Random small to moderate leaks?

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Anyone else have this issue? I have mixed incontinence but sometimes just when standing up after sitting down, or walking more fast I have random leaks. I understand both stress and urge, but in this case its just random?
 
Hi Koigal,

if I understand you correctly, you have random leaks while standing, sitting and walking.

I think that these leaks are not as "random" as it may seem. In fact, it is most likely part of the stress incontinence problem. The crucial factor is the pressure in the lower abdomen, which increases during such activities. Normally, one already unconsciously tries to work against this with the pelvic floor. If the pelvic floor or sphincter is weak, however, this is sometimes no longer sufficient.

This is sometimes difficult to reproduce when it is in a "border region", so to speak. For example, if you lift something on purpose to stand up quickly or climb stairs to increase the pressure then you think about it, tense the pelvic floor and nothing happens. It only happens when you don't think about it and the normal tension is no longer sufficient.

If I understood you correctly, you have already been to two PT's and they could not help. How long and how often did you do the exercises? Normally you should do it daily - or even several times a day - even if it gets better.

The pelvic floor is basically a muscle like any other. If you go to the fitness center twice, you won't come out as a bodybuilder. It's the same with the pelvic floor - it takes a while.
 
From what I remember even when keeping up after a few months, I didn't notice any change honestly. They mentioned hypertonic or weak yet tight, but this was awhile back. Sometimes with kegels, that can cause bladder spasms worsening, so I try to avoid that.
 
Hi Koigal,

hypertonic pelvic floor is not that common - but yes, of course it can be.

In this case, Kegels make no sense at all and only make things worse. And yes in such a case they can also cause bladder spasm.

I wonder a little about PTs - because they should know this. Normally a PT would help you feel the tight muscles in this case. If you can feel them, then you can specifically try to relax them. Breathing exercises can also help with this, for example.

The important thing is to find the muscle in the first place, because you don't necessarily notice its tightness. If you can feel it, you can put pressure on it with your finger to get a feeling for where it is.
 
Changing positions and walking make me pee more. Seems to be the worst when getting out of bed and when getting out of a car.
 
@Koigal I experience mild stress incontinence (definitely no urge) and notice that I’ll often lose control a couple of times when I’m lying in bed at night reading. This doesn’t make sense to me as I don’t think that lying down increases intra abdominal pressure.
 
Had a leak last night getting out of bed myself, thankfully it was a lighter one but I should seriously consider switching to pullups since I am a side sleeper.
 
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