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Urinary Incontinence

Types

Urinary incontinence is the involuntary (accidental) leakage of urine. There are several different types of urinary incontinence:

  • Stress incontinence is the most common continence problem in women. It is the loss of urine when stress is placed on the bladder due to coughing, sneezing, laughing, exercising or heavy lifting.
  • Urge incontinence is also a common continence issue. It is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Overactive bladder is a type of urge incontinence, although not everyone with overactive bladder leaks urine.
  • Overflow incontinence is an inability to adequately empty the bladder, which results in the frequent or constant involuntary dribble of urine.
  • Functional incontinence is common in older adults, who may experience continence problems due to a physical or mental impairment.
  • Mixed incontinence occurs when an individual experiences more than one type of continence problem.
  • Short-term incontinence describes continence problems due to urinary tract infections, constipation, or certain foods, beverages and medications. Once these issues are addressed, the continence problem resolves.

Symptoms

The most common symptoms of urinary incontinence are:

Involuntary (accidental) release of urine ranging from small leaks or dribbles, to a large volume that wets your clothing
Urine leakage when you cough, sneeze, laugh, exercise, etc.
Sudden, intense urges to urinate and/or the need to urinate often
A weak urine stream
Feeling that your bladder is not empty, even after urinating

If you are experiencing urinary incontinence, it’s important to speak with your physician. There are many treatment options available to help reduce, control and even cure urinary incontinence-related problems.

Causes

​There are many different medical conditions that can cause urinary incontinence problems in women. Bladder control problems may be caused by:

  • Weakened pelvic floor muscles, which may be due to pregnancy, childbirth or weight gain
  • Problems or damage either in the urinary tract or in the nerves that control urination
  • Bladder disease or irritation
  • Urinary tract obstructions
  • Prior pelvic surgeries
  • Neurological disorders, such as Parkinson’s Disease
  • Emotional stress

Treatment Options

There are many treatment options for urinary incontinence. The type of treatment depends on the type of urinary incontinence you have and how much it affects your quality of life. Your physician will perform a thorough pelvic examination, discuss your symptoms and medical history with you, and order diagnostic tests to help indentify the cause of your continence problem.

There are several diagnostic tools for identifying the causes of urinary incontinence such as pelvic ultrasound and electrodiagnostic testing, which measures the nervous system’s control of the pelvic organs. Other diagnostic studies include bladder capacity testing and cystoscopy, which is used to view the inside of the urethra and bladder.

After your physician has diagnosed the cause of your urinary incontinence, your treatment plan may include lifestyle changes; pelvic floor (Kegel) exercises; pelvic floor physical therapy; bladder training; medications; a medical device, such as a urethral insert or pessary device; or a combination of these treatment options.

In some cases, a minimally invasive procedure may be recommended, such as bulking material injections, which help to increase closure in the urethra and build thickness in the urethral wall so it seals properly. Sacral nerve stimulators are another option that help to stimulate pelvic nerves in order to improve bladder function.

In severe cases or when more conservative treatment options prove unsuccessful, a minimally invasive surgical procedure may be recommended. The most common surgical procedures to treat urinary incontinence, include:

Sling procedures that utilize strips of your body's tissue, synthetic material or mesh to create a pelvic sling or hammock around your bladder neck and urethra to lift them back into a normal position to help keep the urethra closed, especially when you cough or sneeze. There are many types of slings, including tension-free, adjustable and conventional.

Bladder neck suspension is a procedure that uses a suturing technique to help provide support to your urethra and bladder neck, which helps to alleviate the symptoms of stress urinary incontinence.

Because of the variety of innovative treatment options available today, most continence problems can be treated, controlled or even cured. That’s why those individuals who are experiencing a continence-related issue should speak with their physician.

Expert Care

At Hoag, our multidisciplinary team of pelvic health experts consists of urogynecologists, gynecologists and other subspecialists who work together to provide a coordinated approach in the treatment of urinay incontinence.

Hoag’s pelvic health team works together to provide a coordinated approach in the treatment of continence problems, including the latest progressive treatment options personalized to meet the needs of the individual patient.
If surgery is necessary, Hoag’s expert team is well versed in the full gamut of minimally invasive laparoscopic techniques, including robotic-assisted surgery utilizing the state-of-the-art da Vinci® Surgical System.

For more information about the diagnosis and treatment of urinary incontinence, please speak with your physician, or locate a Hoag-affiliated physician near you.