Urinary incontinence, also known as bladder leakage, is very common in women, and usually is treatable. There are different types of urinary incontinence. Stress incontinence is the sudden loss of urine with physical activity or movement, such as coughing, sneezing, bending over, lifting or exercise.
Urge incontinence (also called overactive bladder) usually involves a strong feeling of urgency followed by loss of urine before you can make it to the bathroom. Many women have a combination of these two conditions.
At Urology of Indiana, we have extensive experience in the evaluation, diagnosis and treatment of all types of bladder control problems. Your physician will take a detailed history of your symptoms. He/she will then check a urine specimen and perform a basic physical examination. Sometimes a special test called a urodynamic study is needed to help get more information about your condition.
Obtaining your medical history provides insight into the reasons for your bladder problems. Patterns of urination and leakage, a history of illnesses, pelvic surgeries and a list of current medications also help to ensure an accurate diagnosis.
You will have a focused physical examination of the abdominal and pelvic area. This helps identify other conditions that may be contributing to your bladder problem.
You may be asked to leave a urine specimen for urinalysis. A quick test may also be performed to see how well you are emptying your bladder.
If it is complex or does not respond to conservative treatments, additional testing may be required, including urodynamic, endoscopic or imaging tests to obtain more extensive evaluation of the lower urinary tract to help determine an appropriate treatment plan.
Most cases of urinary incontinence are treatable. However, different patients require different types of treatments. Some forms of urinary incontinence can be treated with pelvic exercises or medications. There are several office-based and minimally-invasive surgical procedures available which can help stress and urge incontinence. You and your physician will work together to identify the treatment that is right for you.
Dietary and Behavioral Modification
Making changes in diet and activity can sometimes improve symptoms. Dietary modification involves avoiding irritants in food and drink that can worsen urinary symptoms. Patients often have different dietary triggers, but substances such as caffeine, acidic foods and carbonated beverages can often worsen overactive bladder and urge incontinence. Behavioral treatments include pelvic exercises and bladder training, which can be performed independently or with the help of a women’s health physical therapy specialist.
Some types of bladder control problems can be treated with medications. In general, medications are only used to treat symptoms of urge incontinence/overactive bladder. There are currently no FDA-approved medications for the treatment of stress incontinence.
For women with stress incontinence, there are surgical procedures that can help. The midurethral sling procedure involves the placement of a small strap of permanent mesh underneath the urethra. A urethral bulking procedure involves injecting a gel-like substance into the wall of the urethra. Both of these are minimally-invasive procedures with a short recovery.
For patients with primarily urge incontinence/overactive bladder, slings and urethral injections are generally not used, but other effective procedures are available. Our urogynecology specialists will help you determine which treatments are best for you.