What Is Urge Incontinence?

Photo of toilet sign showing running person

Urge incontinence–sometimes referred to as overactive bladder–is a sudden, uncontrollable need to toilet, usually in response to something. For example, when you return home from shopping and leak as you rush to the bathroom. You turn on a faucet or hear running water and you suddenly have to go. Maybe you put your hands in water, or step into the shower. Urge incontinence usually results in the loss of a significant amount of urine–not just a few drops.

Crouching as you run to the bathroom does not help, and in fact can increase the chance of a leak. When you crouch, you increase the pressure in your abdomen (your “intra-abdominal pressure”), which makes it harder to stop the flow of urine.

Urge incontinence can be due to imbalance in the autonomic nervous system. The autonomic nervous system has two parts: the sympathetic nervous system, and the parasympathetic nervous system. These two parts are like a see-saw: if one is high, the other is low. They both cannot be activated/”high” at the same time.

The sympathetic nervous system gets revved up by caffeine and adrenaline. The parasympathetic nervous system gets “revved down”, so to speak, by deep breathing, letting go of tension, relaxation. If you consistently live your life under pressure of time deadlines, chances are your sympathetic nervous system is in overdrive most of the time, and the parasympathetic nervous system rarely gets to kick in.

Maybe you feel the urge to go to the toilet and notice that you have varying amounts of urine output—maybe a lot, or maybe a little. The message is sent to the brain that the bladder is full, but it may not be full.

The message being sent up to the brain is not as accurate as it could be, and the sympathetic nervous system can be responsible for sending a message prematurely to the brain something like this, “Hey! We’re getting full down here! You better take action!” when in reality, the message that would be sent by the parasympathetic nervous system is, “Everything is fine. Your bladder is starting to fill, but there is plenty of time before it tops out.”

Weakness in the pelvic floor muscles also play a role in urge incontinence. The bladder can go into fierce and frequent contractions that are so intense the pelvic floor muscles that would normally hold back the flow of urine cannot do so and this leads to a large leak you cannot stop. A significant episode of urge incontinence may require you to change your clothing even if you were wearing a pad.

Fortunately, there are ways to manage and even eliminate urge incontinence. There are activities you can do to deliberately activate the parasympathetic nervous system. Diaphragmatic breathing (long, slow breaths from the diaphragm) help by stimulating the nerves that exit the thoracic and lumbar spine that innervate the bladder to calm down. Deep breathing can result in your parasympathetic nervous system being activated, so the “everything is fine” message is sent up to the brain and you are no longer in danger of a large, sudden leak of urine.

Urge incontinence is no fun, but with practice, and mindful attention to how you are going about your daily life, you can actually have a positive impact on it.

(Photo credit: mantasmagorical from morguefile.com)

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