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Urinary Incontinence

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Urinary Incontinence
As anyone can imagine, urinary incontinence can present as a variety of symptoms including, strong urges to go to the bathroom, frequent urination or leakage of urine.  Problems associated with incontinence affect women of all ages and up to 35% of women older than 65 are thought to be affected by urinary disorders.  Urinary incontinence may be caused or worsened by:

  • Excess consumption of fluids, alcohol or caffeinated drinks
  • Medications to control blood pressure such as diuretics
  • Chronic diseases such as diabetes
  • Obesity 

There are at least five types of urinary incontinence, the most commonly diagnosed by doctors include:

  • Stress incontinence or leakage of urine with activity or heavy lifting.
  • Urge incontinence or sudden feeling to urinate for no apparent reason
  • Overflow incontinence that can present as unexpected or constant dribbling
  • Mixed incontinence 

Women with incontinence often do not report this to their doctors because they are embarrassed or they think there is nothing they can do about it.  However, many treatment options are available.  A gynecologist with special training in urologic disorders can help. 

During the initial evaluation, your doctor will take a very careful history and maybe even ask you to fill out a ‘bladder diary’ where you report your urinary and drinking habits for several days.  Your provider will also review the types of medications you take and how your daily activities affect your bladder function.   The physician will then do a thorough pelvic exam which is designed to evaluate how your bladder and pelvic floor structures function based on their location and strength.  The provider may then perform several diagnostic tests including:

  • A urinalysis to look for infection in the urine
  • A stress test where you cough to see if you leak urine
  • A cystoscopy where a thin camera is placed in the bladder to evaluate the inside of the bladder
  • A urodynamics procedure where the bladder and function of the bladder is measured with of pressure catheters

Each type of incontinence has several treatment options.  Your provider may recommend that you change your fluid intake, that you undergo what is called “bladder retraining” with the help of a physical therapist.   Sometimes medications can be used to control frequency and urgency. 

For stress urinary incontinence your provider may offer you non-surgical options such as a pessary (a vaginal silicone device that gives the bladder neck extra support) or minimally invasive therapies such as urethral injections or mid sub-urethral slings. 

The bottom line is that women with incontinence may have multiple treatment options. To learn more about your best treatment option for urinary incontinence, call Dr. Hoover or Dr. Lamvu at Advanced & Minimally Invasive Gynecology through the convenient contact form on this website, or by calling 407.303.2780.