Wetting oneself is not a topic that is brought up easily even among close female friends and sometimes not even with a physician.  The medical term for this is “urinary incontinence” and it is an embarrassing issue. I would like to explain a little bit about female incontinence - the various types and some treatments.  This is a condition that approximately 25 million people in the US suffer on a daily to weekly basis.  

Urinary incontinence is the involuntary leakage of urine; in simple terms, to pee by accident. It is the inability to hold urine in the bladder because voluntary control over the urinary sphincter is either lost or weakened. The condition can occur in several forms: stress incontinence, urge incontinence, mixed incontinence, overflow incontinence, and even insensate incontinence. A Female Pelvic Medicine and Reconstructive Surgery trained Urologist is specially trained to diagnose and treat each of these conditions.

Stress incontinence is urine leakage caused by an increase in abdominal pressure. Coughing, laughing, sneezing, lifting, exercising or any increased strain may cause the increase in abdominal pressure. Urinary urge incontinence is when a patient experiences a sudden urge to urinate and is unable to make it to the bathroom. It is often associated with overactive bladder (OAB). Some patients may experience a combination of stress and urge incontinence, known as mixed urinary incontinence. Overflow incontinence is when the bladder doesn’t empty properly and so leaks occur as the limit of the bladder is reached.  It is often characterized by frequent urination as the bladder tries to empty. Overflow incontinence can also be associated with stress and urge.  Insensate incontinence is when urine is noted in the undergarments but one does not know when it occurs.  There is no urge warning or sensation that the leakage is occurring at the time of the episode.  

Once the type of incontinence is diagnosed, your physician can tailor therapies that fit with your lifestyle and goals.  These can range from exercise focused therapies to medicines to minimally invasive procedures.  If you have any type of urinary incontinence, please see a physician specially trained to treat your condition with the best possible therapy for you.  

Whatever you do, please do not feel it is a normal part of aging because it is not.  No need to feel isolated or alone but talk about it with a trusted friend and then find a physician who can listen and help.  Urine should stay in the bladder except at very rare times when the laughter is so hard that no normal physiology could keep it in when rip roaring belly hurting laughter with good friends causes a little to escape!  Strive for health and make good choices ladies. 

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