It’s a stall world after all

Do you suppress laughter or cross your legs for fear you might leak? Do you rush to the bathroom as soon as you walk through your front door? Do you leak when you cough or sneeze? Have you missed family or social events because you were worried you might have an accident?

If you answered yes to any of these questions, you have symptoms of a bladder disorder such as urinary incontinence or overactive bladder.  Urinary incontinence is any loss of urine that occurs before you can get to the toilet. The amount of leakage can vary from a few drops of urine noticed in undergarments to large amounts of urine that can overflow even the heaviest pad. There is no amount of leakage that is considered “normal” and urine leakage is not considered a normal part of aging.  Overactive bladder may present as strong  urges to urinate or frequent trips to the bathroom to urinate.  Uncommonly, these bladder disorders may be a sign of a more significant underlying disease.

There are several different types of urinary incontinence, but the most common are:

Stress incontinence: Leakage with coughing, exercise, sneezing, or changing position. This is generally an anatomical issue related to the bladder or urethra.

Urge incontinence:
Leakage with an urge to urinate. This occurs because of an uncontrolled bladder contraction. Although less common than stress incontinence, urge incontinence is often described as more bothersome.

Mixed incontinence: A combination of both stress and urge incontinence.

Your doctor can recommend testing, or refer you to a specialist, to help clarify the specific type and extent of urinary incontinence. This evaluation may include a pelvic examination, urine culture, bladder diary, cystoscopy, urodynamic testing, or possible imaging studies.

Talk to your doctor about lifestyle changes you can make to improve urinary incontinence. For example, women who can successfully perform Kegel exercises may notice less urinary incontinence with better coordination and strength of the pelvic floor muscles. Others improve urinary urgency symptoms by decreasing caffeine intake or by changing their bathroom routine.

The good news is that urinary incontinence can be successfully treated, and in many cases, it can be eliminated entirely. These treatments range from targeted pelvic floor exercises and/or medications to minimally invasive outpatient procedures.

If you’re having a problem with urinary incontinence, you might feel reluctant to talk with your doctor about it. Studies suggest that at least half of the people struggling with urinary incontinence don’t discuss the problem with their doctors or health care professionals. You may be embarrassed to talk about it. You may have convinced yourself that urinary incontinence is something you just have to live with.  You don’t.

The most important step is the first one: Starting a dialogue with your health care provider about urinary incontinence and/or overactive bladder.  Your health care provider can direct you toward effective options to regain a more active, confident, and dry lifestyle. Don’t let bladder issues get in the way of enjoying the important things in your life.


Meet Dr. Epstein at the Y Healthy Living Center in Ponte Vedra on April 29 for a free talk on women’s pelvic health and urinary incontinence.

Other pelvic health topics:
Pelvic floor issues | Painful intercourse

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