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Women's Pelvic Health and Reconstructive Surgery

Urinary Incontinence

Involuntary loss of urine is a common problem that can affect a woman at any age. There are many possible causes for urinary incontinence. Incontinence is typically caused by pelvic floor muscle weakness after childbirth or complex neuromuscular (nerve and muscle) changes related to other health conditions.

Common types of urinary incontinence and lower urinary tract dysfunction:

  • Stress incontinence
    Involuntary loss of urine related to physical effort or exertion, sneezing, or coughing
  • Urgency incontinence
    Involuntary loss of urine related to a strong and sudden urge to urinate, even if the bladder is not full
  • Nocturia
    Waking up with a need to use the bathroom more than once a night
  • Overactive bladder
    Feeling an urgent and/or frequent need to urinate, usually accompanied with urgency incontinence and nocturia
  • Mixed urinary incontinence
    Involuntary loss of urine associated with a sense of urgency, physical effort or exertion, sneezing, and/or coughing
  • Insensible urinary incontinence
    When a woman is unaware of how or why leakage occurs
  • Overflow incontinence
    Urinary leakage related to an inability to completely empty the bladder
     

The physicians and staff at University Women's Care are a team of caring professionals. Our providers have the expertise to treat even the most complex urogynecologic problems. We provide practiced, thoughtful care and work with patients to find the most appropriate diagnosis and treatment to meet each woman's unique personal needs.


Diagnosing urinary incontinence

Accurately diagnosing the cause of urinary incontinence helps determine the most effective treatment for a woman's particular situation.

Exams used to diagnose urinary incontinence include:

  • Medical history and physical
  • Urine culture
  • Voiding diary
  • Pad test - Using a sanitary pad to collect and measure the amount of leakage
  • Urodynamics - Tests how well the bladder and related organs are functioning
  • Urethrocystoscopy - Visual examination (cytoscopy) of the inside of the urethra and bladder

Treating urinary incontinence

There are many ways, surgical and nonsurgical, to treat urinary incontinence. Treatment recommendations are based on the  type of incontinence a patient has.

  • Stress incontinence
    • Pelvic floor muscle exercises
      Kegel exercises, with or without biofeedback.
    • Urethral bulking
      A minimally invasive procedure done endoscopically, without incisions.
    • Pessary
      A pessary is a silicone device that is placed in the vagina to hold up or support whatever organ may be prolapsed. These devices come in different shapes and sizes and are often easy for patients to place and remove themselves. The goal of this treatment is to find a pessary that comfortably relieves the patient of her prolapse symptoms.
    • Midurethral sling
      This minimally invasive surgical procedure is done on an outpatient basis and generally involves placing a  permanent mesh sling beneath the urethra as a backstop to prevent leakage.
  • Urgency incontinence
    • Dietary changes
      Certain foods and beverages (such as citrus, sodas, alcohol, chocolate) and tobacco are known to irritate the bladder or increase frequency of urination urges.
    • Timed voiding/Bladder retraining
      A process of retraining the bladder to hold increasing amounts of urine over time.
    • Medications
      Numerous medications can relax the bladder muscle and allow a person to hold more urine, longer.
    • Biofeedback, with or without electrical stimulation.
      A process of weekly pelvic floor muscle rehabilitation, usually with added electrical stimulation to retrain the neural connections between the brain and the bladder.
    • Percutaneous nerve stimulation
      A version of acupuncture that often provides significant relief with no medicinal side effects.
    • Botox® prescription medicine
      Botulinum toxin type A (Botox) is FDA approved for treating overactive bladder and urinary incontinence when medical treatment has failed. Botox can be used in a variety of bladder conditions and is thought to decrease bladder spasm, increase bladder capacity, and decrease pain signals. For this treatment, Botox is injected into into bladder muscle in a simple in-office procedure.
    • Sacral neuromodulation (InterStim® neurostimulation system)
      An implantable "pacemaker" which activates nerves that control the bladder can be placed as an outpatient surgical procedure.

Request an appointment

Our providers have the expertise to treat even the most complex urogynecologic problems with practiced, thoughtful care for the needs of our patients. Request an appointment or learn more about our physicians below.

Healthcare professionals

To refer a patient to the University Women's Care pelvic health program:


Patients

The pelvic health program at UMMC sees patients by physician-referral and self-referral.