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Urogynecology

Urinary Incontinence

Definition
Urinary incontinence is any involuntary leakage of urine, whether it’s a large amount or just a few drops. More than 38 percent of women in the United States experience urinary incontinence. The four most common types of urinary incontinence are stress urinary incontinence, urge urinary incontinence, mixed urinary incontinence and overflow incontinence.

Stress urinary incontinence is leakage with physical activity. Urge urinary incontinence is leakage preceded by a sudden urge to urinate. Mixed urinary incontinence is a mix of both stress and urge incontinence. Overflow incontinence is leakage due to a bladder that is always too full.

Symptoms
Women with stress urinary incontinence experience leakage of a small to moderate amount of urine with activity. This includes coughing, sneezing, laughing, running, walking, bending over, lifting or just changing positions.

Symptoms of urge urinary incontinence include a moderate to large loss of urine immediately preceded by a sudden, strong urge to urinate. Women with urge urinary incontinence are often not able to make it to the bathroom in time. Some women experience urge urinary incontinence when they hear running water or get close to a bathroom. Certain foods and beverages can make urge urinary incontinence worse.

Women with mixed urinary incontinence suffer from symptoms of both stress and urge urinary incontinence. Often one type seems worse than the other.

Symptoms of overflow incontinence include the continual loss of urine without a sense that the bladder is full. Other symptoms associated with overflow incontinence are an incomplete emptying of the bladder, a slow urine stream, difficulty starting urination or dribbling of urine after urination is complete.

Causes
While the likelihood of experiencing urinary incontinence increases with age, it is not considered normal by any means and can interfere with work, socializing, exercise and sexual functioning. Urinary incontinence can be caused by a urethra that does not compress tightly enough (stress urinary incontinence), the bladder muscle contracting when it is not supposed to (urge urinary incontinence) and urinary retention, or the inability to urinate (overflow incontinence).

Diagnosis

Click here to learn more about diagnostic testing.

Urinary Incontinence Treatment

Both non-surgical and surgical treatment options are available for urinary incontinence, depending on which form the patient is diagnosed with.

Non-surgical treatment options include:

  • Kegel exercises
  • Pelvic floor therapy
  • Low-dose vaginal estrogen
  • Vaginal pessary
  • Urethral insert
  • Various overactive bladder medications
  •  

Surgical treatment options include:

  • Suburethral sling
  • Tension-free Vaginal Tape™ (TVT)
  • Urethral injections
  • InterStim™ Therapy
  • BOTOX®
  •  

Click here to learn more about the treatment options available for urinary incontinence.


Click here to view before and after photos of urinary incontinence.

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