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4 Types of Incontinence

As a urologist, Dr. Floyd Seskin understands that urinary incontinence can be uncomfortable and embarrassing. However, effective treatments are available, and the staff at Seskin Urology is dedicated to helping you deal with this problem. 

Approximately 13 million people in the United States experience some type of urinary incontinence each year. Although women are about twice as likely as men to experience incontinence, men do have problems with urinary incontinence, particularly as they age. 

Dr. Seskin first determines the type or types of incontinence you’re experiencing before suggesting a treatment plan. There are four common types of incontinence. 

1. Stress incontinence

This is the most prevalent type of incontinence, especially among women. If you leak a bit of urine when you cough, laugh, sneeze, carry something heavy, or do something else that puts stress on your bladder, you probably have stress incontinence. 

There’s a small, tight band of muscle, called the urethral sphincter between your bladder and your urethra. This muscle squeezes tight most of the time, and relaxes when you urinate, allowing the urine to flow from your bladder through your urethra and out of your body. If your urethral sphincter is weak, it may allow urine leak when it’s under stress.

The other muscles involved in urination are your pelvic floor muscles, which surround and support your bladder and other pelvic organs. These muscles create a sort of hammock that both supports and compresses your urethra. When they are weak, your urethra opens and urine may leak out. 

Strengthening your pelvic floor muscles is often the best approach to treating stress incontinence, though there are other treatments if building strength doesn’t provide the desired response. 

2. Urge incontinence or overactive bladder

Your bladder is relaxed as it fills with urine, and the pelvic floor muscles that surround it are contracted, supporting the bladder and your urethra. Once your bladder is full, you feel the urge to urinate. When your bladder is overactive, you feel this urge even when your bladder isn’t full. 

Often, people who have urge incontinence don’t feel a normal urge to urinate, but rather an overwhelming urge to urinate immediately. It happens so quickly you may leak some urine before you can get to a restroom. 

A muscle called the detrusor is responsible for contracting and signaling the need to urinate to your brain. Sometimes urge incontinence is called detrusor overactivity. 

There are numerous potential causes of urge incontinence, including brain or spinal damage, problems with the nerves that go from your spine to your bladder, an enlarged prostate, or an infection among others. Sometimes, the exact cause of overactive bladder can’t be determined. 

You may be able to “train” your detrusor(the wall of your bladder) through specific exercises and solve the problem of urge incontinence. If bladder training doesn’t work, Dr. Seskin may suggest other treatment approaches. 

3. Overflow incontinence

This type of incontinence is more common in men than in women. Overflow incontinence happens when there is some blockage that prevents urine flowing out of your bladder and through your urethra, such as an enlarged prostate. 

You may also develop an underactive bladder — when your detrusor doesn’t send a signal when your bladder is full. It may become so full the pressure pulls open your urethra and urine leaks out. 

Many chronic conditions, like cardiovascular disease, diabetes, prostate issues, multiple sclerosis and others, are associated with overflow incontinence. Nerve damage, uterine prolapse (in women), and some medications may also cause this type of incontinence. 

Medication, either alone or in combination with exercises to strengthen your pelvic floor muscles and bladder training, may be the best treatment for overflow incontinence. The underlying cause often determines the treatment. 

4. Functional incontinence

With functional incontinence, the problem isn’t with your urinary tract, but is due to a physical or mental impairment that makes it difficult for you to reach the bathroom in time. For example, if you have severe arthritis, you may move slowly, or if you have an injury, it may prevent you from moving freely. Often, the treatment for functional incontinence involves treating whatever your physical or mental impairment is. 

Mixed incontinence

It’s entirely possible, and quite common, for a person to have more than one type of incontinence. You may have both stress incontinence and an overactive bladder. Dr. Seskin always provides a thorough evaluation so that he understands your problem and can suggest the treatment(s) most likely to be successful in your individual case. 

If you’d like to learn more about the causes of and treatments for incontinence, book an appointment at Seskin Urology today.

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