Urinary incontinence is the involuntary leakage of urine and affects twice as many women as men. This is likely due to factors unique to women, such as pregnancy, childbirth, and menopause.
There are two main types of urinary incontinence in women:
- Stress incontinence: Leakage occurs during physical activities that put pressure on the bladder, such as coughing, sneezing, laughing or exercising. This is the most common type of incontinence in women
- Urge incontinence, also called overactive bladder: The sudden, intense urge to urinate that may result in leakage before reaching the time
Some women can have a combination of both types of urinary incontinence.
While the risk of urinary incontinence increases with age, it should not be accepted as normal part of aging – and it can be treated. There are many treatment options available, ranging simple lifestyle changes and pelvic muscles to medications and surgery.
The symptoms of UI may mimic other health conditions, so it’s important to see a doctor for an accurate diagnosis.
Many women hesitate to seek treatment due to embarrassment. However, urinary incontinence can negatively impact their quality of life and lead to isolation, even from intimate relationships.
Urogynecology, also known as pelvic reconstructive surgery, is a medical and surgical subspecialty that focuses on conditions like urinary incontinence. These highly trained doctors are skilled and compassionate in talking to women about these types of problems and offer an array of effective treatment options tailored to a woman’s individual situation.
Causes and Risk Factors
Urinary incontinence is most often caused by problems with the muscles and nerves that help the bladder hold or pass urine. Factors that increase the risk include:
- Pregnancy, childbirth, and menopause
- Being overweight puts pressure on the bladder and weakens support muscles over time
- Chronic constipation can strain and weaken pelvic muscles over time
- Nerve damage from childbirth, spinal cord injury, or conditions like diabetes, multiple sclerosis or Parkinson’s disease
- Surgery involving a woman’s reproductive organs, such as a hysterectomy, can affect bladder support
- Heavy lifting can cause repetitive strain that may weaken pelvic floor muscles
Urinary incontinence can also be temporary, triggered by:
- Medications like diuretics (“water pills”) that are used to treat heart failure, liver cirrhosis, high blood pressure, and certain kidney diseases.
- Caffeine, which can make the bladder to fill quickly and cause urine leakage
- Urinary tract infections
Symptoms of Urinary Incontinence
Urinary incontinence is a symptom of another health issue, usually weakened pelvic floor muscles. Other urinary symptoms may include:
- Sudden, intense urge to urinate
- Frequent urination (more than 8 times a day or more than twice at night)
- Bedwetting
- Pain when filling the bladder or urinating
- Frequent bladder infections
- Feeling like the bladder isn’t fully emptied after urinating
Treatment Options
Treatment for urinary incontinence depends on the type and severity of the condition. The available treatment options include:
Behavioral therapies
- Bladder training that teaches control over the urge to urinate and expand the time between “going”
- Scheduled toileting with set bathroom times to prevent leaking
Pelvic muscle rehabilitation
- Kegel exercises that involve relaxing and clenching targeted pelvic muscles
- Biofeedback to identify the correct muscles to target
- Vaginal weight training in which small weights are held within the vagina by clenching the vaginal muscles
- Electrical stimulation to strengthen muscle
Lifestyle changes
- Weight loss
- Avoiding caffeinated drinks or alcohol
- Quitting smoking
- Managing constipation through diet (eating more fiber)
Medications
- For overactive bladder
- Topical estrogen therapy (post-menopause), vaginal creams, rings or patches to strengthen urethra and vaginal muscles
Devices and injections
- Vaginal pessary, in which a small plastic or silicone ring-shaped device is inserted into the vagina
- Bulking agents, such as collagen, that are injected into the tissues around the bladder and urethra that cause them to thicken and reduce leakage
Surgery
Surgery may be considered when other treatments aren’t effective or if structural problems such as an abnormally positioned bladder or a blockage is involved. The two most common types of surgery for urinary incontinence are:
- Sling procedures in which synthetic mesh or tissue from your body is placed under the urethra; it acts like a hammock to support the urethra and hold the bladder in place
- Colposuspension, which helps hold the bladder in place with stitches on either side of the urethra
Surgery for urinary incontinence is not recommended for women planning future pregnancies, as pregnancy and childbirth can cause leakage to occur again.
Why Choose Cooper to Diagnose and Treat Urinary Incontinence
Cooper University Health Care offers a comprehensive urogynecology program that is on the forefront of care for urinary incontinence in women. Women trust Cooper for our:
- Compassionate, expert care: Our fellowship-trained urogynecologists offer a full range of today’s most advanced diagnostic and treatment options, delivered in a caring, sensitive manner
- The only pelvic floor physical therapy (PT) program in the region: this specialized form of rehabilitation focuses on strengthening the pelvic floor to help control urinary incontinence
- Minimally invasive surgical expertise: Cooper is the only health system in the region to offer robotic surgery for pelvic floor disorders and urinary incontinence, resulting in faster recovery, reduced pain and minimal scarring
- Academic excellence: Our urogynecologists are faculty at Cooper Medical School of Rowan University, training the next generation of specialists
- Innovation and research: Our urogynecologists are involved in ongoing research, giving your access to the latest advances in treatment
Schedule an Appointment
To learn more about the resources available for diagnosing and treating urinary incontinence in women at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).