Millions of women experience involuntary loss of urine, called urinary incontinence or UI. Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. UI can be slightly bothersome or totally debilitating.

For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress. Women experience UI twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.

The first step toward relief is to see a doctor who has experience treating incontinence to learn what type you have. To diagnose the problem, your doctor at Advanced Urology Institute will first ask about symptoms and medical history. Your pattern of voiding and urine leakage may suggest the type of incontinence you have. Thus, many specialists begin with having you fill out a bladder diary over several days. These diaries can reveal obvious factors that can help define the problem, including straining and discomfort, fluid intake, use of drugs, recent surgery, and illness. Often you can begin treatment at the first medical visit.

• Stress Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).
  
  
• Urge Leakage of large amounts of urine at unexpected times, including during sleep.
  
  
• Overactive Bladder – Urinary frequency and urgency, with or without urge incontinence.
  
  
• Functional – Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
  
  
• Overflow – Unexpected leakage of small amounts of urine because of a full bladder.
  
  
• Mixed – Stress and urge incontinence often occur together in women. Combinations of incontinence, and this combination in particular, are sometimes referred to as mixed incontinence.
  
  
• Transient – Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing).

All types of urinary incontinence are treatable at any age. Just as there are many types of UI, there are many treatment options. One of the easiest is Bladder Retraining and Kegel Exercises. By keeping a ‘bladder diary’, the doctor may see a pattern and suggest making it a point to use the bathroom at regular timed intervals, a habit called timed voiding. As you gain control, you can extend the time between scheduled trips to the bathroom. Kegel exercises also strengthen the muscles that help hold in urine.

• Medication – There are many different medications that can help with UI.
  
  
• Biofeedback – uses measuring devices to help you become aware of your body’s functioning
  
  
• InterStim – For urge incontinence not responding to behavioral treatments or drugs, stimulation of nerves to the bladder leaving the spine can be effective in some patients.
  
  
• Vaginal Devices for Stress Incontinence –  a stiff ring that a doctor or nurse inserts into the vagina, where it presses against the wall of the vagina and helps reposition the urethra.
  
  
• Injections for Stress Incontinence – these injects help to make tissue thicker in the urethra and bladder neck to help reduce the effects of stress UI.
  
  
• Surgery for Stress Incontinence – in some cases surgery might be necessary to repair or reposition the bladder to restore normal function
  
  
• Catheterization – in some cases a catheter may be inserted so that your bladder can empty completely.

Regardless of your age, urinary incontinence is treatable. Many women are afraid to mention their problem. They may have urinary incontinence that can improve with treatment but remain silent sufferers and resort to wearing absorbent undergarments, or diapers. This practice is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation and sores. If you are relying on diapers or modifying your activity because of UI, contact Advanced Urology Institute to schedule a consultation appointment.