Incontinence

What causes urinary incontinence?

Urinary incontinence becomes more common with age, and it can also be caused by hormonal changes, nerve damage, and weakening of the muscles and ligaments that support the bladder, uterus, and other structures. Being very overweight or obese and having had multiple vaginal births and certain types of diseases also increase the risk of experiencing urinary incontinence. There are three primary types of urinary incontinence:

• Stress incontinence causes the bladder to leak after a sneeze or cough or during strenuous physical activity, including sex. This type of incontinence develops when the pelvic floor muscles become weak or damaged and can no longer adequately support the bladder.
• Urge incontinence causes an increased need to urinate throughout the day and even during the night, often interrupting sleep. Urge incontinence is often referred to as overactive bladder.
• Mixed incontinence includes symptoms of both stress incontinence and urge incontinence.

How is the cause of incontinence determined?

Diagnosing incontinence and the issues causing it begins with a physical examination and a careful review of symptoms, as well as a complete medical history to look for possible risk factors. Lab testing including blood work or urinalysis may be performed, and in many cases, special diagnostic testing will be performed to measure the bladder’s ability to retain urine or to test the muscles or nerves that control the flow of urine. In some patients, a minimally-invasive procedure called a cystoscopy will be performed to view the inside of the bladder using a tiny camera inserted through the urethral opening.

What treatments are available for urinary incontinence?

Once the underlying cause of urinary incontinence has been determined, treatment options can include medications, BOTOX® injections, nerve stimulation, pelvic floor exercises, and lifestyle changes including losing excess weight. In some cases, surgery may be recommended to repair or provide additional support for weak or damaged pelvic floor structures.