The most basic definition of UI is the involuntary leaking urine — either in the form of a few drops, or the complete emptying of the bladder. Women with UI typically leak urine before they can get to a bathroom; some may feel a sudden urge to urinate that can’t be controlled, while others may lose a few drops of urine whenever they cough or laugh hard. UI may also occur during sexual intercourse.
The main causes of UI in women are pregnancy, childbirth, and menopause. Pregnancy puts increased pressure on pelvic floor muscles that can weaken them and lead to urinary leakage. Vaginal childbirth can exacerbate already weak pelvic floor muscles and damage the nerves that control bladder function. Although these effects usually heal within a few months of childbirth, they sometimes persist, particularly in women who have gone through multiple pregnancies and vaginal deliveries.
The loss of estrogen brought on by menopause may contribute to UI, because it weakens urethral tissues.
There are several different types of UI. The two most common types are:
Stress incontinence: This is the most prevalent type of UI in women. It involves leakage that occurs when physical movement puts pressure on your bladder. Women with stress incontinence may leak urine when they cough, sneeze, laugh, exercise, or lift heavy things. It’s typically the result of the physical changes caused by pregnancy and childbirth, or menopause. Stress incontinence can often be treated successfully.
Urge incontinence: This type of UI is often referred to as having an overactive bladder. It involves a strong, sudden urge to urinate, followed by leakage. It often happens when it’s least expected, including during sleep, after drinking water, or while hearing running water.
Many women have mixed incontinence, meaning they experience symptoms related to stress incontinence as well as urge incontinence.
To avoid unnecessary surgery, your gynecologist may start by recommending specific lifestyle changes, bladder training, physical therapy, or bladder support devices. For example, certain aspects of your diet may exacerbate your UI problem — eating high-sodium foods can cause you to have to urinate more often. Certain prescription medications may also be contributing to your problem.
Performing pelvic floor exercises (Kegels) can help strengthen your pelvic floor muscles for better bladder control. You may also regain some control by retraining your bladder, a process that involves going to the bathroom at set times, even if you don’t feel the urge to go yet. Losing weight can help take pressure off your bladder.
If these methods don’t work, you may be a good candidate for bladder control medication, nerve stimulation therapy, or surgery.
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