Female Urinary Incontinence
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).
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.
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
Behavioral modification, pelvic floor physiotherapy (kegel exercises with or without aid of physical therapist), medications, devices such as a pessary or urethral insert, transurethral bulking agent injections, surgery (typically a synthetic mesh sling)
Discuss your symptoms with your doctor if they are bothersome to you.