Incontinence is the involuntary loss of urine and/or stool.

Incidence in women:

As many as 20 million women suffer with bladder control and/or prolapse.

• up to 30% of women older than 60 y/o.
• up to 25% of women younger than 65 y/o.
• young women can also be affected.

You do not need to live with your problem or limit your social contact. There are treatment options and management solutions to help you lead your life the way you prefer.

Types of incontinence

• Stress Urinary Incontinence (SUI)

  Unintentional release of urine during normal everyday activities.
  You may lose urine when you laugh, sneeze or cough, walk or exercise, get up from a seated or lying position.
  Basic causes of SUI: 1) weakening of the pelvic floor; 2) Intrinsic sphincter deficiency (ISD)

• Urge Incontinence

  Involuntary loss of urine as soon as you feel a strong need to go to the bathroom.
  You may feel like you never get to the bathroom fast enough.
  Causes are overactive bladder muscles rather than a weakness in the pelvic floor.
  Main symptoms of (OAB) are urge with or without incontinence, frequency and nocturia (waking to void more than once at night).
  The main treatments for (OAB) involve behavioral modification, medications and neuromodulation.

• Mixed Incontinence

  Some women experience a combination of stress and urge incontinence.

• Overflow Incontinence

  Random leaking, not necessarily associated with a daily activity or going to the bathroom.
  You may feel as if you never completely empty your bladder.
  Causes include blockage of the urethra that prevents the flow of urine leaving residual urine, nerve damage to the bladder muscle not allowing complete emptying.

• Other types of Incontinence are associated with:
  • Diabetes
  • Infection
  • Atrophy from menopause
  • Anatomical reasons such as diverticulum
  • Medications
  • Psychological problems
  • Endocrine problems
  • Restricted mobility
  • Stool impaction

Options for treatment

There are many ways to treat incontinence. Not all approaches will work for every person or every type of incontinence.

• Behavioral/Muscle Therapy

  This option is aimed at teaching you ways to control your bladder and muscles involved with incontinence. Women learn how to use and strengthen the pelvic floor muscles.

  • Kegel exercise - focus on strengthening the muscles involved in urination.
  • Biofeedback - helps you gain control over bodily functions by making you more aware of them.
  • Electrical Stimulation - aids pelvic floor exercises by isolating the muscles involved.
• Medication
  • HRT
  • Bladder muscles spasm inhibitors
• Surgery

  For some patients, surgery is required to treat the underlying case of incontinence and prolapse. Surgical repair may give the most long-term results. There are multiple surgical approaches and each is recommended for a specific type or cause of incontinence. Abdominal, vaginal approaches, laparoscopic minimally invasive treatments are available depending on a careful evaluation of all the pelvic areas involved in the problems related to anatomical relaxation and prolapse.

  Your doctors refer all patients with a desire to treat their incontinence to the CPMC Pelvic Incontinence Center or their urologist for diagnostic testing before any surgical treatment decision is confirmed.

  A complete gynecologic pelvic relaxation evaluation will be needed to assess if your complaint of incontinence is the only problem that needs to be addressed.

  Certain patients with significant stool loss or motility problems will also need an evaluation at the gastrointestinal motility laboratory.