Urinary incontinence is the involuntary or unintentional loss or urine that is a social or hygienic problem. It is not a normal part of aging. Incontinence of urine is one of the most under treated problems facing over 7 million American women of all ages. It prevents many women from enjoying an active lifestyle. Women may avoid exercise or strenuous activity for fear of leaking. They may limit the places to which they go in order to avoid being too far from a bathroom and leaking in public. They wear pads and may feel unclean. Often it can affect sexual activity and lower self-esteem.

Urinary incontinence affects women of all ages and often results from childbearing and less commonly neurological problems. It is worsened by lifestyle factors such as excessive caffeine intake, alcohol consumption, or smoking. Often, it goes untreated because a woman is embarrassed to discuss the problem with her health care provider or a failure on the part of the provider to ask patients if incontinence is an issue. Loss of urine should never be a problem that a woman feels she ‘just needs to live with.’ 

The two most common types of incontinence are overactive bladder and stress incontinence. Overactive bladder is a result of involuntary contractions of a specific part of the bladder causing loss of urine. Stress incontinence results in leakage of urine when a woman laughs, coughs, sneezes or exercises. Sometimes a woman may suffer from a combination of both types. The two types are treated differently. Overactive bladder tends to respond to lifestyle modification, bladder “retraining,” and/or medications while stress incontinence requires pelvic muscle exercise (Kegel exercises) and sometimes surgery. Surgical procedures for stress incontinence have evolved greatly. Incisions are usually only ¼ of an inch long and the woman may be discharged from the hospital the same day.

It is essential to accurately diagnose which type of incontinence a woman has. This is done through a thorough history, physical examination and (often) urodynamics.  A urodynamics procedure is an objective way to determine (the) type of incontinence and the severity of the problem. It involves filling the bladder with sterile fluid and measuring various pressures. From these studies, a course of treatment can be initiated.

Seeking care for urinary incontinence is a woman’s first step toward taking back control of their active lifestyle. No woman should live her life fearful of leaking urine or embarrassed to get help. It is not a normal part of aging and not something to live with. Any woman suffering from incontinence should contact their health care provider to pursue becoming continent again.

Download patient questionnaireDownload a urinary bladder diary.

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