Female Urinary Incontinence: Do You Leak Urine?

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

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