Urogynecology/Incontinence
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Urinary incontinence is the inability to control urination. It may be temporary or permanent, and can result from a variety of problems in the urinary tract.

Often, more than one type of incontinence is present. When this occurs, it is called mixed incontinence. Because incontinence is a symptom, rather than a disease, it is often hard to determine the cause. In addition, a variety of conditions may be the cause.

Types of Urinary Incontinence

There are two types of incontinence that women experience:

  • Stress incontinence is caused by activities (coughing, sneezing, laughing, running, or lifting) that apply pressure to a full bladder. Stress incontinence is very common among women, with childbirth and menopause increasing the risk for it. It can also affect men who have had surgical procedures for prostate disease, especially cancer.

  • Urge incontinence, also called overactive bladder, is marked by a need to urinate frequently. There are many causes of urge incontinence, including medical conditions (benign prostatic hyperplasia, Parkinson’s disease, multiple sclerosis, stroke, and spinal cord injuries), surgeries (hysterectomy, radical prostatectomy), and infections.

Syptoms of Urinary Incontinence

It is possible to experience one or more of these signs and symptoms of bladder and bowel incontinence:

  • Frequent urge to urinate (overactive bladder)
  • Urine leakage more often or in greater amounts
  • Weak urine stream
  • A urine stream that stops and starts
  • Difficulty emptying bladder
  • An urge to urinate after urination
  • Frequent or ongoing bladder infections
  • Feeling of bladder fullness that cannot be relieved by urinating
  • Blood in the urine that is not associated with a urinary tract infection
  • Pain with full bladder
  • Pelvic pressure and vaginal fullness
  • Stool leakage (anal incontinence)
  • Constipation or straining to have a bowel movement
  • Bladder or bowel fistula (abnormal hole between the bladder or bowel and any other organ of the body.)

Treatment of Urinary Incontinence

Treatment options for urinary incontinence depend on the type of incontinence and the severity of the condition. Treatments include:

  • Lifestyle Changes. Significant weight gain can weaken pelvic floor muscle tone, leading to urinary incontinence. Losing weight through healthy diet and exercise is important. Regulating the time you drink fluids and avoiding alcohol and caffeine are also helpful.

  • Behavioral Techniques. Pelvic floor exercises (Kegel exercises) can help strengthen the muscles of the pelvic floor that support the bladder and close the sphincter. Bladder training can help patients learn to delay urination.

  • Medications. Drugs, such as oxybutynin (Ditropan, generic) and tolterodine (Detrol), are mainly used to treat urge incontinence.

  • Surgery. Many types of surgical procedures are used to correct anatomical problems that contribute to severe urinary incontinence.