Female Incontinence

Incontinence is the involuntary loss of control of the bladder or bowel.

Female urinary incontinence describes the involuntary loss of urine and can be further described by the different types of incontinence.

Types of Incontinence

Stress Urinary Incontinence

The most common type that we see. It is associated with symptoms of leakage of urine that occurs with coughing, sneezing, laughing or lifting. Symptoms are not just in older individuals as many younger women complain that they cannot exercise/run or jump on the trampoline with their kids without having accidents.

Overactive Bladder

Further described as "wet" (meaning having incontinence episodes) or "dry" (meaning significant urinary urgency and frequency symptoms without the incontinence episodes). Symptoms include significant urgency and uncontrollable leakage without warning.

Other Types of Incontinence

Mixed incontinence which is a combination of both of the above symptoms.

Overflow incontinence which is usually due to incomplete emptying of the bladder, which commonly occurs with prolapse.

Functional incontinence which is often related to medications or issues such as chronic constipation.

Incidence

The true incidence of urinary incontinence is unknown but is felt to be very underestimated. We know that at least 18 million people suffer from stress urinary incontinence and a large number of women with overactive bladder go untreated.

A common misconception is that this is a normal part of aging.

Treatment Options

Stress Urinary Incontinence

Behavioral Therapies 
This is the least invasive treatment. Ask your doctor for more informatoin.

Pelvic Floor Therapy
Talk to your doctor about which therapy would  work best for you.

External Devices
External devices such as incontinence pessaries or inserts.

Medications
Discuss options with your doctor.

Surgery
Talk to your doctor acout which surgical options are best for you.

Bulking Agents
Injectable fillers traditionally used for specific types of stress urinary incontinence associated with very weak support of the urethra.

Mid Urethral Sling Procedures 
Are still felt to be the gold standard treatment for simple stress incontinence and involves an outpatient 30-minute procedure under sedation. Most patients are back to most normal activities within a couple of days.

Abdominal Surgical Procedures
This describes the procedures previously performed with a larger skin incision on the abdomen including MMK or Burch colposuspension procedures.

Overactive Bladder

First Tier
This involves nonsurgical nonmedical treatment such as behavioral modification which may involve dietary and fluid intake changes.

Second Tier
Medications designed to minimize bladder contraction such as anticholinergic medications such as Detrol, Toviaz, Enablex or new class medications such as the beta 3 agonist Myrbetriq.

Third Tier- Botox Injection
Discuss options with your doctor.

Sacralneuromodulating Device
This consists of an outpatient implantable device that lies under the skin below the hip that acts as an electrical stimulator for the bladder, providing 24-hour around-the-clock improvement in bladder symptoms when all else has failed.