Diseases & Conditions

Female Urinary Incontinence

Authors: Jane L. Miller, MD
Last updated: March 11, 2006

Overview |
Symptoms |
Causes |
Risk Factors |
Diagnosis |
Complications
Treatment |
Self-care |
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Overview

Urinary Incontinence in women is very common. Approximately 38% of woman experience urinary incontinence, and 135,000 women each year will undergo surgery to correct incontinence. There are two types of urinary incontinence. The first and most common is Stress Urinary Incontinence (SUI) which is the result of weak urethral muscle and support. Patients with SUI complain of incontinence with activity. The second type of incontinence is Urinary Urge Incontinence (UUI) which is the result of over active bladder muscle. Patients with UUI complain of incontinence with a strong urge to go to the bathroom. Some women have a combination of both types, and this is called Mixed Urinary Incontinence (MUI).

Symptoms

Women who experience SUI will leak urinary during activities that increase their intraabdominal pressure, such as coughing, laughing, sneezing, bending, lifting, walking down hill, running. Women who experience UUI will leak urine with strong urges to get to the bathroom. The leakage amount might be quite large, and they may have large, embarrassing accidents. They may also leak when they hear or see running water, when they place their key in the door upon returning home, or when they stand up from a chair or get out of bed. Women with MUI experience both symptoms.

Causes

It is not known with certainty what causes incontinence, but it is believed that vaginal delivery, pregnancy, and genetic factors likely increase risk of developing SUI. Women who are obese, have excessive fluid in the abdomen (ascites) and women who have a chronic cough from asthma or emphysema may also be at risk. Women who lift heavy objects chronically may also be at risk of developing SUI. The causes of UUI are not known.

Risk Factors

See above.

Diagnosis

Urinary incontinence is diagnosed by any physician. However, most primary care physicians may not ask about urinary symptoms at an office visit. Therefore, patients need to discuss there urinary symptoms with their doctor who can then refer them to a specialist. Urologist and urogynecologists treat urinary incontinence. Once referred to one of these doctors, a history and physical examination, including vaginal exam, will be performed. Sometimes, the specialist will request other tests before recommending therapy, such as a bladder diary, wet pad collection, and a urodynamic study (see link). A urodynamic study is a procedure that is done to evaluate the reason for incontinence, and severity of incontinence. This test helps the specialist recommend the best therapy.

Complications

The effect incontinence can have on quality of life is immeasurable. Some women stop exercising for fear of incontinence. Others will not travel or even leave their home for any duration of time for fear of embarrassing leakage accidents. Some women with severe incontinence can have rashes and skin breakdown from chronic skin exposure to urine.

Treatments

Sling, Retropubic Bladder Neck Suspension, Periurethral Bulking Agents, Pelvic Floor PT, Pessary, Urethral Plug

Self-care

Discuss your symptoms with your doctor if they are bothersome to you.

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