Urinary Incontinence

What is Incontinence?

Urinary incontinence refers to the inability to control your bladder, while fecal incontinence affects your bowels. There are different types of urinary incontinence. Some people leak a small amount of urine when they sneeze, laugh, or cough. Others experience an uncontrollable need to urinate and struggle to hold the urine until they reach a bathroom. Regardless of how much or how frequently you experience urinary incontinence (UI), it’s probably an uncomfortable and embarrassing problem. Because of this, many people choose not to talk about the issue and instead live with it for years.

Woman with incontinence


Urinary incontinence can have a number of different causes and contributions. One of the most common causes of urinary incontinence is pelvic floor muscle weakness, typically called stress urinary incontinence.

Stress UI can affect people of any age, including athletic teenagers, postpartum moms, men with prostate issues and peri-menopausal women. With pelvic floor muscle weakness, you might experience involuntary leakage during any type of activity that increases abdominal pressure, such as lifting heavy objects, exercise, or even sneezing or laughing.

Urge incontinence describes a sudden, strong urge to urinate with difficulty making it to the toilet in time. Often the urgency has ‘triggers,’ such as thinking about going to the bathroom, putting your key in the door at the end of the day, unbuttoning your pants, or hearing running water. People with mixed incontinence have symptoms of both stress and urge urinary incontinence.

Urge or mixed incontinence may be related to pelvic floor muscle weakness or tightness and spasm. In addition, diet and toileting habits often contribute to this type of UI.

Urinary incontinence can affect women and men of all ages but does become more frequent after the age of 60 and after childbirth. In elderly people living in assisted care facilities, the incidence of UI is close to 50 percent.

Treatment for Urinary Incontinence

Treatment for urinary incontinence focuses on solving the underlying issues. Stress UI typically requires pelvic floor muscle strengthening, while urge UI might actually be a result of tension in the pelvic floor muscles and therefore benefit from help to relax the muscles. A qualified pelvic floor physical therapist can identify the best way to treat your symptoms. Behavioral changes, appropriate exercise, and pelvic floor therapy can usually solve urinary incontinence.

Kegel Exercises

Kegel exercises are one of the most common recommendations given by doctors to address urinary incontinence and help strengthen the muscles inside the pelvis. When these muscles are strong and working properly, they can contract with enough force to prevent stress leakage.

Unfortunately, people are not usually given correct and appropriate instructions on how to do these exercises effectively. In fact, studies have shown that more than 50% of people do them ineffectively! Also, many people with mixed or urge incontinence may be worsening their symptoms by doing Kegels. A pelvic floor physical therapist can give you a strengthening program designed for your body, if appropriate, and make sure you are doing the exercises correctly so that you will see results!


Biofeedback is also very useful for treating urinary incontinence. It teaches the patient how to regain control over his/her muscles by seeing what the muscles are doing on a computer read-out. Many patients find biofeedback very useful to understand the ‘mind-body’ connection, as well as to get motivation from seeing improvement in their computer read-out over time!

If you are looking for help with pelvic health in North Carolina, Dr. Grace and Grace Physical Therapy & Pelvic Health can help you figure out the best treatment option so you don’t have to live with urinary incontinence any longer.