If you have bladder issues, you're not alone. Urinary incontinence is a common condition that affects millions of women every year.
Incontinence may be a minor issue for some people. But for others, it's a major problem that affects all aspects of their everyday life.
Often, embarrassment and shame prevent people from seeking care for urinary incontinence. But you don’t have to deal with incontinence or “just live with it.” Bladder issues, like many other health concerns, are easier to treat the earlier you detect the problem.
At UPMC, we have treatment options that can help with urinary incontinence.
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Doctors define urinary incontinence as the unintentional passing of urine or loss of bladder control.
Although urinary incontinence problems are most common in post-menopausal women, they can affect women of any age. About half of adult women report having urine leakage at one time or another.
As many as 18 million women of all ages are unable to predict when and where they'll urinate.
The types of urinary incontinence in women are:
Bladder control is a complex process that involves the brain, spinal cord, and muscles of the bladder and pelvis. Loss of bladder control can be caused by many problems with any of these components.
Some causes of urinary incontinence include changes in muscles because of:
Risk factors for having an uncontrollable bladder include:
Urinary incontinence affects everyone differently.
You may have urinary incontinence if you leak pee:
Other signs of urinary incontinence are:
Because urinary incontinence can be caused by different issues and there's more than one type, your doctor will need to run tests to make a diagnosis.
Tests your doctor might order include:
Your doctor may order urodynamic tests that evaluate how well your bladder is working. Urodynamic tests can be simple or complex and can provide a range of measurements.
A urodynamic evaluation can show:
A urogynecologist will evaluate the results of your urodynamic tests to determine if your bladder is functioning normally. They'll also recommend appropriate treatment, if needed.
Your urogyn may ask you to keep a diary of your bathroom habits. This voiding diary or bladder diary keeps track of how much you drink and pee.
Together, urodynamic tests and a voiding diary can provide valuable details about your bladder.
An accurate diary gives your urogynecologist a clear picture of:
Many people are embarrassed or ashamed by a loss of bladder control, and mistakenly believe nothing can be done to correct it. But that's not the case — we have a range of treatment options for urinary incontinence.
The two different types of urinary incontinence — urgency incontinence and stress incontinence — are treated differently. Not every treatment will work for every person, and some people will need a mixture of treatments for the best outcome.
Drinking less water isn't a good way to solve either kind of urinary incontinence because it may cause dehydration. Concentrated urine caused by dehydration can irritate the lining of the bladder and urethra and make your incontinence worse. Drinking two to three quarts of water a day may actually help.
But some fluids, like alcohol and caffeinated drinks, may make your incontinence worse. Stop drinking any fluids two to three hours before bedtime.
Urgency incontinence is usually treated through behavioral modification and medicine to control bladder spasms.
Behavioral approaches to urgency incontinence
These therapies may be helpful in treating urgency incontinence:
Your doctor may prescribe medications to relax the bladder and reduce spasms or instability. These drugs help prevent your bladder from contracting spontaneously.
If other treatments provide only some or no relief, there are other treatments that may be recommended.
They include:
Stress incontinence is usually treated with physical therapy and a procedure known as a midurethral sling.
For stress incontinence, treatment options can consist of physical therapy, pelvic floor exercises, or an over-the-counter product called Imprezza™, which stabilizes the urethra during increased abdominal pressure.
Midurethral sling
Midurethral sling surgery uses a piece of synthetic material to stabilize the urethra and help it to close. The procedure helps prevent bladder leaking when coughing, sneezing, laughing, or exercising, and can provide cure rates up to 90%.
The midurethral sling procedure usually is performed as an outpatient surgery. It has been used in the U.S. for 20 years with significant clinical data that supports its treatment outcomes and safety profile with minimal risk.
Bladder neck sling
The bladder neck sling uses your own native tissue to stabilize the urethra. Bladder neck slings can be performed for people who don't want synthetic material placed or who've had complications from midurethral slings.
Periurethral bulking
Periurethral bulking is a procedure that can be done in addition to the sling.
For stress incontinence caused by weakened muscles that close the urethra, a substance can be injected around the urethral muscles to create bulking. The bulking improves the ability to close the urethra and prevent incontinence.
Periurethral bulking can be done in the office or in the operating room.
Bladder issues don’t have to stop you from enjoying life. UPMC has effective treatments for urinary incontinence.
Our providers have many years of experience treating women with these conditions. Treatments vary from behavioral modification and physical therapy to advanced surgical techniques that can maximize your quality of life with minimal-to-no downtime.
Last reviewed by a UPMC medical professional on 2024-09-05.
