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Different reasons you leak urine

So, why are you leaking urine? You probably don't care why, but I bet you want to fix the problem.  This problem can be really embarrassing and interfere with your life.  Now you need to change your pad, change your underwear and maybe change your pants or your plans.  Treatment is different depending on why you’re leaking, so defining why your leakage is the first step toward solving your problem. Let's get down to understanding why it happens so we can give you the right solution to stay dry and get rid of the pads.

There are three main types of leakage.

·       The first, called urge incontinence is associated with a condition called overactive bladder.

·       The second type of leakage is called stress incontinence which is associated with physical stress such as a cough or sneeze.

·       If you have both problems at the time, it's called mixed incontinence.

Imagine this:

Cup a small water balloon, stem side down, in your hand. Think of the balloon as your bladder, and your cupped hand surrounding the balloon as your bladder muscle...that’s right, the bladder has its own muscle!  Think of the stem of the balloon as your urethra (the exit tube so your pee can come out). Now, to keep the water in the balloon, pinch the balloon stem between your finger and thumb. Think of this gentle pinching of the stem as your pelvic floor muscles which are the muscles that help keep urine in when it's supposed to stay in. If you un-pinch the stem of the water balloon, think of this as your pelvic floor muscles relaxing to let the pee out. This essentially is a system of the bladder.

This is what’s happening:

Overactive bladder:  the bladder muscle is working overtime (your cupped hand keeps squeezing the water balloon). Result:  you feel like you urgently need to pee.

Urge incontinence: the bladder muscle is squeezing so forcefully that the pee is pushed out (your cupped hand is forcefully squeezing the balloon and the amount you can pinch the stem of the balloon is not enough to keep the water in).  Result: you leak.

Stress incontinence: a physical force from outside the bladder pushes into the bladder.  For example, you cough hard, and the force of your abdominal muscles pushes into and squeezes the bladder.  At the same time your pelvic floor muscles aren’t as strong as they need to be. (go back yo your childhood:  your kid brother thinks it would be funny if you got wet, so he swats your hand that is cupping the balloon and you lose your pinch on the stem).  Result:  you leak.

Mixed Incontinence:  all the above is happening at the same time.

I hope you found this introduction interesting and informative.  Stay tuned for my next post where you will learn things you didn't know about overactive bladder and urge incontinence!

This is Dr. Katie Barnacle, physical therapist at Integristic (think Integrative + Holistic) Physical Therapy in Norwood Massachusetts, specializing in women’s pelvic floor and orthopedic care.  We are here to help you get better!  Wondering if our services are right for you? At the top of the page, click "schedule with us" to schedule a free best fit phone call so we can discuss your needs.