Female Incontinence

If a woman is struggling with incontinence, the first step in treating her is to find out why. There are several possible causes of incontinence in women, and treatment varies according to the type and severity.

Types of Urinary Incontinence

• Stress Incontinence
  Leakage of small amounts of urine during physical movement such as coughing, sneezing, laughing, or exercising

• Urge Incontinence
  Sudden, unexpected leakage of large amounts of urine, including during sleep

• Overactive Bladder (OAB)
  The sensation of urinary urgency–feeling the need to go many times a day, with or without urge incontinence
• Functional Incontinence
  Untimely urination because of physical or mental disabilities
• Overflow Incontinence
  Unexpected leakage of small amounts of urine because of a full bladder
• Mixed Incontinence
  A combination of more than one type of incontinence, usually stress and urge
• Transient Incontinence
  Temporary leakage due to circumstances such as infection, taking a new medication, or colds with coughing

Treating Incontinence

There are several ways to treat incontinence, such as:

• Prescription Medications
  Prescriptions called anticholinergics can help, especially if combined with pelvic floor physical therapy and core-strengthening exercises. Anticholinergics are used in cases of overactive bladder and may be helpful for urge incontinence.
• Periurethral Bulking
  This method involves injecting agents such as collagen into the area where the bladder meets the urethra to help thicken tissues, narrow the urethra, and reduce leakage.
• Botox^® Injection in the Bladder
  This technique can sometimes help overactive bladder symptoms. The effect of these injections wears off over time and treatment must be repeated.
• The Burch Procedure
  This method is used to improve stress incontinence, when the bladder or urethra have fallen out of their normal position due to relaxation of the pelvic floor. This procedure uses surgical sutures to create support for the bladder neck. The Urogynecologist makes an incision a few inches below the navel and then secures the sutures to pelvic ligaments, creating support for the urethral sphincter. This is often done at the same time as a hysterectomy.
• Sacral Neuromodulation
  This leading-edge treatment can be very helpful for treating overactive bladder. The procedure involves the surgical implantation of a pacemaker-like device to electrically stimulate the bladder. The stimulation can restore normal communication between the brain and the bladder and/or bowel, which can result in an improvement of your overactive bladder, bowel incontinence, and urinary retention symptoms. Patients spend one week with a temporary simulator, and if the incontinence improves by at least 50 percent, a permanent device is implanted.
• Sling Procedures
  Sling procedures are performed through a vaginal incision using either a strip of a woman’s own tissue or man-made material to create a sling that supports the bladder neck. The Urogynecologist attaches both ends of the sling to the pubic bone. The latest advance in sling procedures is the use of synthetic mesh mid-urethral slings, which can be implanted minimally invasively, on an outpatient basis.