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Bladder Control Issues: The Right Diagnosis Matters

October 26, 2021

Do you sometimes leak a little when you laugh, sneeze or exercise? You’re not the only one. Known as urinary incontinence, this involuntary urine leakage is common. In fact, nearly 50 percent of adult women experience some form of incontinence. 

Although it’s not always easy to talk about bladder control issues, you should bring up any symptoms with your doctor. When it comes to treating urinary incontinence, getting the right diagnosis can make all the difference. 

Types of Urinary Incontinence 

There are two main types of urinary incontinence: stress urinary incontinence and urgency urinary incontinence (also known as overactive bladder, or OAB). 

Stress urinary incontinence is leakage during activities such as coughing, sneezing, laughing, jumping and exercise. It happens when the ligaments and muscles in your pelvis (collectively known as the pelvic floor) are stretched or weakened, resulting in a loss of bladder control. 

Stress urinary incontinence is the most common type of incontinence that affects women in their 30s, 40s and 50s. It’s especially prevalent during pregnancy and after childbirth but can occur at any time. 

Urgency urinary incontinence is the sudden urge to urinate and not being able to “hold it all in.” People with this type of incontinence may also feel the need to urinate many times throughout the day and night. 

Urgency urinary incontinence affects about 40 percent of women. It’s most common after menopause, when lowered estrogen levels may worsen an already weakened pelvic floor. 

It’s not unusual to experience a combination of stress urinary incontinence and urgency urinary incontinence, meaning you may leak during activities but also feel an urgent need to go. This is known as mixed urinary incontinence

Why the Right Diagnosis Matters 

Although both stress urinary incontinence and urgency urinary incontinence cause similar symptoms, they are treated very differently. This is why it’s important that women experiencing bladder control problems get the right diagnosis — the treatment for one type of incontinence can actually make the other type worse. 

To get a proper diagnosis, you should seek specialized care with a urogynecologist. 

Treatments include lifestyle modifications and pelvic muscle exercises. Additional in-office treatment for stress urinary incontinence is a bulking injection. This involves injecting fillers like collagen into the urethra, narrowing it so that urine can’t leak out as easily. 

Urgency urinary incontinence, on the other hand, is treated with bladder Botox injections. 

Since these two injections have different effects, using them incorrectly leads to the opposite result. If a woman has stress incontinence and is treated with Botox instead of bulking injections, it will make her stress incontinence worse. And if a woman has urgency incontinence and receives bulking injections instead of Botox, it will make the urgency worse. 

Talking To Your Doctor About Incontinence 

If you’re experiencing stress incontinence or urgency incontinence (or both), don’t be shy about discussing your symptoms with your doctor. When you’re ready, seek a referral to a urogynecologist so you can get the right treatment.

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