Doc Talk Looking for ‘Dry Land’? Take the First Step toward Controlling a Leaky Bladder By: William J. Rush, MD Some women with urinary incontinence may experience just a slight bladder leak when they cough, sneeze, run or jump. Others may feel an overwhelming need to “go,” followed quickly by an involuntary gush of urine. Still others may experience both these types of incontinence or other variations. No matter the details, however, incontinence is an embarrassing, debilitating and inconvenient problem for many women. If you are experiencing incontinence, it’s time to talk with a health care provider. Step one is to identify your symptoms. Here is a brief description of the different types of incontinence. Stress Incontinence. If a cough, laugh or sneeze cause your bladder to spring a leak, you may have stress incontinence. Physical changes caused by normal aging, pregnancy and childbirth can cause this type of incontinence. When your pelvic floor muscles and ligaments weaken, your bladder may move downward toward your vagina. Muscles that ordinarily force the urethra shut don’t work as well as they used to, allowing urine to leak during moments of physical activity. Stress incontinence can worsen during the week before your menstrual period when lowered estrogen levels can decrease muscular pressure around the urethra. The incidence of stress incontinence increases following menopause. Urge Incontinence. If upon suddenly feeling the need to urinate you leak urine, you may have urge incontinence, which is usually triggered by bladder spasms caused by abnormal signals from nerves in the bladder itself or in the spinal cord or brain. If you have urge incontinence, your bladder may empty during sleep, after you drink a small amount of water or when you touch water or hear it running. Medications such as diuretics, medical conditions such as hyperthyroidism and diabetes, and emotional states such as anxiety can worsen this urge incontinence. Multiple sclerosis, Parkinson's disease, Alzheimer's disease, stroke and injury can complicate the harm to bladder nerves or muscles. Overactive Bladder. When nerves send signals to and from your bladder at the wrong time, thus causing bladder muscles to squeeze without warning, you may have to urinate more often than normal (about seven times a day, including once at night is considered normal for most women). An Overactive bladder is also characterized by a sudden, strong need to urinate, immediately followed by gushing of urine, and awaking at night to urinate. Functional Incontinence. People with medical conditions that impair thinking, moving or communicating may experience functional incontinence. For example, a person with Alzheimer's disease may not be able to plan well enough to take a timely trip to the bathroom; a person in a wheelchair may have a difficulty getting to a bathroom in time. Overflow Incontinence. If your bladder does not empty properly, it will remain full and continually leaks. Weak bladder muscles or a blocked urethra can cause overflow incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Other Types of Incontinence. Stress and urge incontinence often occur together. Known as mixed incontinence. Transient incontinence is a temporary condition typically caused by medication, urinary tract infection, mental impairment or restricted mobility. If you recognize yourself in any of these descriptions, please call Lifestages Women’s Center for Bladder and Pelvic Health at 888-808-1016 and make an appointment for an evaluation. There is no need to be embarrassed or to suffer in silence. Lifestages offers a full spectrum of incontinence diagnostic tools and treatment options. Let us help you get yourself back on “dry land.” By: William J. Rush, MD, Obstetrician & Gynecologist, with Lifestages-Samaritan Centers For Women