types of urinary incontinence

Four main types of urinary incontinence affect women and each has different treatment options.

Stress incontinence
Leakage of urine with coughing, sneezing, laughing or any other activities that increase the pressure on the bladder and/or the supporting tissue. Stress incontinence is related to the weakening of the muscles surrounding the bladder and urethra (the tube urine comes out of) or damage to the urethra causing it to remain open.


Urge incontinence
The inability to get to the bathroom in time to prevent leakage of urine. People have usually little or no warning that the bladder needs to empty. Urge incontinence is related to numerous factors, including dietary, neurological and behavioral characteristics.


Mixed incontinence
A combination of urge and stress incontinence.


Overflow incontinence
The involuntary loss of urine that occurs when the bladder fails to empty any significant amount. It constantly fills and overflows. Diabetes and neurological diseases are often contributing factors to overflow incontinence.

getting started

  1. Prepare to discuss this problem with your physician by paying special attention to:
    • Conditions and events that lead to your frequency, urgency or incontinent episodes
    • The frequency of your incontinence
    • The strategies you use to cope with your incontinence

  2. Make sure you obtain records from your primary care provider prior to your visit. If you have had a previous surgery for this problem, obtain those records as well.


  3. Once you have taken the first step in speaking with your physician, the next step is a thorough evaluation by a physician specializing in urinary incontinence in women. This evaluation may include:
    • Patient history
    • Physical examination
    • Urologic assessment:
      • Urinalysis and urine culture
      • Post void residual urine - measured after urination
      • Cystoscopy - a small telescope that looks in the bladder
      • Urodynamics - a series of tests, performed in the office, to determine the characteristics of storing and emptying fluid

 

Once all of the initial evaluation is complete, an individualized treatment plan will be developed to meet your specific condition.

treatment options

Congratulations to you for taking an important first step in addressing issues with continence. Urinary incontinence affects as many as 17-25 million Americans. Experts estimate that greater than 12 billion dollars is spent each year on incontinence and related problems. Approximately 85 percent of those affected with urinary incontinence are women. One out of every four women between the ages of 30 and 59, and 50 percent of the elderly, suffers with urinary incontinence. It affects people not only physically, but emotionally, psychologically and socially. It may lead to embarrassment, social isolation and depression and prevent its sufferers from fully participating in normal daily activities.


With a thorough assessment, we are able to offer several treatment options, which may include:


Noninvasive therapies:

  • Bladder retraining
  • Toileting programs (habit training, prompted voiding)
  • Pelvic floor muscle rehabilitation
  • Dietary management
  • Fluid management
  • Constipation prevention/management
  • Patient education


Rehabilitation therapies:                                    

  • Pelvic floor muscle rehabilitation using biofeedback  (on site and referral to physical therapy)
  • Intermittent catheterization instruction


Devices:                                                                  

  • Fitting of devices (intermittent catheterization, catheters)
  • Referral for on site pessary fitting


Drug therapy:                                                   

  • Anticholinergic/OAB drugs
  • Antibiotics
  • Topical estrogen
  • Alpha blockers


Surgical interventions:                                         

  • Stress urinary incontinence surgery
  • Sub-urethral sling procedures
  • Transobturator sling surgery
  • Synthetic mesh
  • Pelvic organ prolapse surgery
  • Injection of urethral bulking agents
  • Interstim sacral nerve implantation
  • Interstim for urge incontinence
  • Urethral diverticulum surgery


Other treatments:                                             

  • Indwelling catheterization
  • Skin care product recommendations and care
  • Absorbent products and devices recommendations
  • Referrals for dietician, psychologist, gynecologist and physical therapy