What is Urinary Incontinence?

Urinary incontinence, no matter how minor or infrequent it may seem, can be an embarrassing and uncomfortable issue. If you’re having problems with bladder control, Patrick Nosti, MD, FACOG at Urogynecology of Kansas City, can help. Book your incontinence evaluation in our main office or at a satellite location.

UROGYNECOLOGY OF KANSAS CITY
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There are different types of urinary incontinence (UI) in women. The most common types of women’s incontinence are stress urinary incontinence (SUI) and urge incontinence, also called overactive bladder (OAB). Many women often have symptoms found in more than one category (i.e., mixed incontinence).

Stress Urinary Incontinence

Stress urinary incontinence (SUI) is loss of urine that occurs at the same time as physical activities that increase abdominal pressure (such as sneezing, coughing, laughing, and exercising). For women with stress incontinence:

  • These activities can increase the pressure within the bladder, which acts like a balloon filled with liquid.
  • The rise in pressure can push urine out through the urethra, especially when the support to the urethra weakens.
  • The result is incontinence caused by the stress.

Some women leak occasionally. For example, when they exercise aggressively, have colds or allergies, or their bladder is very full. Other women have a great deal of leakage with simple activities such as getting up out of a chair, or simple walking. Although the severity may vary, many women find that these symptoms begin to limit their physical or social activities, and can have a serious impact on quality of life.

Pregnancy Link

With the joys of childbirth also comes increased weight pushing on your pelvic floor. This added pressure can lead to urine leakage. Pregnancy incontinence is not an official type of incontinence, but incontinence related to pregnancy often resolves in the first few months after delivery. Urinary incontinence associated with pregnancy may signal the development of more troublesome incontinence in the future. That said, overall the risks of vaginal birth are generally significantly less than Cesareans.

Urge Incontinence (Overactive Bladder/OAB)

Overactive bladder (OAB) is a complex condition affecting about 15 percent of women across all ages. Also called urge incontinence, overactive bladder is leakage of urine accompanied by a sensation of the need to urinate, or the impending sense that a large leak is going to happen. Other symptoms include:

  • Frequency—the need to rush to the bathroom, more than 8 voids in each 24 hours.
  • Urgency—that gotta-go now sensation, a powerful urge to urinate, which is difficult to put off.
  • Nocturia—waking up twice or more at night to urinate.

Unlike stress incontinence, OAB usually means a bladder "squeeze" or contraction occurs at an unwelcome time. You may notice severe urgency and leakage when driving into the driveway, placing the key in the front door, running water, or with temperature changes. OAB is a very common condition. At your first visit, we will discuss when and how often you leak urine. A physical exam will be performed to identify other conditions that influence the bladder, such as prolapse.

Seven Categories of Urinary Incontinence

Stress Incontinence
Urine leakage occurs with increases in abdominal pressure. For example, when you cough, laugh, sneeze, or lift a heavy object.
Urge Incontinence
(Overactive Bladder)
Inability to hold urine long enough to reach restroom. Women often describe a sudden urge to urinate followed immediately by leaking. Some leak on the way to the bathroom or while they are taking off their clothes.
Mixed Incontinence
Two or more causes contribute to urinary incontinence. For example, if a woman has the combination of stress incontinence (leaking with coughing, sneezing, exercise, etc.) and urge incontinence (leaking along with a need to get to the bathroom), the diagnosis may be mixed urinary incontinence. Often, you first experience one kind of leaking and the other begins to occur later.
Overflow Incontinence
Leakage or “spill-over” of urine when the quantity of urine exceeds the bladder’s capacity to hold it. Usually due to some blockage or obstruction preventing the bladder from emptying. This stops the bladder from emptying well and so, small amounts of leakage happen frequently. Overflow incontinence is less common among women, unless they have had bladder surgery, vaginal prolapse, or a neurologic problem.
Functional Incontinence
Leakage (usually resulting from one or more causes) due to factors impairing your ability to reach the restroom in time because of physical conditions (e.g., arthritis or using a walker). This may or may not represent a problem of the pelvic floor, but your health care provider can offer potential solutions.
Fistula
This is an abnormal connection between the vagina and the urinary tract, which results in urinary incontinence. This usually happens after some types of surgery, trauma, or radiation to the area. Urinary incontinence due to fistulas is relatively uncommon.
Diverticulum
Urine collects in a pouch within the urethra and tends to dribble out.

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Georgetown Medical Building

8901 West 74th Street, Suite 280
Shawnee Mission, KS 66204

P 913.262.3000 | F 913.262.3002

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Satellite Office

Encompass Medical Building

4811 South Arrowhead Drive
Independence, MO 64055

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