Urinary incontinence is a common yet often overlooked condition that can affect individuals of all ages, particularly women. It can range from occasional leaks when laughing or sneezing to more significant and frequent urges to urinate.

As a member of the Nebraska Medicine Women's Health team, Kristina Wade, APRN-NP, is dedicated to helping patients understand this condition and find solutions to improve their quality of life. Below, she discusses the most common types of urinary incontinence, their causes and potential treatment options.

What is urinary incontinence?

Urinary incontinence is a common condition characterized by the involuntary loss of urine. It can occur for various reasons and may be temporary or long-lasting.

The three main types of urinary incontinence are:

1. Stress incontinence – This type of urinary leakage occurs during activities that increase pressure on the bladder, such as laughing, coughing, sneezing, bending or exercising.
2. Urge incontinence – Often referred to as overactive bladder, urge incontinence is characterized by a sudden, intense need to urinate, which may lead to an accidental leak.
3. Mixed incontinence – This type is a combination of stress and urge incontinence, which is common in many patients.

Causes of urinary incontinence

Urinary incontinence can be caused by a variety of factors, including:

• Pregnancy and childbirth – The physical strain of pregnancy and delivery can weaken pelvic floor muscles or cause prolapse, affecting the bladder’s ability to hold urine.
• Age – As we age, the bladder and pelvic floor muscles weaken, which can lead to urinary incontinence.
• Menopause – The drop in estrogen levels during menopause can affect bladder control and lead to incontinence.
• Obesity – Excess weight can put pressure on the bladder and pelvic floor muscles, increasing the likelihood of leaks.
• Dietary factors –Certain foods and beverages, such as alcohol and caffeine, can irritate the bladder and contribute to urinary urgency and frequency. 
• Chronic conditions – Certain health issues like diabetes, stroke and neurological disorders can contribute to urinary incontinence.

Urinary incontinence treatment

Urinary incontinence is treatable; many individuals can manage or even resolve the condition with the right approach.

Potential treatment options include:

• Lifestyle changes – Understanding how fluid intake, bladder irritants like caffeine and alcohol, diet and bowel regularity affect our bladder is important. Making simple lifestyle modifications can often help decrease and/or prevent incontinence.
• Pelvic floor exercises – Many women benefit from guidance on properly performing pelvic floor exercises, such as Kegel exercises, with options for strengthening through home or office pelvic floor biofeedbackand physical therapy.
• Pessary – Inserting a small silicone ring helps support the urethra and prevents incontinence.
• Medications – Your medical provider can prescribe certain medications to address urge incontinence, allow you more time to get to the bathroom and decrease the frequency of bathroom trips.
• BOTOX® injections – This therapy is helpful in women with urge incontinence where medications have not been effective.
• Surgery – Depending on your situation, your doctor may recommend certain procedures, such as bladder sling surgery or sacral nerve stimulation, to help resolve incontinence.