Stress Vs. Urge Incontinence

The answer is true, in that both conditions cause leakage of urine from the bladder. The causes, however, are very different. Stress incontinence (SUI) often occurs when a person laughs, coughs, or sneezes, which puts added abdominal pressure on the bladder. If the muscles of the pelvic floor have been weakened by childbirth, for example, they are unable to counteract this increased pressure, resulting in leakage of urine. Urge incontinence, on the other hand, "is an urgent desire to void, which is followed by an involuntary loss of urine," according to information from the Cleveland Clinic (www.clevelandclinic.org). 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.

The answer is false. In fact, no medications exist that are currently approved by the Food & Drug Administration (FDA) for treating SUI. This is because SUI is most often associated with weak pelvic-floor muscles, and there are no known medications that can help strengthen weak muscles. Instead, just like when doctors treat a sprained ankle with rehabilitation, people suffering from SUI can benefit from retraining the muscles of the pelvic floor. The exercises that help strengthen these muscles are called Kegels.

Medication is often used to treat urge incontinence or overactive bladder, however, as certain types of drugs can help reduce or weaken the involuntary spasm of the bladder muscle associated with urge incontinence.

The answer is false: Both types of incontinence usually require treatment by a specialist. There are several types of specialists, however, who treat both stress and urge incontinence. According to information from the National Association for Incontinence (www.nafc.org), the best place to start is with your primary care physician (PCP). He or she may refer you to one of the following types of doctors:

• A urologist is a surgeon who specializes in urinary conditions. Many have advanced training in surgery or medical treatments for incontinence, and some have experience with Kegels, bladder training, biofeedback, or electrical stimulation.
• A gynecologist is a doctor who specializes in female reproductive health.
• A urogynecologist is a gynecologist who has advanced training in the diagnosis and treatment of urinary incontinence and prolapse.
• A geriatrician is a doctor who specializes in treating older people. Some have additional training in incontinence.
• A gastroenterologist is a doctor who specializes in problems of the intestinal system, including fecal incontinence.
• Other specialists in incontinence can include nurse specialists, psychologists, physical and occupational therapists, and behavioral scientists