There are several misconceptions about urinary incontinence in women, including that it’s a condition without effective treatment options. The facts are more hopeful. Here’s what you should know.
You may have heard these myths about urinary incontinence: It’s caused by the size of your bladder, or, it’s just a part of aging. The facts about urinary incontinence, however, offer solutions and hope to women with the condition. If you’re experiencing urinary leakage and need help separating fact from fiction, our guide offers key answers, including treatment options that can improve your quality of life.
Myth 1: Urinary incontinence is just a part of aging.
While age can play a role in the development of urinary incontinence, getting older does not mean that urinary leaks are an inevitable nuisance and, therefore, not a real health concern.
“As we get older, our bodies and tissue get weaker, but urinary incontinence should never be considered normal,” explains Tanaz Ferzandi, MD, a urogynecologist at Keck Medicine of USC and associate professor of obstetrics and gynecology at the Keck School of Medicine of USC.
Myth 2: Treatment options for urinary incontinence are limited or nonexistent.
Even though urinary incontinence is common among women — half of all women will experience issues in their lifetime — this doesn’t mean that there’s nothing that can be done about it.
“Women are so used to taking care of everybody else around them that they may not prioritize their own need for treatment,” Ferzandi says. “Urinary incontinence is not just a nuisance — it affects a woman’s quality of life — and it’s important for them to get the care they need.”
In reality, there are many treatment options for urinary incontinence, but the treatment plan that’s right for you depends on the type of incontinence you have.
“A patient may say, ‘My bladder is acting up and I’m leaking.’ As physicians, we have to tease out exactly what the bladder condition is,” Ferzandi explains.
Types of urinary incontinence include:
- Stress incontinence: Urinary leaks that occur during activities, like coughing or laughing, are a tell-tale sign. This type of incontinence is caused by weakened pelvic floor muscles and is more common in women.
- Urge incontinence: Leakage occurs because the need to urinate is very sudden, offering little warning or time to get to the restroom. This type of incontinence may be caused by an overactive bladder or a urinary tract infection and is prevalent in older adults.
- Overflow incontinence: Small, uncontrollable leaks of urine occur due to an overfilled bladder. This type of incontinence may be caused by a neurologic condition, diabetes and certain medications.
- Functional incontinence: Leakage that occurs because of mobility issues, rather than urine control issues, that prevent a person from getting to the restroom in time.
- Mixed incontinence: Urine leakage occurs due to a combination of stress incontinence and overactive bladder.
Regardless of the type of incontinence you have, Ferzandi says that your doctor will likely start with a conservative approach that includes examining and changing some of your behaviors, including your bathroom habits.
“Based on your diagnosis, you may also be an excellent candidate for physical therapy that will help you tighten up — or relax — your pelvic floor muscles,” she adds. “Medications are available to treat some types of urinary incontinence, but they may not work for everyone. Some types of incontinence actually do not respond to medications, so it’s important for us to get a clear diagnosis of the problem.”
Myth 3: Surgery is the only real treatment for urinary incontinence.
Once you’re properly diagnosed, you and your doctor can decide if, and when, surgery is right for you.
“A lot of people hesitate to come forward about their incontinence because they’re worried that they’ll have to undergo surgery. But there are a lot of different treatment options that we can offer our patients before exploring surgery,” Ferzandi explains.
“We want to make sure we understand what the patient’s needs are. If we try a couple of nonsurgical treatment options but the patient isn’t getting better — and if they feel that surgery is a good option for them — then we can offer surgery as a next step.” Many of these surgical procedures do not require hospitalization and have positive outcomes.
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Myth 4: If you have urinary incontinence, absorbent products are a must.
For many women, once they’re being treated for their specific type of incontinence, using absorbent products won’t be necessary. Although some patients feel more comfortable using an absorbent product during certain activities, Ferzandi explains that “absorbing products can be quite expensive, and they don’t always work very well.” And for some patients, she adds, these products may cause skin irritation and redness.
“I think there’s definitely a role for absorbent products, but it concerns me that some patients believe there are no other options for them,” Ferzandi says. “We want to make sure they understand that there are other solutions available.”
Myth 5: Restricting your fluid intake will improve urinary incontinence.
Although it may seem like cutting down on liquids will reduce your need to urinate, restricting fluids can actually make your bladder problems worse.
“Urinary incontinence can have such a negative impact on a person’s quality of life, that some people try to stop drinking fluids in order to reduce the urge to use the restroom,” Ferzandi says. That approach, however, is counterproductive “because when they do drink liquids, their bladder can’t tolerate it.”
“People are always surprised, but we actually tell them not to restrict their fluids,” she adds.
According to Ferzandi, people with urinary incontinence should drink a steady amount of liquid throughout the day. “We want to make sure that they’re getting enough to hydrate their bodies and their bladder, but not so much that their bladder can’t tolerate it.”
It also matters what you drink. In general, Ferzandi recommends avoiding too much caffeine and alcohol, since these can be bladder irritants and worsen symptoms.
Myth 6: Urinary incontinence is caused by a small bladder.
Urinary incontinence isn’t caused by the size of your bladder, even though that misconception may seem real.
“Patients will say, ‘I have a small bladder,’ but what they’re really describing is an overactive bladder,” Ferzandi explains.
Whether you’re experiencing a really strong urge to urinate or you’re going to the bathroom but very little urine comes out, your bladder size is not the root cause of your symptoms, she says.
“It’s not the size of the bladder but, rather, how the muscles and the nerves in the bladder manage and release urine over the course of time.”
A urogynecologist, or a urologist who’s trained in pelvic floor disorders and women’s health, can help women find the root cause of their urinary incontinence, so they can get the proper treatment and restore a better quality of life.
by Tina Donvito