OAB and Urinary Incontinence
Overactive bladder can start with a drop, a trickle or a gush of urine, especially when you cough, laugh or run. Or it can catch you completely off-guard, causing you to have an accident as you bolt for the nearest bathroom. When you begin to leak urine frequently or severely enough for it to interfere with your everyday activities, it's considered urinary incontinence and it's surprisingly common.
It's estimated that 25 million adults in the U.S. experience incontinence, and the vast majority are women, according to the National Association for Continence (NAFC). One of those women is Peggy Cicero, who began experiencing symptoms three years ago. "I would feel the urge to go and instantly I'd leak," says Cicero, a mother of three and a manager at a nonprofit organization in Winfield, IL.
"Anything could trigger it; I never knew when it was going to happen. I felt anxious when I was away from home because I couldn't control it. I also felt angry and embarrassed because I didn't have the freedom I should have—and wanted."
Contrary to what many people think, "urinary incontinence is not an inevitable part of aging, nor is it something to be ashamed about,” says Jill Maura Rabin, M.D., chief of the division of ambulatory care and head of urogynecology at the Long Island Jewish Medical Center, North Shore-LIJ Health System in New Hyde Park, NY, and coauthor of Mind Over Bladder: A Step-by-Step Guide to Achieving Continence (iUniverse, 2008). "Women who have it shouldn't suffer silently because incontinence is almost always treatable."
Debbie Stempel, a teacher in Los Angeles, found herself too embarrassed to bring up her bladder issues when she was pregnant with her twin girls. "I had no bladder problems during my first pregnancy, but a few months into this pregnancy, I started to have urine leaks," she says. "I didn't say anything to my doctor at first because I was mortified. But then I worried that something might be wrong so I sort of blurted it out to my OB/GYN at one of my prenatal appointments."
"My doctor was totally matter-of-fact about it and she showed me how to do Kegels to make my bladder muscles stronger. After a few months, I really saw results. And I still do my exercises faithfully." Stempel turned to her gynecologist for help, as many women do. If you're experiencing bladder leaks, you can start by talking to your primary care provider—usually an internist or a gynecologist.
He or she may refer you on to a urologist (a doctor who specializes in urinary conditions) or a urogynecologist (who specializes in urinary incontinence and other bladder problems). What's important to keep in mind is that not all types of incontinence are the same. There are four primary (and three secondary) kinds, with varying causes, risks and treatments, so it's important to figure out what you're dealing with.
- Functional incontinence: Leakage due to the inability to physically get to the bathroom
- Mixed urinary incontinence: A combination of stress incontinence and urge incontinence
- Overactive bladder: The sudden and urgent need to urinate
- Overflow incontinence: When the bladder doesn't empty properly and urine dribbles out
- Stress urinary incontinence: Involuntary urine leakage due to physical activity
- Transient incontinence: Temporary leakage due to a short-lived medical issue or treatment of a medical problem
- Total incontinence: Complete loss of bladder control
- Urge urinary incontinence: A sudden sense of needing to use the bathroom, accompanied by leakage of urine