Urinary Incontinence

If you experience the involuntary loss of urine, you’re among the millions who suffer from urinary incontinence or “UI.” UI occurs because of problems with muscles and nerves that help to hold or release urine.

Symptoms of Urinary Incontinence

Men can also suffer from UI, but it is far more common in women because of pregnancy, childbirth, menopause and the structure of the female urinary tract. It is also more common in older women than younger women. Both men and women can become incontinent due to physical problems associated with aging and:

  • Birth defects
  • Multiple sclerosis
  • Neurological injury
  • Stroke

The types of UI are:

  • Stress: Small amounts of urine leakage during physical movement, such as coughing, sneezing and exercise
  • Urge: Large amounts of urine leakage at unexpected times, including sleep
  • Overactive bladder: Frequent and urgent need to urinate, with or without leakage
  • Functional: Untimely urination that keeps you from reaching the toilet due to physical disability, external obstacles or problems thinking or communicating
  • Overflow: Small amounts of urine leakage due to a full bladder
  • Mixed: The occurrence of stress and urge UI together
  • Transient: Leakage that occurs because of a temporary situation, such as infection, medication or a cough due to a cold

Diagnosis of Urinary Incontinence

To determine the type of UI you have, your urology specialist will ask you about symptoms and about your medical history. You may be asked to keep a bladder diary for several days to help define the problem, including:

  • Discomfort
  • Drug usage
  • Fluid intake
  • Illness
  • Straining
  • Surgery

Your urology specialist will physically examine you for medical conditions causing your UI, such as:

  • Blockages from bowel or pelvic growths
  • Weakness of the pelvic floor called “prolapse”

You may also undergo any one of the following tests:

Urinary Incontinence

  • Bladder capacity: You urinate into a measuring pan and then the nurse or doctor will measure urine remaining in the bladder
  • Bladder stress test: You cough vigorously while the doctor watches for loss of urine from the urinary opening
  • Cystoscopy:  A thin tube with a tiny camera will be inserted into the urethra to see inside it and the bladder
  • Ultrasound: Sound waves will be used to create an image of the kidneys, ureter, bladder and urethra
  • Urinalysis and urine culture: Your urine will be tested for infection, urinary stones or other conditions
  • Urodynamics: Measures the pressure in the bladder and the urine flow

Treatment of Urinary Incontinence

Once UI is determined, you can usually start treatment after your first visit with your urology specialist. While no one treatment works for everyone, most find improvement without surgery.

  • Behavioral remedies: After reviewing your diary for patterns, your urology specialist may suggest that you use the bathroom at regular timed intervals, called “timed voiding.” Kegel exercises to strengthen the muscles that hold in urine may also be advised.
  • Medication: If you suffer from overactive bladder, your urology specialist may prescribe a medication to block the nerve signals that cause frequent urination and urgency.
  • Biofeedback: This treatment uses measuring devices to help you become aware of body’s functioning.
  • Neuromodulation: If your UI does not respond to behavioral treatments or drugs, your urology specialist may suggest this therapy, which involves implanting a device that stimulates the nerves to the bladder leaving the spine.
  • Vaginal device: This involves inserting a stiff ring called a “pessary” into the vagina. The pessary presses against the vaginal walls and nearby urethra, helping to reposition the urethra so there is less stress leakage.
  • Injections: Bulking agents, such as collagen and carbon spheres are injected near the bladder neck and urethra to thicken the tissues and close the bladder opening, thus reducing stress incontinence.
  • Surgery: If the bladder has moved out of its normal position, due to childbirth for example, your urology specialist may suggest surgery.

Request an Appointment

If you suspect you have urinary incontinence, please contact us to make an appointment with the experts at Mercy Specialty Clinics, Urology, the best urology clinic in Johnson County.