Urinary Incontinence

The most common bladder problem in women is urinary leakage or incontinence, which affects 1 of 3 women.  There are different causes of incontinence. The loss of urine that occurs with exertion such as physical activities, sneezing, and coughing, is often called stress incontinence.  It results from activities that increase the abdominal pressure, which pushes on the bladder.

Overactive bladder is another common cause of urine leakage. Overactive bladder causes uncontrollable urgency to urinate that may result in leakage. Some women have both types of symptoms; stress incontinence and overactive bladder.

How do you know if you have urinary incontinence
If you are experiencing uncontrollable leakage, then you have urinary incontinence.   The next step is to determine what type. Diagnosing the cause of incontinence begins with a careful review of symptoms, and this is usually done using a questionnaire. A pelvic exam may allow your physician to make a diagnosis, although in some cases, further studies are needed.  These include Urodynamics & Cystoscopy

If you have been diagnosed
You can make improvements in control of urinary incontinence by making lifestyle and behavioral changes.  For many women, a healthy diet and fit lifestyle really make a difference.

Lose Weight if you are overweight
Weight loss can help improve urine leakage along with pelvic muscle strengthening and other behavioral changes. If you are overweight, a drop of as little as a 5 to 10% of weight will reduce weekly leakage episodes by more than half. 

Manage Fluid Intake
 The amount of fluid that you drink determines how much urine you make. Not overdoing fluids will result in less trips to the bathroom.  Also, restricting drinking after dinner can help reduce the number of trips to the bathroom at night. At the same time, you should not restrict you fluids too much either.  Following your thirst is a good guide to how much you should drink.

Be Diet Savvy
Women with urinary leakage find it helpful to reduce bladder irritants and artificial sweeteners. Bladder irritants, include caffeine found in coffee, tea, chocolate, cola and some energy drinks. These foods may cause bladder muscle spasms, which can make you suddenly feel like they have to urinate.

Adjust Physical Activity

Regular physical activity helps you to maintain a normal body weight, decreasing your risk for urinary leakage. However, high-intensity exercises, like jumping on a trampoline or CrossFit,  can increase your risk for leakage problems.

If You Smoke, Quit Now

The risk for pelvic floor disorders is doubles for women who smoke.

Pelvic Floor Muscle Exercises
Learning how to control and strengthen your pelvic floor muscles will help you reduce or even eliminate urine leakage. Pelvic muscle exercises, also known as Kegel exercises, help with leakage caused by physical activities and also with urgency. Women with mild to moderate symptoms experience the greatest improvement. Like any other form of exercise, improvement is a reflection of good exercise technique and dedication to doing the exercises regularly. Pelvic Floor Physiotherapists are helpful for learning these exercises

Treatment Options
There are a number of treatments to relieve urinary incontinence, including surgical and non-surgical treatments. The most common non-surgical treatment for stress incontinence is a pessary, while the most common treatment for overactive bladder is medications. There are also a number of different approaches to the surgical repair of stress incontinence.  Some are fairly minor procedures like Periurethral bulking that can be performed in the office.  In this procedure we can help bolster the bladder neck by injecting bulking materials beside the bladder neck. There are a number of surgical procedures to provide support for bladder neck.  Some are short procedures that take less than a half hour.  We offer surgical solutions that do not require mesh. Your decision about treatment should be guided by how much the symptoms affect your daily life, and balanced against the potential inconvenience and risk of the treatment.