Urinary leakage: It’s more than what you think

Urinary leakage sucks. It’s embarrassing, it smells, and it’s hard to do certain things if you’re afraid of peeing your pants. And let’s be honest, no one likes to wear a pad or depends if we can help it.

This article is intended to help you better understand urinary leakage. When I see patients, it’s really important that we figure out what kind of leakage they’re having be- fore we can find a solution. So let’s dive in!

Stress Urinary Incontinence

Stress Urinary Incontinence, or SUI, is when we leak urine because the pressure in our abdomen is stronger than or out-performs our pelvic floor (the muscles that keep us from leaking).

For example, I’ve had a cold and I’ve been coughing a lot. I’m also 6 months post- partum. The cough causes my core to contract but because I’m weak in the pelvic floor from just giving birth, the pressure goes to the path of least resistance. As a re- sult, I leak urine when I cough. Sound familiar?

Common situations in which SUI occurs:

1. Running

2. Coughing/sneezing

3. Jumping

4. Picking up something heavy

5. Getting out of a chair

6. Twisting

Urge Urinary Incontinence

Let’s start by looking at an example of urge urinary incontinence: I’ve been running er- rands for a few hours. I’m working hard on getting my water in so my Stanley is now empty. I’m headed home. I see the driveway and all of a sudden my bladder starts tin- gling. I pull in to the driveway and the tingle becomes almost painful. I put the car in park, leave all my bags in the car, rush to the front door, fumble with my keys, open the door....and urine starts coming out...before I can get to the bathroom. This is urge urinary incontinence.

Urge urinary incontinence is a bladder issue. The root cause is that the bladder is trying to squeeze out urine before we can get to the bathroom.

I tell patients that in cases of urge incontinence, there is a disconnect in sig- nals between the brain and the bladder. The bladder has decided it’s in charge.

A few things that might contribute to urge urinary incontinence:

1. Just-in-case pees (I better go pee before I leave the house even though I don’t feel like I need to go)

2. Diet drinks, coffee, tea

3. Certain foods that are acidic

4. Not drinking enough water

5. Weak pelvic floor muscles

6. Overactive pelvic floor muscles

7. Incomplete bladder emptying

8. Pelvic Organ Prolapse

Other causes of Urinary Leakage

Treating urinary leakage is sometimes like peeling back the layers of an onion. For ex- ample: You might have stress and urge urinary incontinence. You might also have a bladder prolapse that is contributing to the leakage. Each person’s reason for their leakage might vary based off of lifestyle, anatomy, strength, etc.

Other causes of Urinary Leakage:

1. Damage to the nerves of the bladder such as from prostate surgery

2. Prolapse (dropping) of the uterus, bladder, and/or rectum

3. Scar tissue from repeated UTI’s

4. Endometriosis

5. Overactive pelvic floor muscles

6. Weak pelvic floor muscles

7. Poor bathroom habits

8. Constipation

In conclusion

Urinary leakage can be the result of many factors as we noted above. If you or some- one you know is struggling with leakage, I would highly suggest meeting with a pelvic floor physical therapist, physician, urologist, or OGBYN to discuss your options. Uri- nary leakage is a treatable issue. It may be common, but it doesn’t have to be normal.