Understanding Stress and Urge Incontinence

What’s the difference between stress incontinence and urge incontinence? If you’re not quite sure, take this simple test about two common types of bladder leakage.

1. True or false: The symptoms of stress and urge incontinence are basically the same.
2. True or false: Medication is often used to treat stress incontinence.
3. True or false: You should see a specialist for treatment of urge incontinence, but not stress incontinence.

Answers:

1. True. Both conditions cause leakage of urine from the bladder. The causes, however, are very different. Stress incontinence often occurs when you laugh, cough, or sneeze, which adds pressure to the bladder. If your pelvic-floor muscles are weakened by childbirth, for example, they are unable to counteract this increased pressure, resulting in leakage of urine.
Urge incontinence is an urgent desire to urinate, which is followed by an involuntary loss of urine, experts at the world-famous Cleveland Clinic say. In a healthy individual, the sphincter muscles of the urethra prevent urine from leaking out. When the muscle of an "overactive" bladder contracts, however, it is strong enough to override the sphincter muscles, causing leakage of urine.
2. False. The U.S. Food and Drug Administration has not approved any medications for treatment of stress incontinence, which is most often linked to weak pelvic-floor muscles. And there aren’t any medications that can strengthen those muscles. Instead, just like when doctors treat a sprained ankle with rehabilitation, people suffering from stress incontinence can retrain the pelvic-floor muscles through exercises called Kegels. Medication is often used to treat urge incontinence or overactive bladder by reducing or weakening involuntary bladder spasms associated with the condition.
3. False. Both types of incontinence usually require treatment by a specialist. According to the National Association for Incontinence, the best place to start is with your primary care physician, who may refer you to:
4. a urologist, a medical doctor who specializes in urinary conditions. Many urologists also have advanced training in surgery or medical treatments for incontinence. Some offer experience with Kegels, bladder training, biofeedback, or electrical stimulation.
• a gynecologist, a medical doctor who specializes in female reproductive health.
• a urogynecologist, a gynecologist who has advanced training in the diagnosis and treatment of urinary incontinence and prolapse.
• a geriatrician, a medical doctor who specializes in treating older people. Some have additional training in incontinence.
• a gastroenterologist, a physician specializing in problems of the intestinal system, including fecal incontinence.

Other specialists can include nurse specialists, psychologists, physical and occupational therapists, and behavioral scientists.

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