Historically, women have always thought of incontinence as something that occurs with age. Until about 20 years ago, we didn’t have any good way to treat incontinence, and women learned to deal with it. It is a source of embarrassment for many people. Believe it or not, it is extremely common. Approximately 15-30% of people over the age of 60 have experienced urinary incontinence at some point in their life, and possibly more. It affects people in many ways. Many people don’t want to go out or travel, because they are embarrassed. It can also be very costly because of the cost of incontinence products, skin barrier products and the cost of changing and cleaning your clothes.
In general, women can be categorized into 2 groups of incontinence- what we often refer to as “stress” incontinence or “urge” incontinence. There are many other causes of incontinence, but these are the 2 most recognized types.
Stress urinary incontinence (SUI) has traditionally been accepted as something most women with have at one point in their life or another. This is the kind of urinary incontinence that most women notice when they cough, sneeze, laugh or do other activities. It really doesn’t occur when she is sitting still or lying down. The prevalence does increase with age, but it can start pretty early. Usually childbirth is the inciting event. It was previously believed that only vaginal deliveries would cause stress incontinence from the trauma of the baby traversing the birth canal. We now know that women who have Cesarean sections are also prone to SUI. It seems that just the pressure of carrying a baby for 9 months of pregnancy can weaken the pelvic floor muscles, and ultimately lead to excessive mobility of the urethra which alters the sphincter function. This can lead to SUI. Treatments can start fairly conservative, but depending on the degree of incontinence, you may need surgical intervention if you want it. There were hopes of a medication to help treat SUI, but it has yet to be approved by the FDA for this purpose.
Urinary Urge incontinence (UUI) is what is often referred to as overactive bladder. It is usually characterized by that feeling of always having to urinate and often an uncontrollable loss of urine in an unpredictable fashion. This is often much more bothersome for people because it is so unpredictable in nature. We really don’t know exactly what causes this to start. There have been some causes identified. For example, these symptoms are much worse with a bladder infection. Most of the time, we really never find out the cause. The only treatment that seems to work is medication. There are many medications available right now, and even though many are closely related to each other, people respond differently to each one. So if you try one medication and it doesn’t work, or you can’t tolerate the side effects, you can always try another one. So don’t be afraid to ask, and don’t be discouraged.
Do not be afraid to talk to your doctor or nurse about incontinence. It is very common, and treatable. There is no need to be embarrassed. Most importantly, even though it is usually a benign process as I mentioned above, it may be a sign of something more serious that needs further medical attention.
Read Dr. Sobol's other blogs.
Published On: June 23, 2006