What is Urinary Incontinence?

Urinary incontinence is an inability to hold your urine until you get to a toilet. Women experience incontinence two times more often than men. Pregnancy and childbirth, menopause and the structure of the female urinary tract account for this difference.

Stress Incontinence

If coughing, laughing, sneezing or other movements that put pressure on the bladder cause you to leak urine, you may have stress incontinence. Pelvic floor muscles support your bladder. If these muscles weaken, your bladder can move downward, causing a bulge in your vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak during moments of physical stress.

Urge Incontinence

If you lose urine for no apparent reason while suddenly feeling the need or urge to urinate, you may have urge incontinence. The most common cause of urge incontinence is inappropriate bladder contractions. Urge incontinence can mean that your bladder empties during sleep, after drinking a small amount of water, or when you touch water or hear it running (as when someone else is taking a shower or washing dishes).

How Is Incontinence Diagnosed?

The first step towards relief is to see a WomanCare physician. After a urine culture is sent to the lab, urodynamic studies are ordered. CLICK HERE FOR MORE INFO >

How Is Urinary Incontinence Treated?

Exercises
Kegel exercises to strengthen or re-train pelvic floor muscles and sphincter muscles can reduce or cure stress leakage. Women of all ages can learn and practice these exercises, which are taught by a health care professional.

Stimulation
Brief doses of stimulation can strengthen muscles in the lower pelvis in a way similar to exercising the muscles. Sensors are temporarily placed in the vagina or rectum to stimulate nearby muscles. This will stabilize overactive muscles and stimulate contraction of urethral muscles. Stimulation can be used to reduce both stress incontinence and urge incontinence and works best when combined with biofeedback.

Biofeedback
This painless therapy provides feedback on the strength and relaxation of your pelvic floor muscles. Using images on a computer screen, you will learn to strengthen, tone and relax the pelvic floor muscles while isolating muscles such as your abdomen and therefore , gaining control over these muscles. CLICK HER FOR MORE INFO ON BIOFEEDBACK >

Timed Voiding or Bladder Training
Timed urinating and bladder training are techniques that use biofeedback. In timed voiding, you fill in a chart recording episodes of voiding and leaking. From the patterns that appear in your chart, you can plan to empty your bladder before you would otherwise leak. Biofeedback and muscle conditioning--known as bladder training--can alter the bladder's schedule for storing and emptying urine. These techniques are effective for urge and overflow incontinence.

Medications
Medications can reduce many types of leakage. Some drugs inhibit contractions of an overactive bladder; however, others relax muscles, leading to more complete bladder emptying during urination. A WomanCare physician can prescribe the proper medication for you.

Pessaries
A pessary is a stiff ring that is inserted by a doctor or nurse into the vagina, where it presses against the wall of the vagina and the nearby urethra. The pressure helps reposition the urethra, leading to less stress leakage. If you use a pessary, you should watch for possible vaginal and urinary tract infections and see your WomanCare doctor regularly.

Implants
Implants are substances injected into tissues around the urethra. The implant adds bulk and helps to close the urethra to reduce stress incontinence. Collagen (a fibrous natural tissue) and fat from the patient's body have been used.

Surgery
Doctors usually suggest surgery to alleviate incontinence only after other treatments have been tried. Many surgical options have high rates of success. A common surgery for stress incontinence involves pulling the bladder up to a more normal position. For severe cases of stress incontinence, the surgeon may secure the bladder with a wide sling. This not only holds up the bladder but also compresses the bottom of the bladder and the top of the urethra, further preventing leakage.

Catheterization
If you are incontinent because your bladder never empties completely (overflow incontinence) or your bladder cannot empty because of poor muscle tone, past surgery or spinal cord injury, you might use a catheter at regular intervals to empty your bladder. A catheter is a tube that you can learn to insert through the urethra into the bladder to drain urine.