Bladder leakage, known as urinary incontinence, is a surprisingly common occurrence. Laughing, sneezing, coughing, exercise, or other types of exertion causes urine leaks for between 25-45% of U.S. women. The rate of likelihood of developing urinary incontinence increases with age, but younger women – even teens – are not immune.
Many women cope by wearing sanitary napkins and/or dark clothing, planning activities around the availability of restroom facilities, or even staying close to home, because they don’t realize urinary incontinence is a treatable medical condition.
Four Types of Urinary Incontinence
- Urge Incontinence is the sudden, intense urge to urinate, followed by bladder leakage. Women with urge incontinence may feel like they can never get to the bathroom fast enough, or may wake up several times a night with a strong urge to urinate. It is believed to be caused by spasms of the bladder muscles.
- Stress Urinary Incontinence (SUI) is the involuntary release or leakage of urine during sudden movements like coughing, sneezing, laughing, and exercising. It can result from pregnancy and childbirth, high-impact sports, or as a result of aging or being overweight.
- Mixed Incontinence occurs when women have symptoms of both stress and urge incontinence.
- Overflow Incontinence is when a woman’s bladder doesn’t completely empty when she goes to the bathroom and she experiences “dribbling” of urine frequently. Overflow incontinence is caused by impaired bladder muscle contractions or bladder obstructions.
Simple lifestyle changes, such as drinking less water, avoiding caffeine, making more frequent bathroom stops, and tightening your pelvic muscles prior to laughing, coughing, or sneezing, can help with urinary incontinence. When these simple lifestyle changes aren’t enough, however, other treatment options are available.
For women with mixed incontinence, Shoemaker Gynecology schedules urodynamics testing to pinpoint the cause. Urodynamics is a series of measurements of the pressure in your bladder, the angle of your anatomy, and whether your bladder muscle is working the way we expect.
Urge incontinence is often improved using medication, available in pills, topical gels, or patches.
Stress Urinary Incontinence (SUI) is treatable at any age, but not all approaches work for every woman. No medication is currently approved to treat stress urinary incontinence, but other nonsurgical treatment options exist. Some of the most common treatments for Stress Urinary Continence include:
Behavioral/Muscle Therapy: Kegel exercises can be used to help strengthen the pelvic floor muscles. Depending on the severity of the condition, however, Kegel exercises may not bring sufficient relief.
Biofeedback: The patient exercises the pelvic floor muscles while connected to an electrical sensing device. The device provides “feedback” to help a woman learn how to better control these muscles. Over time, biofeedback can help a woman use her pelvic muscles to decrease sudden urges to urinate and lessen certain types of pelvic pain.
Electrical stimulation: A small probe provides small doses of electrical stimulation to the vaginal wall, isolating the pelvic floor muscles and exercising them in a way similar to Kegel exercises.
Pessary: In some cases, weak or stretched pelvic muscles may cause a woman’s bladder to drop (or prolapse) from its normal position and push against the walls of the vagina. This condition is called pelvic organ prolapse (POP) and can lead to urinary incontinence. To relieve incontinence caused by pelvic organ prolapse, a plastic device, called a pessary, can be inserted into the vagina to support and reposition the pelvic area. Learn more about pelvic organ prolapse.
Tension-free Vaginal Tape (TVT) Procedure: In this surgical procedure, a tape-like strip of mesh is inserted through very small incisions in the abdomen or vagina to support the urethra. This mesh tape acts as a supportive sling, allowing the urethra to stay closed when appropriate. Dr. Shoemaker performs the TVT procedure. He was the first to pioneer this surgery on the Eastern Shore, and serves as an instructor of other physicians learning to do the TVT procedure.