woman with urge incontinence
Incontinence

Urge Incontinence: When “Gotta Go” Meets Leaks

Understanding Urge Incontinence

Have you ever felt the sudden, intense urge to use the restroom and, before you could even put one foot in front of the other, you experienced a bladder leak? If this is happening to you often, then you might be experiencing urge incontinence.  

While most people urinate 6-8 times per day, someone with urge incontinence will likely go much more than that. In addition, when someone with urge incontinence finally sits down on the toilet, only a few measly drops may come out. If you think that urge incontinence might be cramping your style, then keep reading to learn more about what to look for and what you can do about it.  

What Causes Urge Incontinence?

Urge incontinence is a type of incontinence is usually the result of an irritated bladder or overactive bladder. Our bladders are controlled by many nerves and when they aren’t working properly, that’s when you get these types of spritz and drips. For instance, sometimes your nerves think that a half full bladder is at capacity and so they tell the bladder to react. The bladder contracts, even though it shouldn’t, and a little urine may come through the sphincter muscles that are supposed to be closed. A bladder contraction causes that GOTTA GO right now feeling and may be followed by involuntary leaks as you make your way to the bathroom.  

However, it’s not always that simple. Something often triggers an overactive bladder. Sometimes the things we eat and drink cause the bladder to go a little haywire. Other times it’s the sound of running water. There are also certain conditions that affect your nervous system, like diabetes and Parkinson’s Disease, that cause overactive bladder.  

Symptoms and Causes: Urge Incontinence

The main symptom of urge incontinence is an urge to go that cannot be delayed. That means as soon as you feel like you have to go, you’ve gotta go right NOW! Some people are immediately triggered when they fumble with keys to open the door. Others feel the urge when exposed to the sound and sensation of water. However, here are a few other symptoms to look for:

  • Very frequent bathroom visits
  • Waking up multiple times at night to pee
  • Having to go when you’re exposed to sudden cold

Causes of Urge Incontinence

In addition to the above symptoms, you should also be aware of the causes. The most common causes of urge incontinence are a UTI, bladder stones, inflammation, and bladder obstruction. The following can also make it more likely that you’ll experience this condition:

Urge Incontinence Treatment Options

So what can you do if you start noticing signs of urge incontinence? The first thing you should do is start writing down each time you go to the bathroom in a bladder diary. Note any triggers, such as the sudden urge to go after consuming soda or eating an orange. This will also come in handy when you visit your doctor, who will likely suggest behavioral treatments first, then medications and other options if needed.

Train It Up

With your bladder diary in tow, you’ll be able to see how far apart your bathroom visits are and begin to space them out by not giving into the urge right away. This is called bladder training. Try waiting 5 minutes, then 10 minutes, and more. Over time, you should find that the sense of urgency to go you once had has declined.

Work It Out

Like chicken noodle soup is good for the soul, Kegel exercises are good for controlling your urine flow. Your pelvic floor muscles should be able to contract and relax on demand, which in turn controls the opening and closing of your bladder. By strengthening these muscles, you’ll hopefully notice decreased leaks.

Biofeedback

If you’re already doing pelvic floor exercises, then biofeedback therapy can help you take it to the next level. You’ll be able to see the muscles you are exercising, measure your muscle strength, and thus learn how to better control your pelvic floor.

Switch Up Your Diet

What you eat and drink can definitely have an impact on the health of your bladder. If juice, coffee, and wine (sorry!) are causing more frequent leaks, then they’re probably your bladder irritants. Spicy foods and goods that contain citrus can also cause an overactive bladder. Try to cut down or completely stop consuming these bladder irritants and write the impact of doing so in your bladder diary.

Have A Back-up Plan

While you’re trying to make changes to your diet and lifestyle, it can also help to have an extra layer of security. Disposable pads and underwear can catch the leaks when that urge comes out of nowhere. That way you can still enjoy a social life without the fear of everyone else knowing what’s going on.

Medications

Most of the medications used to treat urge incontinence are ones that help relax the bladder. However, keep in mind that they don’t cure the condition. One medication, Mirabegron, prevents the bladder spasms that make you think you need to go so you can hold more urine in the bladder. If you can learn to hold more, then you’ll go less.  

Relax the Mind and Body

Antidepressant medications like, Duloxetine and Imipramine, not only calm the mind, but also the urethra. There is definitely a mind-body connection when it comes to leaks, which means if you’re stressed out, then your urethral muscles are probably tense too. Tight urethral muscles will not only irritate the bladder, but it’ll also keep you from completely emptying your bladder. And that means another bathroom break is coming sooner than later.

Estrogen Replacement Therapy

Estrogen replacement therapy is another way to treat urge incontinence. Have it be a cream, patch, or ring, the goal is to tighten up surrounding pelvic tissue and muscles. This is a common treatment option when your body is producing less estrogen, like during perimenopause or menopause. Tighter muscles should lead to fewer leaks.

Electrical Stimulation

It might sound a little alarming, but electric stimulation is a real treatment option with some promising results. Sacral nerve stimulation (e.g. Interstim), for example, can decrease the number of abnormal bladder contractions so you don’t “gotta-go” so often. A doctor will implant an electronic, pacemaker-like device in the back along the sacral nerves to help the bladder and brain communicate better. PTNS, or percutaneous tibial nerve stimulation, are repeated, 30-minute sessions, that deliver mild electrical impulses to the tibial nerve. Nerve stimulation tells the bladder, “hey, you don’t have to go yet”. In essence, it changes bladder activity.

Botox for Bladder Leaks

Botox is a great way to smooth out lines and wrinkles in the face, but do you know how it does that? In short, it stops muscles from contracting, which is good news for the bladder. Botox injections have been surprisingly successful in reducing leaks and are worth considering if you’re uncertain about other medical options.

Resist the Urge

Urge incontinence can be managed if you keep fighting the good fight. By working with your healthcare provider and making a few lifestyle changes, you’ll be able to see some progress and ultimately resist the urge.  

Is an unruly bladder one of the things that’s stopping you from living your best life? Lily Bird can help. Lily Bird has you covered with pads and underwear delivered right to your door. Start your trial today.

By Jessica Thomas, MPH