Urinary Incontinence

Approximately 13 million people in the U.S. suffer from urinary incontinence, the inability to control urine flow.

Urinary incontinence can occur in four forms, stress incontinence, urge incontinence, mixed urinary incontinence or overflow incontinence. Patients suffering from stress incontinence experience urine leakage caused by an increase in abdominal pressure. The increase in pressure may be caused by coughing, laughing, sneezing, lifting or increased body strain. Urge urinary incontinence is also referred to as overactive bladder. Patients suffering from this form of incontinence may experience a sudden urge to urinate and be unable to make it to the toilet. Some patients may experience a combination of stress and urge incontinence, otherwise known as mixed urinary incontinence. Overflow incontinence is characterized by frequent urination caused by the bladder's inability to empty properly.

Diagnosis:

Urinary incontinence is diagnosed following a pelvic exam, urinalysis, cystoscopy or urodynamic testing (the study of urine flow).

Treatments:

Urinary incontinence can be treated in a variety of ways, including medication and minimally invasive treatment. Minimally invasive treatments are the first form of treatment used on patients suffering from urinary incontinence. These treatments may include:

• Fluid Management. Patients may be instructed to increase or decrease their fluid intake in order to prevent urinary incontinence. This may involve a reduction in daily caffeine and soda intake and an increase in water consumption to produce no-irritating, non-concentrated urine.
• Bladder Training. With this form of treatment, patients keep a record of their fluid intake, urination schedule and timing of urinary accidents to set time intervals for urination. Patients then urinate based on a time schedule to reduce incontinent episodes.
• Pelvic Floor Exercises. Pelvic floor exercises strengthen the external sphincter muscle and pelvic muscles, which may help with stress incontinence by utilizing a contraction during body strain or with urge incontinence by delaying an accident.

Surgical treatment of urinary incontinence may be necessary if traditional, minimally invasive treatments have no effect on the condition. Depending on the case, potential surgical treatments may include, urethral injections of bulking agents, sling procedures to improve urethral closure or implantation of an artificial sphincter.

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