Incontinence is a very common problem, but no one should have to live with it, says Anne Wiskind, M.D., a urogynecologist at Piedmont Atlanta Hospital.

“Incontinence can be really life-changing and affect somebody’s quality of life,” says Dr. Wiskind.  

There are two main types of incontinence:

• Stress incontinence, when bladder leakage occurs during coughing, laughing, sneezing and exercise.
• Urge incontinence, which is often more bothersome and embarrassing to patients than stress incontinence. This occurs when someone has the uncontrollable urge to go to the bathroom and their bladder will start to leak no matter where they are.

Abnormal bladder function

“Normally when somebody is going to void, their bladder fills, then it signals to the spinal cord that it’s full, and then that [message] goes to the brain,” explains Dr. Wiskind. “That [part of the brain] tells another part of the brain [the hypothalamus] that you need to go to the bathroom. Once you’re in a suitable place, it signals the bladder to empty.”

Urge incontinence occurs when there is a breakdown in the communication between the brain and the bladder. The bladder sends a message to the spinal cord indicating it is full and instead of sending that message to the brain, the spinal cord “tells” the bladder to empty right away. 

“The brain never got the message,” she says.   

How to retrain the bladder to listen to the brain

It’s possible to retrain your bladder to listen to your brain again, says Dr. Wiskind.

One of the most common methods is timed voids, where you empty your bladder by the clock – usually every one to two hours. By doing this, the bladder gets used to listening to the brain again.

 “Even though urge incontinence is common as you get older, it’s not normal,” says Dr. Wiskind. “You don’t have to live with it. It’s all a matter of mind over bladder and you can take control.”

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