Millions of people will experience urinary incontinence, which is the involuntary loss of urine or a sudden urge to urinate (but not making it to the toilet in time). Bladder control problems affect both men and women, however, incontinence is more like to occur in women than in men. Pregnancy, childbirth, menopause and the overall structure of the female urinary system are all reasons why a female will be more susceptible to uncontrolled urine loss.

Urinary incontinence is very troublesome to those who have to deal with it on a regular basis. It is embarrassing, uncontrollable, unpredictable and oftentimes, is associated with an undiagnosed medical problem. Female urinary incontinence usually occurs because of weak pelvic muscles that help to hold or release urine. Female incontinence usually happens if the bladder muscles suddenly contract, forcing urine out of the bladder, or the muscles surrounding the urethra unexpectedly relax, letting urine flow freely. For women, medical conditions such as a blockage, or a problem associated with pelvic floor dysfunction, will be found.

Other factors, regardless if you are a man or woman, can lead to urinary incontinence. For example, certain diseases and illnesses such as multiple sclerosis and Parkinson's disease often leave patients dealing with incontinence. Bacterial and other types of Infections, certain medications, long-term drug use, stroke, neurological disorders, mental illness, diabetes and many other factors can also cause incontinence.

There are different types of urinary incontinence:

• Stress Incontinence is the leakage of urine during swift physical movement such as lifting, jumping, coughing, sneezing and exercising. Typically, when one of these activities takes place, a small amount of urine will leak uncontrollably.
• Urge Incontinence is the leakage of large amounts of urine at unexpected times, including during sleep, after drinking a small amount of water, or when you touch water or hear it running.
• Functional Incontinence is the leaking of urine because an individual was not able to reach a toilet in time. A physical disability, a mental problem, or trouble communicating are reasons why functional incontinence might exist.
• Overflow Incontinence is the unexpected leakage of small amounts of urine because of a full bladder. This happens when the bladder doesn't empty properly, causing it to spill over. Weak bladder muscles, blocked urethra, some tumors, and urinary stones have all been known to cause this type of incontinence even though it's very rare in women.
• Mixed Incontinence is the combination of stress and urge incontinence together. This is the most common type of urine loss in women.
• Many times, incontinence is referred to as an overactive bladder. This term is used to describe very frequent urination. When one has to urinate more than seven plus times a day, it will be described as overactive bladder syndrome.

Every patient who is afflicted with incontinence will have their own array of symptoms, causes and a unique diagnosis. In order to diagnose the problem, a patient medical history including a full detail of symptoms, a recorded pattern of urination (how many times during the day, etc.) and urine leakage amounts are helpful.

Treatment

Urinary incontinence in women is treatable. Surgery may not be appropriate for every individual. Non-surgical urinary incontinence treatments include behavioral modifications, kegal exercises, pelvic muscle therapy, and scheduling yourself to go to the bathroom on a regular basis.

An external device known as a pessary can often prove to be helpful. A pessary is a stiff ring that is inserted into the vagina where it presses against the wall of the vagina and nearby urethra providing support. The pressure helps to reposition the urethra, leading to less stress leakage.

Bulking Injections using collagen and carbon spheres are also an option for a woman. These injections are made near the urinary sphincter and are injected into tissues around the bladder neck and urethra. These injections strengthen the tissues making them thicker ultimately allowing them to reduce stress incontinence.

There are many surgical treatments available as well for urinary incontinence in women. Below, are a few of the options that North Dallas Urology Associates offers women:

• Neuromodulation: For patients who have urge incontinence a stimulator device known as InterSlim, can be surgically implanted. This particular procedure works well for patients who are not responding to behavioral treatments or drugs. InterSlim provides a unique stimulation of nerves in the lower back. These nerves activate muscles and organs that regulate and contribute to urinary control (including the bladder, sphincter muscle and pelvic floor muscles).
• Retropubic Suspension: This procedure uses surgical threads to support the bladder neck by securing the threads (most commonly with sutures) to strong ligaments within the pelvis to support the urethral sphincter. This support often helps decrease urine leakage in patients.
• Sling Procedures: There are many slings that are used today to help support the bladder neck ultimately decreasing urine that is involuntarily lost in patients. Slings serve as support for the urethra during increased abdominal pressure. Some slings will use a strip of tissue to cradle the bladder neck.
• Other slings, such as the Midurethral Sling, will use synthetic mesh materials that are surgically placed midway along the urethra to provide the right amount of support for urethra.

There are many medical treatment options for urinary incontinence in women. Please discuss all of the options with your urologist so that the right treatment plan can be created and managed for you.

For additional resources relating to urinary incontinence in women, or to schedule an appointment at our Plano, Richardson and Frisco locations, call 972.612.8037. To schedule an appointment at our McKinney location, call 972.548.8195.