“Stress” vs. “Urge” Incontinence

The symptoms of incontinence can vary from person to person.  Some may experience minor leaking every once in awhile, while others may experience complete loss of bladder control daily.  There are also different kinds of incontinence, the two most common being “urge incontinence” and “stress incontinence.”  Let’s take a closer look at the differences between these two types of incontinence. 

We will first define “stress urinary incontinence.”  It is the involuntary loss of urine as a result of increased intra-abdominal pressure from activities such as laughing, coughing, sneezing, or jumping.

And the definition of “urge incontinence” is the involuntary loss of urine following a strong, unexpected urge to urinate due to involuntary bladder spasms.

Although the result of these two types of incontinence is the involuntary loss of urine, there are many differences between urge and stress incontinence.  For example, stress incontinence is caused by distinct activities that increase our intra- abdominal pressure, whereas urge incontinence is unpredictable and unexpected.

Another difference is that stress incontinence is due to ineffective contraction of our pelvic floor muscles, meaning that we can’t get our muscles to contract when we want them to.  On the other hand, urge incontinence is due to involuntary contractions of our bladder muscle.  These are unwanted contractions that we can’t voluntarily stop.

And the final difference is in the treatment of these two types of incontinence.  Stress incontinence is most often treated with pelvic floor muscle training and strengthening, whereas urge incontinence is often treated with a combination of medication, bladder retraining, and pelvic floor muscle strengthening.

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7 Responses

06.08.10

Does pelvic floor strengthening help with a urethra that does not close? My incontinence is unpredictable, with constant leaking. Social situations are a nightmare – will I have an “accident”? I believe that perhaps exercise and perhaps a urethral plug would help my situation, but have no idea who to contact about the plug. Any suggestions?

06.08.10

Mary,
Sorry about my delay. We just returned from vacation. As for your quesitons – I do think that exercise will benefit you. The more support you can give your body through strengthening your entire pelvic basket and being aware of your posture throughout your day, will only help to support your urethral sphincter muscle.

As for finding a urethral plug. Talk to you OB/Gyn and if they don’t have an answer, ask for a referral to a recommended urologist or urogynocologist in your area. The plug will allow your to increase your activity level which can be a key to your recovery of control.

Good luck!

-Tasha

06.08.10

I an doing pelvic floor strengthening to help with a urethra that does not close, and I am still having trouble. Do you have any suggestions?

06.08.10

Are you working your pelvic floor along with your transversus abdominus and your multifidi? This would be your first step. If you are confident that you have maximized this muscular control and you are holding appropriate “neutral spine” throughout your day, then you can move on to assistive devices. Options available are urethral plugs and pessary devices. Both of these options will require fitting by your gynecologist and thorough instruction in use.

I want to stress the importance of a consistent, thorough exercise program as your first option. There are no side effects or risks associated with this option. It may required a visit to a women’s health PT for “hands on” assessment and feedback.

Tasha

06.08.10

I do not typically post any private info or questions online, but I just purchased your DVD and I am left with a few questions. First, let me say, I have researched “pelvic floor muscles” for a while and I have never been better educated than I am now after watching just 20 minutes of your DVD. Thank you for considering other women without avenues of information in creating your video. I am among those women who lacked knowledge and have done very little to improve my condition.
I am 30 years old and experienced both a cystocele and a rectocele while six months pregnant with my fourth child. I had a very successful vaginal delivery with no complications. The three and a half years to follow I have only experienced minor discomforts such as a constant urge to urinate and feeling like I could not completely empty. I began to seek medical help as my husband and I desired more children. A medication for nerve damage was recommended to me, but a side effects was incontinence and I thought I would rather have the other discomforts. Now I am pregnant with our fifth child and am already experiencing a 1st degree cystocele and rectocele with further discomforts.
My questions are: Can I do these exercises while pregnant? Is discomfort during these exercises normal for a woman in my condition?
I hope this is not too long. Thank you for your time.
Melissa
If it is helpful to mention I am otherwise a very healthy woman maintaining optimal weight with exercise and good nutrition

06.08.10

Melissa,

I have just emailed you my complete pregnancy write-up. This will be great information and exercises for you to work through consistently during your pregnancy. Keep in mind that immediately following delivery that you can begin the exercises on the Hab It dvd as long as you have no discomfort. One of my favorites following delivery is to get on your stomach and work throught the multifidi extensions. Its a nice way to not only work your multifidi, but also to give a passive tension to the muscles of your pelvic floor.

Feel free to ask any questions after you read through and work through the pregnancy write up.

_-Tasha

06.08.10

Hi Tasha.
I have grade 2 cystocele and rectocele. I am four months pp. My partner and I are already thinking of having baby number two.

When I was diagnosed with pop I was devastated. I had never heard of pop before until my diagnosis. I was an avid long distance runner. I now wear a pessary and can run 3 miles and I also love to workout to Jillian Micheals. My urogyn said I can workout with my pessary. I’ve heard horror stories about surgery and don’t want to go that route. I would also like to have another child but I’m afraid to. I’m afraid the pressure of the baby would harm me further and I’m afraid of what delivery could do to my current situation. However I don’t want my son to be an only child and I don’t want to experience what a stage 3 or stage four cystocele could be like.

I know you had pop with your three pregnancies. Could you share a little more of your story? What grade was it?

I need some encouragement and some inspiration. I find it difficult to find time to workout and do your video everyday with trying to raise a family.

Also I bought the kegel8. What is your experience with kegel8?

Thanks for your time.

Stephanie

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