always start with conservative treatments first. Many women find significant relief through a combination of lifestyle modifications, physical therapy, and sometimes medication. Surgery is typically reserved for cases where other treatments haven't worked or for specific anatomical issues.

Can incontinence go away on its own?

Sometimes, especially if it's related to a temporary condition like pregnancy or a urinary tract infection. However, if it's caused by weakened pelvic floor muscles or other structural issues, it's unlikely to resolve without treatment. The good news is that treatment is usually very effective.

FAQs About Nashville Gynecology Center

What services does Nashville Gynecology Center offer for bladder problems?

We provide comprehensive bladder care including initial evaluations, urodynamic testing to diagnose the exact problem, conservative treatment options, medications, and when needed, minimally invasive procedures. We also offer in-office ultrasound for diagnostic purposes and specialize in finding alternatives to more invasive treatments.

Do I need a referral to schedule an appointment?

Requirements vary by insurance plan. We welcome new patients and can help you determine if a referral is needed based on your specific insurance coverage. Call our office at (615) 284-1500 to get started.

Where is Nashville Gynecology Center located?

We're conveniently located in midtown Nashville at 300 20th Avenue North, Suite 102, Nashville, TN 37203. Our central location makes it easy to access from anywhere in the greater Nashville area.

Does Dr. Gurley specialize in bladder issues?

Yes! Dr. Larry D. Gurley is board-certified in obstetrics and gynecology and has extensive experience treating bladder symptoms and incontinence. He takes a conservative, patient-centered approach and believes in exploring all options before recommending more invasive treatments.

What should I bring to my first appointment?

Bring your insurance card, a list of current medications, and any relevant medical records if you have them. It can also be helpful to keep a bladder diary for a few days before your appointment. Note when you urinate, how much, and when leaks occur. This information helps us better understand your symptoms.

How long does a bladder evaluation take?

Your initial appointment will typically last 30-60 minutes, depending on your specific situation. If urodynamic testing is recommended, that's usually scheduled as a separate appointment and takes about an hour. We take the time needed to thoroughly understand your concerns and develop the right treatment plan.

Does Nashville Gynecology Center accept my insurance?

We work with most major insurance plans. Contact our office at (615) 284-1500 to verify that we accept your specific insurance, and our staff can help answer any coverage questions you might have about bladder symptom evaluation and treatment.