Incontinence and Over Active Bladder (OAB)

Incontinence is the leakage of urine, feces, or flatus. OAB is associated with frequency, urgency and sometimes the loss of urine. Incontinence and OAB can affect people of all ages. Aside from the physical effects, there are significant emotional, social, and financial impacts on the lives of those who are affected.

Common Incontinence Terminology

  • Fecal Incontinence – Accidental loss of solid stool, liquid stool, or gas
  • Constipation – Variously defined as infrequent bowel movements (< 3 bowel movements per week), incomplete emptying of bowel contents, need to excessively strain to effect a bowel movement, passage of small, hard stools, or need to place your fingers in the vagina or the space between the vagina and anus to effect a bowel movement.
  • Urinary incontinence – leakage of urine
  • Stress incontinence – involuntary loss of urine during activities that put “stress” on the bladder such as laughing, coughing, sneezing, lifting, etc.
  • Urge incontinence – an involuntary loss of urine preceded by a strong urge (also known as “overactive bladder”)
  • Dysuria – Painful urination
  • Urgency – A powerful need to urinate immediately
  • Frequency – The need to urinate more often than normal (more than every 2 hours or more than 7 times a day)
  • Nocturia – Waking up frequently (more than once) during the night to urinate

About Incontinence

Urinary incontinence (leakage of urine) is a very common condition affecting at least 10-20% of women under age 65 and up to 56% of women over the age of 65.

Urinary incontinence, (leakage of urine), is a very common condition that is estimated to affect 10-20% of women under age 65 and up to 56% of women over 65. It is an embarrassing problem that has affects beyond the physical issues – there are social, emotional and financial impacts on the lives of those affected. Urinary frequency or urgency, which is the need to run to the bathroom more frequently than is normal, is another bothersome problem that can affect women. There is no need to live with urine leakage or frequency because effective treatments are available.

Fecal incontinence, an inability to control the bowels, leads to leakage of solid or liquid stool or gas. Many women are very uncomfortable talking about bowel control problems. Untreated, it can significantly and negatively impact self-confidence, create anxiety, and impair a normal social life. Fecal incontinence is a treatable condition; treatment can lessen symptoms in most cases and can often completely cure incontinence.

If you answer yes to any of these questions you could benefit from incontinence therapy, or evaluation for other pelvic floor disorders:

  1. Do you urinate more than every two hours in the daytime?
  2. Do you urinate more than once after going to bed?
  3. Do you have trouble making it to the toilet on time when you have the urge to go?
  4. Do you strain to pass urine?
  5. Do you rush to go to the toilet to empty your bladder?
  6. Are you unable to stop the flow of urine when on the toilet?
  7. Do you have an urge to go but when you get to the toilet very little urine comes out?
  8. Do you lack the feeling that you need to go to the toilet?
  9. Do you empty your bladder frequently, before you experience the urge to pass urine?
  10. Do you have the feeling your bladder is still full after urinating?
  11. Do you experience slow or hesitant urinary stream?
  12. Do you have difficulty initiating the urine stream?
  13. Do you have “triggers” that make you feel like you can’t wait to go to the toilet? (running water, key in the door)
  14. Is your bladder controlling your life?

Pelvic floor muscles play an important role in bladder and bowel functions.

The two most common types of urine leakage in women are urge and stress incontinence. People with both stress and urge incontinence are said to have mixed incontinence.

Urge incontinence

Urge Incontinence is the leakage of urine associated with a strong urge to urinate, or not making it to the bathroom in time. When leakage of urine is accompanied by a sensation of the need to urinate, or the impending sense that a large leak is going to happen, this is often what is known as urge incontinence. Unlike stress incontinence, this usually represents a bladder “squeeze” or contraction, occurring at an unwelcome time. Often people with urge incontinence also have increased urinary frequency, have to rush to the bathroom frequently, or wake up more than once or twice at night to urinate. They may also notice severe urgency and leakage when driving into the driveway, placing the key in the front door, running water or with temperature changes.

Stress incontinence

Stress Urinary Incontinence is loss of urine that occurs at the same time as physical activities that increase abdominal pressure (such as sneezing, coughing, laughing, and exercising). These activities can increase the pressure within the bladder, which behaves like a balloon filled with liquid. The rise in pressure can push urine out through the urethra, especially when the support to the urethra has been weakened.  This is what we call stress urinary incontinence. Often the stretching of pelvic muscles during pregnancy and childbirth can cause urinary incontinence in new mothers, which may or may not resolve within a few months after delivery.

Mixed incontinence

Mixed incontinence is the combination of two or more causes, such as the presence of both stress and urge incontinence.

Overactive bladder

People with overactive bladder have a sudden, overwhelming urge to urinate, but may or may not leak urine before getting to the toilet. People with overactive bladder often have urgency to go to the bathroom during the day and/or night.