Urinary Incontinence

Have you ever experienced a leak while laughing? Have you been in a rush to urinate and as soon as you put the key in the door you had a leak? What about a leakage while just simply picking up an object off the floor? If you replied yes to any of the following questions, then you display signs and symptoms related to urinary incontinence.


Basic Anatomy

Before we dive into the world of incontinence, let’s discuss basic urine flow in relationship to the bladder. Our urine is stored in the bladder and passes through a tube connected to the bladder which is called the urethra. Muscles in the bladder wall (detrusor), contract and force urine out of the urethra, while our sphincter and pelvic floor muscles relax during emptying. With urinary incontinence, there are problems associated with the above sequence. Got It?? Now, let’s move on!


What is Urinary Incontinence?

Urinary Incontinence (UI) is a termed used for individuals who experience an involuntary loss of urine. The bladder muscles will suddenly contract, while the surrounding sphincter muscles are not strong enough to hold back the urine. This loss of urine can include symptoms related to leakage, urinary frequency, urinary retention, or a combination of two or all three. According to the National Association for Continence, 25 million adults Americans experience transient or chronic urinary incontinence. Of that 25 million Americans, populations that suffer most from UI include: 25% are young women, 44-57% are middle-aged, postmenopausal women, 75% are older women in nursing homes. UI is twice as common in females than males (Urinary Incontinence New Hope, 2012).

What are the different types of UI?

  • Stress Incontinence: A form of urinary incontinence, the most common type, in which urine is expelled with any type of physical exertion.

-This physical exertion can include: Lifting, coughing, laughing, exercising, and/or sneezing

-Stress UI can also be caused from physical changes to a woman’s body during pregnancy, childbirth, and menopause


  • Urge Incontinence: A form of incontinence that is also referred to as “overactive bladder”. Urge incontinence is the loss of urine either accompanied with or immediately preceded by urgency.

-A person would report a strong desire to void, with that strong urge being often triggered by environmental cues such as, feeling cold, running water, walking to the restroom and seeing the toilet, and/or putting a key in the door.


  • Functional Incontinence: A form of urinary incontinence in which a person is aware that they must urinate, but there may be physical, mental, or environmental barriers, such as person recently having a hip or knee replacement, unable to manipulate clothing, Alzheimer disease, and/or person in a wheelchair.


  • Overflow Incontinence: A form of urinary incontinence in with leakage occurs secondary to the bladders inability to empty completely. This form of UI is the least common among women.


  • Mixed Incontinence: a form of urinary incontinence which combines two types of UI (most commonly a combination of urge and stress UI).


What are some causes of UI?

  • Diabetes
  • Multiple Sclerosis
  • Pregnancy
  • Childbirth
  • Menopause
  • Brain Injury
  • Birth defect
  • Constipation
  • Medications
  • Infections
  • Obesity

Lifestyle strategies:

There are certain foods/beverages that could irritate your bladder, that are listed in the chart below.


Cutting down the amount(s) of bladder irritants we consume could in turn help toward improving overall bladder health.


-The list below are some helpful tips that will help jump start your road to better bladder health:

  • Try to urinate every 3-4 hours

-While urinating, it is important to relax pelvic floor muscles; AVOID straining

-Try to count how long it takes for you to urine in (“MISSISSIPPI’s”); example 1 Mississippi, 2 Mississippi, 3 Mississippi, etc.

  • The goal is to have around 7-8 “Mississippi’s” per void


  • Drink enough fluids
    • Best estimate: Drink half of your body weight in ounces of fluid/day (2/3 should to be water)


  • Seek a healthcare professional that will be able to provide proper education and treatment strategies for UI. Some of these strategies may include bladder re-training, pelvic floor strengthening, managing medications, food/nutrition advice, catherization, or managing healthy weight (depending heavily on type and severity).


If any of these signs and symptoms are related to you, please do not hesitate to contact a doctor. Urinary incontinence should not be embarrassing. There are millions of women that are experiencing these same difficulties. Take the first step toward improving your bladder health and your overall wellness and mindfulness. If you have any additional questions about Urinary Incontinence, please contact us at 540.710.0100.

Article by:

TaLisa Cummings, DPT







Herman and Wallace Pelvic Rehab Institute

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