Female Urinary Incontinence: Do You Leak Urine?

If you have episodes of leaking urine, you're not alone ... Treatments are available.

Have you had embarrassing episodes of leaking urine? This is actually not uncommon for women. I’d like to simplify the explanation of the two most common reasons for urinary incontinence. 

We’ll start first with the anatomy ...

Imagine the bladder as a "balloon" that holds our urine, located centrally just above the mid pubic bone. (It actually dwells right on top of the lower uterus.) This balloon has a short "straw" that empties it (the urethra.) The urethra exits the
bladder at about a 45-degree angle, in a "locked" angle disallowing urine’s unexpected release. For urination to actually occur, a complex neurologic system connects the brain’s signal (which we mentally initiate) to the bladder to "command" urination, with the bladder’s function of "contracingt" to empty the urine, and the urethra "relaxing," to allow the urine to actually release.

The two types of urinary incontinence are "Urge" incontinence and "Stress" incontinence. With Urge incontinence, you may experience a strong/frequent “urge” to urinate, with very little time to prevent a leak. In Urge incontinence the bladder is actually "contracting" on its own (without our signalling from the brain to do so) creating the frequent sensation of ... “I gotta go!”  Stress incontinence is more about laxity of the urethral angle. A lowered urethral angle (from it’s "locked" position) allows for a “straight shot” for urine to escape ... even when unintended. Stress incontinent symptoms usually occur at times of activity or movement (i.e.,
coughing, sneezing, laughing, exercising, or quick changes in position like sitting to standing.)

Fortunately, treatment options are available, and can vary from behavioral treatments (re-training your bladder on how to function), to medications (used mostly for Urge incontinence), or minimally invasive surgical option (used to "lift" the urethral in cases of Stress incontinence.)

So ... If you’re experiencing symptoms of urinary leakage, mention it to your doctor. Depending on the severity on the symptoms (meaning how bad it’s bothering YOU) treatments are available.

S.Hall, MD

Eastside Gynecology Obstetrics

Twitter @drsuzyyhall, FB/GynoGroupie

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Nikki January 31, 2012 at 03:49 PM
Thanks for this post. Very enlightening! Between you post and www.nafc.org I have received good information on Urinary Incontinence.
DrSuzyyHall February 19, 2012 at 12:25 AM
Thanks Nikki! Most of my patients with urinary incontinence know their symptoms, but (understandably) have no real concept on WHY they may be leaking. It helps for me to explain the above 2 concepts, to initiate discussion around possible causes and treatment options.
Austin Sheeley September 03, 2013 at 10:56 AM
Great, informative article! Another treatment option is kegel exercisers (http://justhomemedical.com/incontinence-products). They restrengthen you pelvic floor muscles which can help with stress incontinence that occurs after childbirth
Robyn Baker February 11, 2014 at 01:18 PM
I thought all hope was lost after I had my three children. I had made changes to my diet, added pelvic floor exercises to my daily routine, etc and still had no relief of my symptoms. I did hours of research and came across Laser Vaginal Rejuvenation Institute of Los Angeles. Absolutely amazing results and I would recommend these Doctors to everyone.


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