How is Urinary Incontinence described?
When you are not able to hold your urine until you can get to a bathroom, you have what's called urinary incontinence (also called loss of bladder control). People also say they have a "weak" bladder.
Bladder control means more than just telling yourself to wait to urinate until you get to the bathroom. It is not that simple. It takes teamwork from many organs, muscles, and nerves in your body. Most of the bladder control system is inside your pelvis, the area of your abdomen between your hips and below the belly button.
Are there different types of Urinary Incontinence?
Yes. Typically we see these types of incontinence in women:
- Stress incontinence - Leaking small amounts of urine during physical movement (coughing, sneezing, exercising). Stress incontinence is the most common form of incontinence in women. It is treatable.
- Urge incontinence - Leaking large amounts of urine at unexpected times, including during sleep, after drinking a small amount of water, or when you touch water or hear it running (as when washing dishes).
- Functional incontinence - Not being able to reach a toilet in time because of physical disability, obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
- Mixed incontinence - A combination of incontinence, most often when stress and urge incontinence occur together.
- Transient incontinence - Leaking urine on a temporary basis due to a medical condition or infection that will go away once the condition or infection is treated. It can be triggered by medications, urinary tract infections, mental impairment, restricted mobility, and stool impaction (severe constipation).
How is urinary incontinence diagnosed?
Our urogynecology team will first ask you about your symptoms and get a complete medical history. You will also be asked about your bladder habits: how often you empty your bladder, how and when you leak urine, or when you have accidents. A physical exam will be performed to look for signs of any medical conditions that can cause incontinence, such as tumors that block the urinary tract, impacted stool, and poor reflexes that may be nerve-related. A test may be done to figure out how much your bladder can hold and how well your bladder muscles function. Your provider may also recommend other tests, including:
- The Stress test - You relax, then cough hard as the provider watches for loss of urine.
- Urinalysis - You give a urine sample that is then tested for signs of infection or other causes of incontinence.
- Blood tests - You give a blood sample, which is sent to a laboratory to test for substances related to the causes of incontinence.
- Cystoscopy - A thin tube with a tiny camera is placed inside the urethra to view the inside of the urethra and bladder.
- Urodynamics - Pressure in the bladder and the flow of urine are measured using special techniques.
How is Urinary Incontinence treated?
There are a number of ways to treat incontinence. Your health care provider will work with you to figure out which way(s) is best for you. Don't give up or be embarrassed! Remember, many women have incontinence and all types of incontinence can be treated, no matter what your age.
Treatment often starts with one or more of these more conservative approaches:
- Pelvic muscle exercises
- Electrical Stimulation
- Biofeedback
- Timed Voiding or Bladder Training
- Weight Loss
- Dietary Changes
- Medication
- Urethral Bulking
- Pessary
- Urethral Inserts
Do you use surgery to correct Urinary Incontinence?
If non-surgical options have not solved your stress urinary incontinence, our Urogynecology Team may suggest a more permanent surgical solution. One option they may recommend is a sling procedure.
Transvaginal slings are the current gold standard for the surgical repair of stress urinary incontinence. The risks of erosion are less than 1% and 90% of the women experience successful resolution of incontinence issues.
Dr. Melvin Ashford, the founder and medical director of Minnesota Women’s Care, is trained and board-certified in Urogynecology & Reconstructive Pelvic Surgery (URPS). (Formerly Female Pelvic Medicine and Reconstructive Surgery – FPMRS.) This means, in addition to his training and certification as an OBGYN, he has completed additional training in the treatment of disorders in women such as pelvic organ prolapse, urinary incontinence, fecal incontinence, and other complex pelvic floor conditions.
We're here and ready to help you find relief. To schedule an appointment with one of our providers, please call us at 612-326-3384.
