Urinary Incontinence in Women

More than 20 million women suffer from the consequences of weakened pelvic floor muscles, which can lead to incontinence, prolapse or pelvic floor pain. For example:

• 60 - 90 % of women who undergo major gynecological surgery develop postoperative adhesions that can lead to pelvic pain and bowel, bladder or sexual dysfunction.
• nearly 35 percent of female Medicare patients have urinary incontinence

Pelvic problems are so common that many women who experience them think they are a normal part of life, but they’re not. Urinary incontinence is a medical problem. Your doctor or nurse can help you find a solution. No single treatment works for everyone, but many women can find improvement without surgery.

Understanding Urinary Incontinence

Urinary incontinence (UI) occurs because of problems with muscles and nerves that help to hold or release urine. Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Urine loss can also occur during sexual activity and cause tremendous emotional distress. Many women experience more than one symptom. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends.

Women experience urinary incontinence twice as often as men. Although pregnancy and childbirth, menopause and the structure of the female urinary tract may account for this difference, anyone can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis and physical problems associated with aging. Older women experience UI more often than younger women, but incontinence is not inevitable with age.

Types of Urinary Incontinence

• Stress: Leakage of small amounts of urine during movement (coughing, sneezing, exercising)
• Urge: Leakage of large amounts of urine at unexpected times, including during sleep
• Overactive Bladder: Urinary frequency and urgency, with or without urge incontinence
• Functional: Untimely urination because of physical disability, external obstacles or problems in thinking or communicating that prevents you from reaching a toilet.
• Overflow: Unexpected leakage of small amounts of urine because of a full bladder
• Mixed: Usually the occurrence of stress and urge incontinence together
• Transient: Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing)

How Is Incontinence Detected and Evaluated?

The first step toward relief is to see a doctor. Your family physician or your gynecologist may initiate an evaluation or recommend that you visit a urologist, a specialist in the urinary tract, to learn more about your symptoms and how they can be treated. Tools for diagnosing your problem may include:

• Explaining your symptoms and medical history
• Evaluating your urine specimen for abnormal substances, such as protein or signs of infection
• Completing a questionnaire and/or a bladder diary to identify your pattern of voiding and urine leakage
• A physical exam for signs of medical conditions causing incontinence
• Urodynamic testing

Treating Incontinence

A written report of your test results is sent to your physician, who will discuss the results with you. Based on this report and the discussion with your physician, your treatment plan may include:

• Pelvic floor rehabilitation
• Medication or injections
• Biofeedback: using measuring devices to help you become aware of your body's functioning
• Neuromodulation: stimulation of nerves to the bladder
• Catheterization
• Surgery

Don't let life pass you by because you are embarrassed or afraid to mention this problem to your doctor! You may discover that your urinary incontinence can improve with treatment. Please take the first step and share your concerns with your healthcare provider.

Source: The National Institute of Diabetes and Digestive and Kidney Diseases