WHEN SHOULD I WORRY ABOUT...

Will Urinary Incontinence Go Away on Its Own?

March 19, 2021 - Katie McCallum

There's no doubt that urinary incontinence affects your quality of life. Leakages can not only irritate your skin and cause embarrassment, but constantly worrying about when one might happen next can keep you from living your life. So much so that you might plan everything you do around whether there's a bathroom nearby.

It's a very common problem affecting up to one in three women. If you're experiencing urinary incontinence, you're likely looking for answers. Specifically, what can you do to stop it?

"Urinary incontinence is a loss of urine when you're not actively trying to urinate," explains Dr. Fiona Lindo, urogynecologist at Houston Methodist. "It can happen without you being aware or with physical exertion, such as exercise or even when simply standing up, coughing or laughing."

"Unfortunately, urinary incontinence isn't likely to go away on its own. The good news, however, is that there are things that you can do on your own to improve it, and there are plenty of options for treating it," adds Dr. Lindo.

Why does urinary incontinence happen?

There are two main types of urinary incontinence:

  • Stress incontinence
  • Urge incontinence

"Stress incontinence occurs when your pelvic floor muscles — the muscles that support your bladder and urethra — weaken, either due to childbirth or over time," says Dr. Lindo.

If you're experiencing stress incontinence, you might find yourself leaking urine when you cough, sneeze, laugh, exercise or lift something heavy.

"Urge incontinence, on the other hand, occurs when the bladder muscle squeezes to empty out urine when it is not supposed to. It may be due to the amount or type of fluids you drink, resulting in spasms," explains Dr. Lindo. "Additionally, urgency incontinence can sometimes be a sign of a larger health complication, such as a bladder infection."

With urge incontinence, you likely experience an overwhelming, sudden need to urinate and leak urine before you can make it to the bathroom.

"For many women the exact cause of their urge urinary incontinence is unknown," adds Dr. Lindo. "However, there are many treatments that can help you manage symptoms."

What can you do to relieve urinary incontinence?

Urinary incontinence almost never goes away on its own. But there are steps you can take to help relieve your symptoms.

"Alleviating urinary incontinence starts with understanding which type of incontinence you're experiencing and what's causing it," says Dr. Lindo. "A specialist such as a urogynecologist can help provide those answers for you, as well as help you understand which behavior modifications and other treatments will be most effective for alleviating your incontinence."

Weight loss almost always helps relieve urinary incontinence because it reduces the amount of pressure being placed on your pelvic floor. In fact, losing just 5 percent of your weight can improve your urinary symptoms by up to 70 percent.

Similarly, pelvic floor exercises, such as Kegels, can help reduce symptoms of either type of incontinence. In the case of stress incontinence, pelvic floor exercises are a way to restrengthen your weakened muscles. For urge incontinence, these exercises can help calm and retrain your bladder.

"For women experiencing stress incontinence after childbirth, sometimes weight loss and postnatal pelvic floor exercises are all it takes for symptoms to resolve over time," adds Dr. Lindo.

Depending on the type of incontinence you're experiencing, your doctor may suggest trying additional modifications.

Behavioral modifications for stress incontinence:

  • Weight loss
  • Pelvic floor muscle exercises
  • The use of a vaginal insert, such as a tampon, while exercising

Behavioral modifications for urgency incontinence:

  • Avoid caffeine, carbonated beverages and artificial sweeteners, which are causes of bladder irritation
  • Pelvic floor exercises
  • Manage your fluid intake
  • Prevent constipation
  • Weight loss
  • Don't smoke

What treatment options are available if urinary incontinence still won't go away?

Seeing a urogynecologist as early as possible can help ensure that you have a complete understanding of your condition and treatments options.

"Both stress and urgency incontinence typically respond well to behavioral modifications, but if things are not improving, it's best to get evaluated," says Dr. Lindo. "This is why I always recommend seeing a specialist about your condition right away. You never want to play the guessing game with your health, especially when your condition affects your quality of life."

In addition, your doctor can recommend a pelvic floor physical therapy program. While Kegels can play an important role in alleviating urinary incontinence, Dr. Lindo says they're performed incorrectly more than 80 percent of the time.

"An incorrect Kegel will not help correct urinary incontinence," warns Dr. Lindo. "Seeing a physical therapist who specializes in pelvic floor exercises can help ensure you're performing Kegels and other exercises correctly and truly strengthening your pelvic floor."

And if your condition continues to progress or worsen, your urogynecologist has expertise to perform testing and recommend a range of urinary incontinence treatment options and procedures that can help to correct your condition and address your specific situation.

Treatment options for stress incontinence:

  • Pelvic floor physical therapy – This can improve up to 75% of symptoms.
  • Pessary – This device, inserted in the vagina, helps control leakage by providing support under the urethra and bladder.
  • Urethra bulking – This office-based procedure can help thicken the wall of your urethra so it more tightly seals to hold urine.
  • Sling urethral surgery – This outpatient surgery stops urine leakage via a sling (made from mesh or your own tissue) that lifts and supports your urethra and lower bladder.

"If stress incontinence is severe, sling urethral surgery is typically about 95 percent successful and there's very little down time as far as returning to everyday activities," says Dr. Lindo.

Treatment options for urgency incontinence:

  • Pelvic floor physical therapy – This therapy helps to retrain the bladder.
  • Medications – A range of medications can help you hold your bladder for longer and decrease your urinary frequency symptoms.
  • Botox injections in the bladder – Botox relaxes the wall of your bladder in order to prevent it from contracting when it's not supposed to.
  • Peripheral nerve stimulation – This treatment uses a needle to stimulate a nerve in your foot that travels up the leg to the spine, where it connects with the bladder and calms it down.
  • Sacral neural modulation – In this outpatient surgical procedure, a bladder pacemaker is implanted to help control how the bladder is stimulated by the sacral nerve.

"Regardless of which type of incontinence you're experiencing, it's important to get evaluated simply because there are so many options for treating urinary incontinence," says Dr. Lindo. "We always start with conservative treatment approaches, but if those don't work, you don't have to continue to suffer. We can help to improve your quality of life."

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