Everything you wanted to know about bladder leakage but were afraid to ask

Learn what type you may have, what causes it, and how to fix it

Also known as “urinary incontinence,” bladder leakage is fairly common among women. But you shouldn’t have to suffer from it.

Melanie Dixon, MD, an OB/GYN with Fairview, and Heather Vander Weide, a physical therapist at the Institute for Athletic Medicine, are two of our experts in this arena.

Different types of bladder leakage

There are two main types of bladder leakage, and it’s important to determine which kind you have.

“The first type is stress incontinence,” Heather says. “This is when people have leaking with coughing, sneezing, laughing, jumping, or lifting heavy objects.”

“The second type is urge incontinence, a component of overactive bladder. Urge incontinence is when you get a sudden urge to go to the bathroom and urine starts coming out. You’ll know if you have this type because you won’t have enough time to get to the bathroom, or on the way to the bathroom, urine starts coming.”

You can also have a combination of these types, which is called mixed incontinence.

Causes of bladder leakage

From a woman’s teen years to menopause, there are a variety of causes of bladder leakage (both kinds!)

“Leaking can happen as a result of a bladder infection, in which case it is usually short-term,” says Dr. Dixon.

Women are more likely to get bladder infections than men. Having sex and wiping from back to front after going to the bathroom are two common ways bacteria can get into your urethra (the tube from the bladder to the outside of your body) and then cause a bladder infection. 

“In addition to leakage, you might also have symptoms like burning when you pee, peeing more often, cloudy or bloody urine, or pelvic pain,” Dr. Dixon says. “If you experience these symptoms, see a doctor right away. Antibiotics can fight off the infection.”

Pregnancy and childbirth can also cause leakage.

“The more pregnancies and vaginal deliveries someone has, the more likely they are to have some bladder leakage,” Heather says. “The bigger the baby’s head, the more likely you are to have bladder Ieakage, too.”

In some cases, it could improve on its own. But if it doesn’t, don’t give up.

“Many people think it’s normal to leak after having a baby,” Heather says. “But it’s not. Your life doesn’t have to be this way. The sooner you seek help the better, so it doesn’t become a worse problem.”

As women get older, they can be more at risk for leakage.

“Incontinence can be a result of age-related changes in the bladder and the tissues surrounding the bladder and urethra,” Heather says. The lack of estrogen after menopause is a factor, and the group of muscles that supports your urethra and bladder (called your pelvic floor) naturally weakens over time.

How to fix it

Treatment depends on the type of leakage.

“Stress incontinence can be treated with pelvic floor strengthening exercises, lifestyle changes, and in more severe cases, surgery,” Dr. Dixon says.

“I recommend a lot of core and pelvic – also known as Kegel – exercises,” Heather says. “Pilates can also help to build strength.” 

If it comes to surgery, a “sling” could be inserted to support your urethra and help keep it closed when you cough or sneeze. Another surgical approach is to strengthen the neck of the bladder so it doesn’t sag.

“Urge incontinence is treated with lifestyle changes, physical therapy, medication, or a combination of these options,” Dr. Dixon says. 

Bladder retraining, for example, is a process that usually takes a few months and helps you diminish leakage and increase the amount of time you can hold urine.

Medications include those that block the signal in your body that causes bladder contractions, those that relax the bladder muscle and increase the amount of urine you can hold, and estrogen to re-strengthen your tissues. 

“In some cases,” Dr. Dixon says, “surgery to implant a device that calms the bladder can also help.”

The good news is that there are a lot of options, and simple physical therapy can be a big contributor.

“Almost all of my patients who don’t have structural issues leave physical therapy meeting their goal – at 100 percent continence or very close to that,” Heather says. “Even if they don’t fully recover, the majority of patients experience some improvement in symptoms.”

If you’re suffering from bladder leakage, choose one of our providers and call855-FAIRVIEW to make an appointment.

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