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Urinary Incontinence in Women

Urinary incontinence can negatively impact a woman's quality of life. If you have questions about urinary incontinence or would like to make an appointment, please call 315 464-1500.

We offer the most advanced and innovative treatments and minimally invasive procedures and deliver care with expertise in a patient-centered atmosphere. Women in Central New York and the surrounding area choose Upstate Women's Urology to provide both time-tested and cutting edge treatments for a wide range of women's pelvic health and urologic concerns.

Definition

Urinary incontinence is a loss of bladder control that results in urine leaking.

There are three main types:

  • Stress urinary incontinence—Urine (pee) leaks when pressure is put on the belly, such as when laughing, sneezing, or lifting heavy things (most common type)
  • Urgency (urge) urinary incontinence—Urine leaks during or after a strong urge to pass urine
  • Mixed urinary incontinence—A combination of the above types

Causes

Stress incontinence may be caused by:

  • Poor pelvic floor muscle function
  • Damage to the tissue that supports the bladder and urethra (the tube that carries urine out of the bladder)
  • Problems with the muscle that controls urine flow

The cause of urge incontinence is not clear. It is likely due to many factors, including the aging process.

Muscles Involved in Incontinence in Women
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Risk Factors

Urinary incontinence is more common in women 45 years of age or older. Other things that may raise the risk are:

  • Childbirth
  • Obesity
  • Diabetes
  • A family history of urinary incontinence
  • Hormone replacement therapy
  • Taking certain medicines, such as diuretics and antidepressants

Symptoms

The main symptom is not being able to control the flow of urine.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. This is usually enough to make the diagnosis. Other tests may be done to look for a cause. Urine may be tested.

Treatment

Any underlying causes will need to be treated. The goal of treatment will be to help control the flow of urine. Options are:

Lifestyle Changes

Lifestyle changes that may help to control the flow of urine include:

  • Behavioral therapy and pelvic floor muscle exercises, such as Kegel exercises
  • Limiting caffeine intake
  • Reaching or maintaining a healthy weight through diet and exercise
  • Using pads to collect urine when it passes

Medicine

Any medicine that is causing urinary incontinence will be stopped or changed.

Medicine may also be given to help control the flow of urine. Some options are:

  • Medicines to relax bladder muscles, such as anticholinergics and beta-3 adrenergic agonists
  • Antidepressants, such as duloxetine
  • Estrogen—low levels can weaken bladder muscles

Procedures

People who are not helped by these methods may need procedures or surgery. Options are:

  • Injections of bulking agents into the urethra to help stop leaks
  • Botulinum toxin (Botox) injections to help relax the muscles of the bladder
  • Implanting devices to stimulate the nerves of the bladder to help control the flow of urine
  • Placing strips of material or sutures to ease pressure on the urethra, such as with a urethral suspension

Prevention

The risk of urinary incontinence may be lowered by doing exercises to strengthen pelvic floor muscles.

References

  • Bladder control problems in women (urinary incontinence). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women. Accessed December 19, 2020.
  • Overactive bladder (OAB). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/overactive-bladder-(oab)?article=112. Accessed December 19, 2020.
  • Sobhgol SS, Charandabee SM. Related factors of urge, stress, mixed urinary incontinence, and overactive bladder in reproductive age women in Tabriz, Iran: a cross-sectional study. Int Urogynecol J Pelvic Floor Dys Function. 2008;19(3):367-373.
  • Urinary incontinence. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/urinary-incontinence. Accessed December 19, 2020.
  • Urinary incontinence. Family Doctor—American Academy of Family Physicians. Available at: https://familydoctor.org/condition/urinary-incontinence. Accessed December 19, 2020.
  • Urinary incontinence in women. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T900573/Urinary-incontinence-in-women. Accessed December 19, 2020.
  • Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management. J Urol. 2006;175(3 pt 2):S5-S10.
  • 4/25/2018 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T900573/Urinary-incontinence-in-women#anc-178706624 : Wood LN, Markowitz MA, et al. Is it safe to reduce water intake in the overactive bladder population?: A systematic review. J Urol. 2018 Feb 27. pii: S0022-5347(18)42401-42409.
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