Different Types of Urinary Incontinence

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Urinary Incontinence (UI): There are different types of incontinence including stress, urgency and mixed UI. Some terms and symptoms related to UI include, but are not limited to: bladder leakage, overactive bladder, difficulty voiding, and trouble emptying bladder fully.

Stress incontinence is correlated with leaking urine when coughing, sneezing, or lifting heavy objects, among other physical activities. This condition is usually brought about by weak pelvic floor muscles (PFM).

There are many times that individuals with stress UI are told by a misinformed layman or healthcare professional that this pelvic floor weakness should be treated with kegels (AKA contracting the pelvic floor muscles). The issue with this advice is that if you are having these symptoms due to tight or overactive PFM, performing continuous PFM contractions, without learning to relax these muscles first, can lead to an increase in your symptoms. This is the reason you may require a pelvic floor evaluation by a pelvic floor therapist that is trained to determine the condition of your PFM—whether your PFM are overly tight; overly lengthened; whether there is a discoordination in your PFM contractions when you are attempting to perform heavy lifting, sneezing etc; or something completely different including poor abdominal/ pelvic pressure management.

There are varying treatments for the impairments associated with symptoms that you may be experiencing, which is the reason you may benefit from seeing a pelvic floor therapist. They will be able to assess your pelvic floor and provide you with the manual interventions; therapeutic exercise; posture & lifting mechanics training; abdominal/ pelvic pressure management training and breath therapy that you may require to decrease and eliminate your symptoms.

Urgency/ Frequency urinary incontinence or overactive bladder (OAB) usually corresponds with an intense urge to urinate and this feeling can come on very quickly—so quickly that at times you urinate before making it to the bathroom. There are times when the need to void is very strong, but when you make it to the bathroom not much urine comes out. This condition may be due to an up-regulation of your nervous system due to poor bathroom habits you have acquired and/or these symptoms may have come about by way of eating/drinking bladder irritants. The issue with bad habits related to urgency UI is that they usually come about insidiously, most people don’t even know they are doing anything wrong. 

An example of a poor bathroom habit is urinating when you don’t need to, like when you try to go to the bathroom before going on a long car ride. This leads to bladder dysfunction because you are creating the habit to void even if your bladder isn’t full. Pelvic floor therapists refer to this as “jic-ing” (just-in-case urinating). One of the impairments that comes about usually includes being unable to hold urine in your bladder adequately. It is better to wait and only urinate when you actually need to or when your bladder is full; even if that means you have to make a bathroom stop 30 min to an hour into your long drive.

Voiding without allowing your bladder to fill is just one example of the many poor bathroom habits you could have acquired over the years. By seeing a pelvic floor therapist, you can work together to find the issue or issues related to your condition and begin to make small deliberate, changes that will lead to a decrease and even eliminate your symptoms.

Mixed urinary incontinence is a combination of two types of urinary incontinence: urgency and stress. This is a very common condition, but make no mistake-no type of UI is normal; even if there are numerous people you know that have UI or an uninformed medical professional tells you incontinence is normal. It is not normal. There are gentle manual interventions and therapeutic exercises that your pelvic floor therapist can prescribe and that you can perform to treat your symptoms. Your pelvic floor therapist may also aid in discovering poor bathroom habits that you have formed and educate you on how to change those habits. Please know that you are not alone and there may be a way to get help by participating in pelvic floor therapy.