Bladder leaking is common.  Around 50% of adult women have it- that is a lot of us!  This percentage applies to all of us, not just older women, not just fat women, and not just unhealthy women.  It also applies to young women, pregnant women, and fit women.  Most women dislike the leaking but don’t stop to think about why they leak urine.  Medically, we care about what is causing the leaking.  This is important, as the different causes of leaking are treated in different ways.  And sometimes, you can be leaking for more than one reason and need more than one type of treatment.  So, why do you leak?

Do you leak urine when you run?

Stress urinary incontinence is when an activity (think sneeze, jump, or laugh) causes you to leak urine.  During the activity, there is an increase in pressure in the belly cavity and it pushes the urine out of the bladder.  This usually happens because the urethra (tube that carries the urine from the bladder to outside the body) isn’t well supported and doesn’t close as firmly as it needs to. If you have stress urinary incontinence, you may be frustrated because you leak with running, exercise, laughing, or cross-fit.

Do you leak urine because you can’t get there on time?

Urgency urinary incontinence (AKA overactive bladder) is feeling the need to pee often (more than 8 times in a day), feeling the need to pee urgently (“gotta-go”), waking up to pee frequently at night, or when you leak urine because you just can’t get there on time.  Generally, this happens because the bladder muscle is contracting at times when it should not be.  It can happen for different reasons but the most common reason is idiopathic (we don’t know why it happens). If you have urgency urinary incontinence, you may leak urine when you park in the driveway, put your key in the door, or when you hear running water.

Do you feel like everything makes you leak urine?

Mixed urinary incontinence is urgency incontinence and stress incontinence.  Some women can have both.  It can be hard to figure out why you are leaking when this happens without some testing. If you have mixed urinary incontinence, you may feel like everything makes you leak urine!

Does your leaking not make sense?

Overflow urinary incontinence is when you leak urine because you are emptying your bladder poorly. Some women don’t empty well and don’t realize it.  When you walk around with a full bladder, you are more likely to leak.  This happens for different reasons including neurologic diagnoses like multiple sclerosis. It can also happen after surgeries. If you have overflow urinary incontinence, your leaking may not follow a pattern!

Diagnosing your leaking

Because each different type of leakage has a different set of treatments, it is important to identify WHY you are leaking.  I do this by talking to you, identifying your symptoms and when you are leaking.  I usually use questionnaires that were specifically designed to diagnose your type of leaking.  If you are interested in self-diagnosing, check out the QUID, one of the questionnaires that I use.  Sometimes it is not possible to diagnose leaking just based on history and physical.  In this situation, I do some testing.  This testing is called urodynamics or a cystometrogram.  It measures that pressures in the bladder, urethra and abdomen and detects what is causing the leaking