Urinary incontinence is the involuntary loss of urine. There are many different types of urinary incontinence but the most common types we treat in women are:
- Stress urinary incontinence is loss of urine with activity or strain such as, coughing, sneezing, jumping, laughing, etc. This problem often starts after having children. Patients may complain of no longer being able to run secondary to embarrassing leaking of urine.
- Detrusor instability or over active bladder is loss of urine usually associated with frequency and/or urge with inability to control it. Sometimes, patients with this problem will get up to empty their bladder several times during the night. For example, a person affected by this may not be able to get to the bathroom in time or may lose urine with the sound of running water or when they place their hands in water.
- Mixed incontinence is urinary loss that occurs as a result of both stress urinary incontinence and overactive bladder.
It is important to determine the type of urinary incontinence that a patient has because optimum treatment is different for each. The workup for urinary incontinence usually involves a detailed history and physical, urodynamics (study of the bladder), bladder diary, urine analysis, and sometimes, a pelvic floor evaluation. Your doctor will review the results of the workup and the treatment options with you.
The treatment options overlap for these types of urinary incontinence, however, stress urinary incontinence is effectively treated with surgery. This surgery involves placing a sling under the mid urethra and can be done as an outpatient surgery. Overactive bladder does not respond to this surgery, but is better treated with behavioral changes such as diet modification, bladder training, medications, and pelvic floor strengthening.
If a patient has mixed urinary incontinence then your doctor will determine which type is bothering the patient more, and begin the appropriate treatment. Sometimes, patients will do several treatment modalities to cure or significantly improve the problem.
Occasionally, urinary incontinence can be caused by other problems such as urinary tract infection, interstitial cystitis, tumors, stones, neurologic diseases, or even, certain medications. If this is the case, then this problem needs to be treated specifically, thus improving or eliminating the urinary incontinence.
If you have urinary incontinence, you do not have to live with this problem. Please discuss your symptoms with your doctor so that treatment can begin and lead to an improved quality of life.