When your bladder works as it should, the need to urinate can usually wait — unless you’ve just finished drinking a super-sized soda. If you’re away from home, you might wait for a more private place to take a bathroom break. If you’re driving, you may watch for a safe place with clean, comfortable restrooms.
But if you have an overactive bladder, bathroom basics aren’t so simple. You may experience symptoms such as urge incontinence. This involves a sudden, intense urge to urinate and loss of bladder control. Urine leaks out before you can get to a bathroom.
Urge incontinence is associated with a chronic condition called overactive bladder. There are various types of urge incontinence, including latchkey incontinence. UW Health experts can help with these and other bladder control issues.
What is latchkey incontinence?
Latchkey incontinence is a type of urge incontinence with specific triggers. If you have latchkey incontinence, symptoms may kick in when you’re almost home or the instant you turn the key and walk through the door. You experience sudden urge incontinence — the urgent need to urinate and loss of bladder control resulting in urine leakage.
Although it’s informally called latchkey incontinence, this type of overactive bladder and urge incontinence can have other symptoms and triggers.
“Some people experience nighttime urination frequency and urge incontinence, while others may have different triggers, such as running water,” said Dr. Margaret Wilkes, a UW Health urogynecologist and pelvic surgery specialist. “Sudden exposure to cold environments can also trigger urinary frequency and leakage.”
Dr. Wilkes describes the condition as a breakdown in communication between the bladder and the brain.
“The bladder muscle contracts when it shouldn’t, which leads to symptoms,” she said.
What causes latchkey incontinence?
If you suffer from overactive bladder and latchkey or other incontinence triggers, you’re not alone.
“Bladder disorders are somewhat more common in women than men, but they affect people of all ages and stages of health,” said Dr. Wilkes.
Causes or risk factors for urge incontinence include:
Aging
Excess weight
History of pregnancy and childbirth
History of stroke
Menopause complications
Multiple sclerosis (MS)
Severe or frequent constipation
Smoking
Spinal cord injury
Uncontrolled diabetes
Ways to manage urinary urgency
You can take steps to prevent or limit loss of bladder control, including:
Avoiding bladder irritants, such as alcohol, carbonated drinks, chocolate, citrus fruits and beverages, coffee and caffeinated drinks
Limiting fluids
Managing blood sugar levels, especially if you have diabetes
Scheduling frequent and regular bathroom breaks
When to see a doctor for incontinence
Dr. Wilkes recommends seeing a specialist if symptoms don't improve with lifestyle adjustments. She works as part of a UW Health team of experts offering Integrated Specialty Care for Women. These experts work together to diagnose and treat incontinence, overactive bladder, pelvic and colorectal disorders, and other conditions.
Our experts can find the cause of your symptoms and treat your related disorders. You may have a urinary tract infection (UTI), nerve disorders or urinary retention, which prevents you from fully emptying your bladder.
“People who have MS or any neurologic disease should see us quickly if they have urinary disorders,” Dr. Wilkes said. “These conditions require specialized evaluation and care.”
How to treat latchkey incontinence
UW Health experts offer tailored evaluation and care for urinary incontinence and related conditions.
“We encourage people to make lifestyle changes to manage their chronic condition, regardless of any additional treatments,” said Dr. Wilkes. “Once we diagnose symptoms, we may recommend starting with conservative therapies, such as pelvic floor physical therapy.”
Pelvic floor physical therapy
Pelvic floor therapists focus on pelvic muscles and tissues that support the bladder and rectum. They teach therapies and exercises, such as Kegels, which tighten and relax muscles that control urine flow. Deep breathing and relaxation techniques can also help you manage symptoms.
Medications for incontinence
There are varied types of medications designed to help you hold urine, decrease urinary frequency and lower the amount of urine leakage associated with urge incontinence.
Procedures for incontinence
If nonsurgical treatments aren’t effective, your specialists may discuss minimally invasive procedures for overactive bladder, such as:
Botox for bladder control — Botox injections in the bladder muscle can help reduce leaking caused by nerves that contribute to your overactive bladder.
Nerve stimulation for bladder control — Also called neuromodulation, this minimally invasive procedure uses a surgically implanted device to stimulate nerves that help you control your bladder. There is also a procedure that can be done in clinic that uses nerve stimulation to help improve symptoms.
Choosing UW Health for integrated care
Integrated Specialty Care for Women coordinates care across specialties. Dr. Wilkes is part of a team of fellowship-trained urologists and urogynecologists who have additional obstetrics and gynecology expertise. Their team includes colorectal surgeons, advanced practice providers, nurses, pelvic floor physical therapists and other specialists.
“Issues affecting the vagina and pelvic health, the bladder and urination, and bowel function coexist in many patients,” said Dr. Wilkes. “We work together to address all those concerns. We also work with other providers as necessary to help people get the care they need in one convenient, centralized location.
“Treatment can make a huge difference,” she said. “Our goal is to help people enjoy the things that are important, like family, friends, travel and hobbies.”