Urinary Incontinence


Urinary incontinence is the inability to hold urine in the bladder because voluntary control over the urinary sphincter is either lost or weakened. This can be diagnosed as urge urinary incontinence, or the sudden and intense need to urinate due to spasms or contractions but being unable to hold it long enough to reach a bathroom. A stress urinary incontinence diagnosis means losing urine without control while doing physical activity. Mixed urinary incontinence is a combination of stress and urge incontinence.


If the muscles that hold the bladder in place, also known as the pelvic floor muscles, or the muscles that keep the urethra closed, known as the sphincter muscles, are not working properly, the muscles may not be able to handle anything that puts pressure on the bladder. The bladder and urethra must be well supported by the pelvic muscles and tissue in order to prevent involuntary urine loss.


There are many things that can cause involuntary urine loss. Some of the causes of pelvic floor muscle weakening could be:  age, pregnancy, vaginal delivery, obesity, diabetes, physical activity, smoking, and personal medical history. Working with a physical therapist, however, can allow you the ability to not have to live with this condition.


The symptoms of urinary incontinence can range from mild to severe urine loss. Doing such things as physical activity, laughing, bending over, and anything that causes strain to your bladder may result in an accident to occur. Also, frequent urges to use the restroom or waking in the middle of the night may be symptoms of incontinence.


In order to correctly diagnosis this problem, your doctor may ask you to keep a bladder diary in order to record how much liquid you consume versus how much urine you output. Often times, you will also be asked to do a urinalysis to rule out other medical conditions. There are other specialized tests that your doctor may have you do, such as a pelvic ultrasound, urodynamic testing, or a stress test.


While surgery may be a necessity down the road, one of the first steps to treatment of urinary incontinence may be physical therapy to try to strengthen the pelvic floor muscles. Also, learning how to train your bladder may greatly reduce the need for further intervention. Using physical therapy as a means of treatment of this disorder will require determining the type of incontinence (stress, urge, or both), the extent of incontinence, assessing the strength, motor control and endurance of pelvic floor muscles, and screening for any other musculoskeletal issues. At that point, your physical therapist will be able to develop an individualized exercise treatment program that is right for you.

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