by Michael M. Fiegen, MD, FACOG, Sanford Clinic Urogynecology & Female Pelvic Medicine
One out of three women suffer from urinary incontinence — often struggling in silence with the social and emotional anxiety it can cause. The good news is you do not need to deal with pelvic pressure or loss of urine because treatments are available. It’s never too late to meet with a urogynecologist to accurately diagnose pelvic disorders causing incontinence and begin treatments that could change your life!
Types of urinary incontinence
There are several types of incontinence, each with its own symptoms. If you are experiencing these symptoms, talk to your physician. Many of these disorders can be treated through non-invasive procedures right in the urogynecologist’s office.
Stress incontinence: When pressure on the bladder causes urine to leak out. Symptoms of stress incontinence include a urine leak when a woman coughs, sneezes, exercises, lifts something heavy or gets up from a bed or chair.
Urge incontinence: Many refer to this as an “overactive bladder.” Women with this problem may feel a strong urge to urinate, leading to leakage. Women may experience several symptoms including the need to go to the bathroom often during the day, needing to go to the bathroom two or more times at night, urinating in small amounts or having an accident if she doesn’t get to the bathroom right away.
Overflow incontinence: Women with overflow incontinence have a bladder that doesn’t empty properly and becomes very full, causing leakage. These women may feel as if their bladder is never completely empty. Other symptoms include urinating only a little each time, having a weak urine stream, experiencing an inability to urinate or the having the need to get up often at night to go to the bathroom.
Mixed incontinence: This occurs when symptoms of both stress and urge incontinence are present.
Testing for urinary incontinence
Because there are multiple causes of urinary incontinence, finding an accurate diagnosis is key to effective treatment. When visiting a urogynecologist, several tests may be done in the office to determine what is causing your symptoms. Testing may include reviewing a voiding diary to track your symptoms, visually examining the bladder, taking an x-ray or engaging in urodynamic studies. A urodynamic study is a series of tests that measures the strength of your bladder and tracks how the bladder works.
Treating urinary incontinence
Treatments for urinary incontinence have evolved greatly over the past decade. Today, women have a variety of non-invasive treatments available including medication, bladder retraining exercises and physical therapy. Other non-invasive treatments include injection therapy, in which injections are made into the urethra to bulk up the tissue and control leaking. Stimulator implants can also be used to provide electrical signals to the nerves that control the bladder and help it to work more normally. For women with severe stress incontinence, surgery may be an option to control urinary leakage.
Lifestyle Changes can affect treatment
Lifestyle changes can also make a difference for women with urinary incontinence. In addition to the other health benefits, the following lifestyle changes can help women control their urinary incontinence symptoms:
- Consider quitting smoking. Smoking can damage the bladder and urethra. It can also create a chronic cough that strains pelvic floor muscles.
- Lose excess weight. Even a few extra pounds can put pressure on the bladder.
- Avoid caffeine and alcohol. Caffeine and alcohol are diuretics and can increase the urge to urinate.
Who treats pelvic disorders?
A urogynecologist is a physician with advanced training in gynecology and urology. By combining expertise in treating women’s reproductive systems with that of the urinary tract, these physicians are specially trained to treat urinary incontinence, pelvic pain and various forms of pelvic organ prolapse.
Everyday, physicians are learning more about urinary incontinence. Advancements are changing the way physicians diagnose and treat the millions of American women it affects. If you are experiencing symptoms of urinary incontinence, talk to your physician and get back in control.