How To Stop Urine Leakage When Coughing
Discover the reasons you may be leaking urine when coughing, and what you can do about it.
In order to help you stop urine leakage when coughing, we have to figure out why you are leaking in the first place.
There are a number of reasons why somebody might be leaking urine when coughing:
The pelvic floor muscles are weak
There is poor coordination of the pelvic floor muscles: meaning that the muscles are relaxing when they should be contracting.
There could be a prolapse or downward displacement of the bladder.
The first reason, is that the pelvic floor muscles are weak. This weakness could be a true weakness, or a relative weakness. True weakness means that when tested, the muscles are actually weak. Relative weakness means that the muscles are weak relative to the task. In this case, the force that is placed down on the pelvic floor is greater than the pelvic floor muscle strength force.
The excess force that is placed through the pelvic floor muscles mostly happens due to compensations in the body. Therefore if we fix the compensations, somebody can improve whether they are leaking with a cough (even without ever getting the pelvic floor muscles stronger!).
Another reason that somebody might be leaking urine when coughing, is that there is poor coordination of the pelvic floor muscles. In this situation, the pelvic floor muscles are actually relaxing when they should be contracting.
In normal circumstances, as somebody coughs, their pelvic floor muscles should reflexively contract to counteract the force of the cough. However sometimes, due to poor mechanics, habits, and other postural reasons, the pelvic floor muscles do the opposite of what they should do.
The last reason you could be experiencing urine leakage when coughing could be happening is due to a prolapse or a downward displacement of the bladder. In this situation, the bladder sits lower in the pelvic cavity, therefore making the squeeze and contraction of the pelvic floor muscles less effective.
So how do we stop urine leakage when coughing?
If the urine leakage is happening because the pelvic floor muscles are weak, pelvic floor muscle training and strengthening would be an effective way to resolve urine leakage when coughing. Things that can help with this include strengthening of the pelvic floor muscles, the hip muscles, and the core muscles.
If the urine leakage is happening because there is poor coordination of the pelvic floor muscles during the cough, then retraining timing, breath, posture and teaching patient strategies like the "knack" can be effective.
The “knack” is a strategy where you essentially squeeze before you cough. So as you feel a cough coming on, you would try to squeeze your pelvic floor muscles right before you coughed.
Lastly, if your urine leakage is happening due to a prolapse, pelvic floor muscle training, and possibly use of a pessary, which is an intravaginal support to the bladder could be effective. The pessary would stay in for a period of time, usually several months depending on the pessary, and it is extremely effective at helping to keep the bladder lifted so that your pelvic floor muscles can function optimally.
And all three situations, pelvic floor physical therapy is extremely effective at identifying why you may be experiencing urine leakage when coughing, and directing you to the appropriate treatment for this condition.
Unfortunately, many patients are told to "just do Kegels" (or repetitive pelvic floor contractions) in order to manage their symptoms. The problem with just doing Kegels is that they only address one aspect of why somebody might be leaking when coughing. Kegels do not address timing concerns, and will not be enough to help patients overcome urinary leakage if there is a prolapse present.
If you are struggling with the urine leakage when coughing, this is something that can be addressed virtually or in person. If you our local to be bucks county, PA area we can see you in the clinic. Otherwise, we can do virtual sessions to help you overcome urinary leakage. Click here to find out more.
