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 Bladder Problems

URINARY INCONTINENCE – Accidental leakage of urine or “urinary incontinence” is a common condition among women.  Studies of the prevalence and incidence of urinary incontinence in women vary – some reporting up to 53% with this condition at some point in their lives.  Although incontinence is seen most commonly in older women and those who have borne children – women of all ages may be affected as well as those who have never delivered a baby.  Severity and personal affect of leakage varies greatly from woman to woman.  For some their degree of leakage may cause mild inconvenience or bother, while others completely altered their social lives because of the potential embarrassment and discomfort of leaking.

Many factors may contribute to the development, progression and severity of pelvic floor disorders.  Practicing a healthy bladder and pelvic floor lifestyle can help prevent or alleviate symptoms.

The general categories of incontinence are stress, urge, mixed.  Less commonly found – functional and overflow incontinence – are each described below.

Stress Incontinence – The “stress” referred to is a physical stress, not an emotional stress.  Stress incontinence is a symptom defined as leakage of urine at the moment of a physically stressful activity.  Common reports are of this leakage occuring with coughing, sneezing, laughing, lifting and/or jumping.  Amount of leakage may range from a few drops to a large spurt or gush of urine.

Urge Incontinence – The symptom “urge incontinence” is frequently described as having the urge (strong desire) to urinate and not being able to hold back the urine before arriving at a toilet.  The bladder begins to empty prematurely and unplanned.  Amount of urine leakage may also be of only a few drops but typically the leakage is more pronounced.

Mixed Incontinence – Mixed incontinence refers to the symptoms of BOTH stress and urge incontinence.

Functional Incontinence – Individuals with mental and/or physical inability to get to a toilet to empty their bladders prior to inadvertent leakage experience “functional incontinence.”  This may be seen in both the community and nursing homes with MS, Parkinson’s, Alzheimer’s, debilitating arthritis and other mobility-limiting conditions.

Overflow Incontinence – Overflow incontinence occurs when the volume in the bladder exceeds its capacity and the urine leaks out of the urethra.  This may occur in individuals with neurologic impairment to the bladder resulting in decreased or absent sensation to void as well as those with incomplete voiding resulting in large amounts of urine being left in the bladder (“Post-void Residual”).

OTHER BLADDER CONDITIONS – section under development

Frequency / Urgency

Painful Bladder Syndrome / Interstitial Cystitis

Urinary tract infections (“UTIs”, “bladder infections”)

Urinary retention

Bladder fistula

Urethral diverticulum

Bowel Problems

ANAL INCONTINENCE – The inadvertent or accidental passing of gas (flatus) or stool (feces) via the anus is called “anal incontinence.”  Anal incontinence can be embarrassing and socially debilitating.  The range of loss with anal incontinence varies from occasional emission of flatus, smearing of liquid stool or complete loss of solid feces.  There is not always urgency or warning associated with the loss.

CONSTIPATION – Bowel movements (BMs) should pass easily, painlessly and with no or minimal straining.   Dry, hard, infrequent and/or painfully or not easily passed BMs occur when we are “constipated.”  Occasional constipation may occur but longstanding issues are referred to as “chronic constipation.”   Not only is this uncomfortable, but the straining usually required to pass the stool may contribute to hemorrhoids, hernias/ prolapse.

INCOMPLETE DEFECATION – Inability to complete or finish a bowel movement can be uncomfortable and aggravating.  Stool sometimes becomes temporarily trapped or difficult to pass – some patients utilize “splinting” or pressing their fingers upon the perineum (area between the vagina and rectum) or the back wall of the vagina to assist in evacuation (emptying).  This symptom of incomplete defecation can sometimes occur when there is a rectocele – or a pouching of the rectum behind the wall of the vagina.