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.
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.
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
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.
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.