As we age, we’re still the same person we have always been, just slightly different physically. Our muscles weaken, we gain weight, start losing hair, and developing wrinkles, just to name a few changes. Another change that we may notice is with bathroom habits, especially in women. We like to think that recognizing and controlling urinary urges is something we have in the bag and have for a majority of our lifetimes, almost like second-nature. Our bladder signals to our brain that it’s full, we feel the urge to go, and we seek out a place to relieve ourselves. As we age and our bodies change, this process may become a little more complicated and may lead to urinary incontinence.
What is Mixed Incontinence?
The term “urinary incontinence” is actually fairly broad as there are four identified forms of urinary incontinence. Urge Incontinence is also referred to as Overactive Bladder and occurs when a sudden, strong urge to go comes about and cannot be held back. Stress Urinary Incontinence (SUI) occurs when pressure or “stress” is placed on the bladder, abdomen, and/or urinary tract causing an involuntary leak. Overflow Incontinence happens because there is a blockage in the urinary tract or the bladder is too weak to empty correctly, causing residual urine to build up, while simultaneously not sending signals to the brain the bladder is full. Mixed Incontinence occurs when two or more urinary incontinence symptoms are present, most commonly SUI and Urge Incontinence. In most cases, one set of symptoms is more prevalent than the other. If you leak during the following activities, you may be experiencing SUI, and perhaps Mixed Incontinence as well:
If you’re experiencing a sudden, desperate urge to go that results in a leak in addition to other urinary incontinence symptoms, you may have Mixed Incontinence involving both SUI and OAB.
Because Mixed Incontinence is a combination of both Stress and Urge incontinence, the causes of the symptoms are usually the same. In the case of SUI, a weak pelvic floor is to blame. The pelvic floor is the group of muscles, tissues, and nerves that support the urinary tract and urethra. As a result, the urethra leaks when put under pressure as the pelvic floor is too weak to close it. The pelvic floor can be weakened from:
- Pelvic surgery or radiation – cervix, uterus, prostate, etc.
- Repeated high-impact activities – running, gymnastics, horseback riding, etc.
- Chronic coughing
In the case of Urge Incontinence, or Overactive Bladder, the bladder is performing just as described. The muscles in the bladder are over-contracting, either because of a miscommunication between the brain and the bladder about when you need to “go” or because the bladder is physically spasming and contracting on its own regardless of fullness. Either cause may result in a leak, especially if you’re also experiencing SUI symptoms. There are risk factors that may lead to developing OAB. They include:
- Neurologic disorders or damage to the signals between your brain and bladder
- Post-menopausal women
- High BMI
- Pelvic muscle weakness or spasms
- Previous surgeries (POP surgery, urinary incontinence procedures)
- Developing a Urinary Tract Infection
Again, if you’re experiencing urinary incontinence symptoms that match either one or more of these descriptions, see a healthcare professional! Urinary incontinence may be common, but that doesn’t mean you have to live with leaks. There are solutions for light bladder leaks, no matter the causes.
Luckily, for those suffering from light bladder leaks, it is a fairly common problem that has garnered multiple solutions to fit every lifestyle and budget. Talk with your doctor if you’re not sure which solution would be right for you!
Pads & Liners – These are made to fit much like pads and liners meant for menstruating women, and are usually even found in the same aisles at the store. While they are designed to fit the same way, incontinence pads are designed to quickly whisk away urine and not blood. Pads and liners are a quick, convenient way to cover leaks, but are often bulky and noticeable and have to be changed every few hours to prevent odor and infection.
Surgery – Pelvic mesh surgery or pelvic sling surgery is a procedure in which either artificial mesh or a sling made from organic matter (skin graft) is used to internally support the urethra and reducing leaks.
Medication – For those that are experiencing symptoms with OAB, medication is available to take orally to calm overactive muscles, as well as Botox injections to achieve the same results. For those with SUI symptoms as a result of slowed estrogen production during perimenopause, your doctor may prescribe a hormonal supplement. This prescription will allow for increased estrogen in the body, which will help line and support the tissue surrounding the urethra.
Exercise – Kegels are pelvic floor exercises that may help reduce leaks by contracting and relaxing the muscles that start and stop the flow of urine.
Another solution for women suffering from Stress Incontinence is a bladder support device called Revive®. Revive works from the inside out to reduce leaks for up to 12 hours a day. The reusable device is one size, easy to insert, and FDA-cleared for over-the-counter use. Now available in retailers nationwide! Find a store near you.