Why Urinary Incontinence Is Not “Normal” (and What It Actually Means)
Urinary incontinence is not always “normal” and often signals an underlying pelvic floor, bladder, nerve, or inflammatory issue. While occasional leakage can happen in high-pressure situations, frequent or unpredictable urinary leakage should be evaluated. Dr. Reza Askari explains that incontinence is typically classified as urge or stress incontinence, both of which have identifiable and treatable causes. In some cases, conditions like endometriosis can also contribute to bladder dysfunction. At PRM, evaluation focuses on identifying the root cause to guide targeted, individualized treatment.
Ask an Endo Surgeon | Urinary Incontinence Isn’t “Normal” What Women Need to Know
Clinical insights informed by Dr. Reza Askari, Gynecologic Surgeon at PRM
Urinary incontinence is something many patients quietly normalize.
It gets brushed off as:
But as Dr. Reza Askari emphasizes in clinical practice, urinary leakage is not something patients should automatically accept as normal, especially when it happens frequently or without a clear trigger.
There are a few situations where leakage can happen occasionally, like holding your bladder for hours or increased pressure during exercise.
But when urinary leakage becomes regular, unpredictable, or disruptive, it deserves a medical explanation.
For patients with chronic pelvic pain conditions, urinary symptoms often reflect an underlying functional or structural issue, not something to ignore.
Not all urinary leakage is the same.
There are moments when leakage can be expected:
These situations create temporary stress on the bladder.
But Dr. Askari highlights a key distinction:
When leakage happens frequently, unpredictably, or with minimal triggers, it is no longer considered normal physiology.
This is where evaluation becomes important.
Most urinary incontinence falls into two major categories:
This occurs when the bladder contracts too strongly or unexpectedly.
Patients may feel:
This is often related to an overactive or “irritated” bladder.
Management may include:
These treatments aim to calm bladder overactivity and reduce urgency episodes.
Stress incontinence is mechanical.
It happens when pressure increases inside the abdomen and the pelvic support system cannot fully contain the urethra.
Common triggers include:
This is often related to weakening or laxity of pelvic support structures, which can occur after childbirth, chronic strain, or repetitive pressure over time.
This is commonly seen in patients with pelvic floor dysfunction.
Treatment may include:
Dr. Askari notes that treatment is individualized based on anatomy, symptoms, and severity.
Bladder control is not just about the bladder itself.
It depends on:
When any part of this system is disrupted, urinary symptoms can develop.
This is why urinary incontinence is often evaluated alongside broader pelvic health conditions rather than in isolation.
One of the most important clinical points Dr. Askari highlights is the role of endometriosis in urinary dysfunction.
Endometriosis is not limited to reproductive organs, it can create widespread inflammation in the pelvis.
This inflammation can:
In some cases, it may also contribute to urinary retention, where the bladder does not empty normally.
This is especially relevant for patients seeking endometriosis treatment who also report urinary symptoms.
Endometriosis can act as a “driver” that disrupts normal pelvic function, not just a pain condition.
Many patients delay seeking care because:
But urinary incontinence is a treatable condition.
And earlier evaluation often leads to more targeted and effective care.
As Dr. Askari explains, management always begins with understanding why the leakage is happening.
That may include:
A comprehensive pelvic pain evaluation helps determine whether symptoms are muscular, neurological, inflammatory, or structural in origin.
Urinary incontinence is common, but it is not something patients should automatically accept as normal.
Occasional leakage in very specific situations can happen.
But frequent, unpredictable, or disruptive symptoms deserve evaluation and treatment.
At PRM, care is focused on understanding the full pelvic system—not just isolated symptoms.
Learn more about PRM’s Center of Excellence in pelvic pain care and our multidisciplinary approach to pelvic floor and bladder-related conditions.
Occasional leakage in high-pressure situations (like coughing or holding urine too long) can happen, but frequent or unpredictable leakage is not considered normal and should be evaluated.
The two most common types are urge incontinence (bladder overactivity) and stress incontinence (mechanical pressure-related leakage).
Yes. Pelvic floor dysfunction can affect bladder support and coordination, leading to leakage, urgency, or difficulty controlling urination.
Yes. Endometriosis can cause inflammation in the pelvis that may irritate the bladder, contributing to urgency, frequency, or urinary discomfort.
Treatment may include pelvic floor physical therapy, medications, bladder Botox for urge incontinence, or procedures such as slings or urethral bulking agents for stress incontinence.
