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Urge Incontinence, Stress Incontinence, & Overactive Bladder: What’s the Difference?

Urinary Incontinence

If you pee a lot or can’t control when you pee, you may have urinary incontinence. And if you’re like most women, you may assume that urinary problems are a normal part of life—especially as you get older.

But they don’t have to be.

In fact, 80 to 90 percent of women who get treatment for incontinence don’t urinate as often. They also have fewer bathroom accidents.

If your overactive bladder is getting in the way of your life, it can be helpful to know that there are different types of incontinence. Two of the main types are: 

  1. Urge incontinence and
  2. Stress incontinence.

Understanding the differences between stress incontinence and urge incontinence can help you find treatments that work for you.

What Is Urinary Incontinence?

How Do I Know If I Have Incontinence?

The biggest tip-off that you have incontinence is if you can’t always control when you pee.

But you may also have incontinence if you have the following symptoms: 

  • You need to pee a lot (more than eight times a day)
  • You wake up at night because you have to pee
  • You feel like you need to pee badly and that feeling comes on quickly and strongly (called urge incontinence)
  • You accidentally pee when you laugh, cough, or exercise (called stress incontinence)

Lots of women have some kind of urinary incontinence. In fact, one in eight women can’t always control when they pee (also called leaking urine or leakage).

Many women can’t control when they urinate after they give birth. But most new moms shrug these accidents off as normal. However, urinary incontinence is even one of the most common postpartum (after childbirth) pelvic floor complications

Even though bathroom accidents are common, that doesn’t mean you can’t get treatment.

What Causes Overactive Bladder?

When your bladder is full, your bladder muscles move or contract. This movement in your muscles helps you push urine out of your body so you can urinate.

If you have incontinence, this means you can’t always control when your bladder muscles move.

When you have overactive bladder, your bladder muscles contract before your bladder is actually full. These muscle contractions cause you to accidentally pee even though your bladder isn’t completely full and doesn’t need to empty itself yet.

What Conditions Cause Overactive Bladder?

Many medical conditions can cause an overactive bladder. They include the following:

  • infections, including UTIs
  • diabetes
  • pelvic prolapse
  • conditions that affect your nervous system like stroke, Parkinson’s disease, and MS

Even though medical conditions can cause overactive bladder, it’s important to remember that you can still have incontinence even if you’re perfectly healthy.

Your chances of having urinary incontinence go up if:

  • you’re overweight,
  • you’re over age 60,
  • you’ve been pregnant multiple times, or
  • your family members have had urinary incontinence (genetics).

Is Overactive Bladder the Same as Incontinence?

Overactive bladder (also called OAB) is another name for urge incontinence. There are two major signs of urge incontinence:

  1. you need to pee often, and
  2. that feeling is strong and comes on quickly.

Stress incontinence is different. It happens when your bladder has pressure on it when you:

  • cough,
  • laugh,
  • sneeze, or
  • lift something that’s heavy.

Because your bladder has pressure on it, urine leaks out of your bladder without your control.

Your chances of getting stress incontinence go up if:

  • you’re pregnant,
  • you’ve had a baby, or
  • you’re going through menopause.

Home Treatments & Lifestyle Changes for Overactive Bladder

There are several things you can try at home to have more control over when you go to the bathroom.

Try these options:

  • limit caffeine
  • avoid spicy & citrusy foods
  • lose weight (because extra weight puts pressure on your bladder)
  • stop smoking (women who smoke are twice as likely to have pelvic problems)
  • practice pelvic exercises like Kegels

Caffeine: Remember that caffeine is found in many foods—not just coffee. Sodas, teas, chocolate, and even energy drinks can all have caffeine. Why should you avoid caffeine? Caffeine can cause the muscles in your bladder to contract. This can make you feel like you have to pee more often.

Weight Loss: You don’t have to lose a lot of weight to improve incontinence symptoms. Losing just five to 10 percent of your body weight can cut the number of bathroom accidents down by half.

Obesity can affect how the muscles and nerves inside your genital tract work. So obesity can also cause urinary problems.

Pelvic Exercises & Kegels: If aren’t noticing much improvement after doing Kegels at home, a physical therapist can teach you how to do Kegels properly (along with other exercises).

What If Diet & Exercise Don’t Work?

If home treatments don’t work, it may be a good idea to see a urogynecologist. Urogynecologists are doctors who specialize in treating conditions that affect the bladder and other organs in your pelvis, including your vagina, cervix, and uterus.

A urogynecologist can recommend other treatments like physical therapy or devices you can put inside your vagina (like a pessary).

Treatments for Urge Incontinence

Popular treatments for urge incontinence include the following:

  • physical therapy (Kegels)
  • biofeedback, nerve stimulation, or Botox injections
  • pessaries or other devices you insert into your vagina

Bladder Retraining

Another major treatment for urge incontinence involves “retraining” your bladder to pee during certain times of the day.

In the beginning of this type of treatment, you’ll want to empty your bladder often enough that you don’t have accidents. Over time, you can slowly increase the amount of time you wait between your trips to the bathroom.

The goal of this treatment is to retrain your bladder so you don’t have to pee more than every two and a half to three hours.

A doctor can help you set up a record of how often you pee (called a bladder diary). A doctor can also help you decide when and how often you should aim to go pee.

Treatments for Stress Incontinence

If you have stress incontinence, treatments will focus on getting pressure off your bladder so you don’t leak urine when you sneeze, laugh, or work out.

Like urge incontinence, treatments can include physical therapy or diet and lifestyle changes. But treatment can also include urethral inserts.

When to See a Doctor

If you’ve changed your diet or other lifestyle habits but still can’t control when you urinate, you may benefit from seeing a doctor.

It’s an especially good idea to see a doctor if: 

  • you avoid going out in public because you’re afraid you’ll have an accident;
  • you don’t spend time with family or friends because you’re worried you smell like urine or can’t control when you pee; or
  • you’re worried or embarrassed about how often you urinate.

You can schedule an appointment with a urogynecologist or call 801-213-2995.

Resources for Our Patients

When Should You See a Urogynecologist?

Do you have trouble with an overactive bladder, feel pressure in your pelvis, or feel like your vagina, bladder, uterus, or rectum has dropped, causing a bulge or pressure? You do not have to suffer through these symptoms. They are treatable.

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Postpartum and Pelvic Floor Complications

As a mother-to-be or a new mom, there’s a lot you are juggling – life with a new baby, lack of sleep, breastfeeding, and adapting to other changes to your body. Our new clinic for postpartum (after childbirth) pelvic floor problems at University of Utah Health is specifically designed to address pelvic floor issues that may occur before or after childbirth.

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