A Story about Leaks, Awareness, and Information: Our Incontinence 101

While menstrual health has slowly but surely been gaining more attention on supermarket shelves, in the media, and in our consciousness, another form of leakage is still often deemed invisible. 

Whether it occurs during a Pilates class, on the dance floor, or due to an allergy-induced sneeze, people rarely discuss incontinence openly.  

However, research shows that in the Netherlands, 49% of adult women reported experiencing urinary leakage, making it crucial to break taboos, educate, and spread awareness. 

That´s why we met up with gynecologist Dr. Andreas Widschwendter, who gave us a deep dive into all things incontinence. Are you in for a splash? 

1. What is incontinence, and what different forms are there? 

Urinary incontinence refers to the involuntary and uncontrolled leakage of urine. There are four main types of urinary leakage: 

• Stress incontinence (exertional incontinence): Urine leakage during physical exertion, coughing, sneezing, going downhill, or jumping. 

• Urge incontinence: A sudden, strong urge to urinate followed by involuntary urine leakage. 

• Overflow incontinence: The bladder can’t empty completely, fills up more and more, and then “overflows.” 

• Reflex incontinence: Caused by neurological disorders (e.g., spinal cord injury).

2. What causes incontinence? 

The cause of urinary leakage often depends on the type of incontinence. 

A weak or damaged pelvic floor (e.g., after pregnancy or childbirth) often causes stress incontinence. Other causes can include pelvic surgery or hormonal changes, especially due to estrogen deficiency during menopause. Experts also frequently cite obesity or chronic coughing (as seen in smokers or asthma patients) as contributing factors. 

Urge incontinence often results from an overactive bladder, which typically has no obvious organic cause. Recurring bladder infections or urinary tract infections can also trigger this type of incontinence. Additional factors that may contribute to urge incontinence include neurological diseases like multiple sclerosis or Parkinson’s, as well as tumors or polyps in the bladder. 

As the name implies, overflow incontinence usually stems from problems emptying the bladder. In this case, the bladder never fully empties despite the urge to urinate, which can result in leakage. Other causes include a narrowing of the urethra, nerve damage due to diabetes, or side effects from medications like psychotropics or muscle relaxants. 

Reflex incontinence can be a symptom of neurological disorders. Conditions such as multiple sclerosis, spinal cord injuries, or brain and spinal cord damage (e.g., from injury or tumors) are often associated with this form of urinary leakage. 

3. How should I deal with incontinence? 

In cases of incontinence, it’s best to seek a prompt and thorough medical evaluation. Since incontinence often appears as a symptom of other underlying conditions, gaining clarity and information is a key part of managing it. 

A comprehensive understanding and an open approach also contribute to a sense of security, something especially valuable when dealing with incontinence. Often it’s not just the physical but also the mental burden that patients with incontinence encounter, affecting their quality of life. In this context, for example, it is crucial to find products that make you feel supported and comfortable throughout your day.  

4. When should I seek medical help? 

For mild stress incontinence, pelvic floor training under the guidance of a physiotherapist can be a helpful and effective approach. For more severe stress incontinence and all other types, doctors strongly recommend a medical evaluation. 

5. Can incontinence be temporary, or is it always permanent? 

After childbirth, temporary urinary incontinence is quite common. With targeted pelvic floor training, this type is often short-lived. If the underlying cause of urge incontinence is treated (e.g., polyps, infections), this form of incontinence can also be resolved. 

But most importantly it’s crucial to talk openly about these topics, seek help when needed, and not let societal pressure convince you that you should feel ashamed of your body! 

Links 

Dr. Andreas Widschwendter´s homepage 

Leading Medicine Guide Dr. Andreas Widschwendter