What is Urinary Incontinence?
Urinary incontinence (leakage) refers to the involuntary loss of urine from the bladder. According to recent reports by the National Institutes of Health, approximately 20 million women experience or have experienced urinary incontinence in the US. It is not uncommon to have fecal incontinence. Contrary to popular belief, incontinence is not a normal part of aging. Fortunately, most of these urinary problems and conditions can be treated.
What are the Types of Incontinence?
Stress urinary incontinence – leakage of urine during events that result from increased abdominal pressure such as sneezing, coughing, physical exercise, lifting, bending, jumping, etc.
Urge urinary incontinence – involuntary leakage of urine accompanied by or preceded by a sudden desire to urinate, also unable to make it to the bathroom in time
Mixed incontinence – stress incontinence that occurs in combination with urge incontinence
Overflow urinary incontinence – the bladder never completely empties, so it continually drips urine
Nocturnal enuresis – night-time bedwetting
How is Urinary Incontinence Evaluated?
A complete medical history will be taken, as well a physical exam. An examination of the urine may help identify causes and conditions. Specialized tests, such as urodynamic, endoscopic, and imaging provides more extensive evaluation into any conditions. You may be asked to keep a bladder diary. You may also undergo a pelvic floor evaluation.
What Treatments are Available?
Any or some of these options are individualized for each patient.
Lifestyle Changes – Avoid constipation, stop smoking,
Bladder Training – techniques that can alter the bladder’s storage capacity and emptying time such as, timed urinating, retraining your bladder to urinate every 3-6 hours, double urinating
Exercise Training – keeping active, walking, core strength exercises
Pelvic Floor Muscle Training – using electronic devices to measure and track pelvic floor muscles to gain control over those muscles, Kegel exercises
Injections - Botox® is injected into the detrusor muscles to paralyze the overactive muscles
Implants - collagen or synthetic material are injected into the tissues around the urethra; the implant adds bulk and helps to close the urethra
Medications – can help inhibit bladder contractions
Pessaries – a silicone flexible ring inserted into the vagina can sometimes help
Neuromodulation – electrical stimulation is used to improve the communication between the nerves that control the bladder, this is an outpatient procedure
Surgery – usually an outpatient surgery, involves placement of a vaginal sling under the urethra