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Urinary Incontinence

Q: What is Urinary Incontinence?
Urinary incontinence is the involuntary loss of urine.

Q: Are there different types of Urinary Incontinence?
Yes. The loss of urine can have different causes, and each cause is treated differently. The most common types of urinary incontinence are

  • Stress urinary incontinence: This refers to the loss of urine with physical activity like coughing, sneezing, walking, straining. ,
  • Urge urinary incontinence: This is urine leakage preceded by a strong urge to urinate
  •  Mixed urinary incontinence: This is a combination of stress and urge incontinence
  • Overflow urinary incontinence: This is leakage which happens when the bladder cannot empty normally

Q: What causes Urinary Incontinence?
The most common cause of stress urinary incontinence is vaginal childbirth. Other causes of stress incontinence include obesity, and prior prolapse repair surgery.
The causes of urge incontinence are less well known, but women with vaginal prolapse are known to be at higher risk for urge incontinence. Post-menopausal women tend to be at higher risk for urge incontinence, and stress incontinence surgery can also increase the risk of developing  urge incontinence.
The cause of overflow incontinence is urinary retention, which are most often caused by severe prolapse, stress incontinence surgery, or rarely, tumors.

Q: What are the symptoms of Urinary Incontinence?
Unexpected urine leakage, or unexpected wet underwear or pads are indications of urinary incontinence.

Q: How is Urinary Incontinence Diagnosed?
Stress Urinary incontinence is diagnosed by looking for a jet of urine from the urethra during coughing or straining. Urge urinary incontinence is diagnosed by looking for unintended urine leakage during bladder filling. Urge incontinence can also be diagnosed if a woman leaks urine associated with an urge that she cannot defer.

Q: Is Urinary Incontinence life threatening?
Urinary incontinence is not life threatening, but it can dramatically affect a woman’s quality of life. Very rarely, tumors can cause urge incontinence, so it is a good idea to have your incontinence evaluated by a pelvic floor specialist to determine if it can safely be ignored.

Q: What if I choose to do nothing about my Urinary Incontinence?
There are generally no ill effects to doing nothing about your urinary incontinence. A woman can usually safely manage the leakage the leakage with absorbent pads, and or specialized underwear. It is a good idea to have the incontinence evaluated by a qualified pelvic floor specialist to determine if the incontinence.

Q: Are there nonsurgical treatments for Urinary Incontinence?
Yes. Nonsurgical treatments for stress incontinence include pelvic floor physical therapy and exercises, pessaries, and vaginal inserts. Nonsurgical therapy for urge incontinence includes bladder retraining therapy (sometimes called timed voiding), vaginal electrical stimulation, tibial nerve stimulation, medications, and pelvic floor physical therapy. Decreasing caffeine intake can also help to decrease urge incontinence symptoms.

Q: What are the surgical options for treating Urinary Incontinence?
Surgical options for stress incontinence include vaginal slings (which can be made from a woman’s own tissues, or from synthetic material), urethral bulking agents, and laparoscopic/Robotic bladder neck suspensions.

For Urge Urinary incontinence, Botox injection into the bladder muscle, and Sacral Neuromodulation (a kind of bladder pacemaker) are both effective treatment options.

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