Urinary Incontinence in Women

Causes of urinary incontinence in women

Urinary incontinence can be caused by physical problems or an underlying medical condition. Your Mercy Health doctor will be able to determine the cause of your case in order to develop the most effective treatment option for you.

Patients who develop temporary urinary incontinence may have developed it from consuming alcohol, caffeine, carbonated drinks, chocolate, chili peppers or spicy, sugary or acidic foods.

If you have persistent urinary incontinence it may be caused by a physical problem such as:

• Pregnancy
• Childbirth
• Menopause
• Hysterectomy
• Obstruction
• Neurological conditions such as Parkinson’s disease or brain tumor

Risk factors for urinary incontinence of women

• Age — older women are more likely to suffer from urinary incontinence.
• Being overweight or obese — if you are overweight or obese, your extra weight may press on your bladder, which may allow urine to leak when you cough or sneeze.
• Smoking — if you are a smoker, you are more likely to develop urinary incontinence as you age.
• Family history — you are more likely to develop urinary incontinence if you have a family history of the condition.

Symptoms of urinary incontinence in women

There are a variety of types of urinary incontinence in women; therefore, signs of the condition will depend upon what type you are suffering from.

Types of urinary incontinence in women include:

• Stress incontinence — a type of female urinary incontinence that occurs when urine leaks from your bladder with you cough, sneeze, laugh, exercise or lift something heavy.
• Urge incontinence — a type of female incontinence that is characterized by a sudden, intense urge to urinate followed by accidental leakage; can be caused by infections, diabetes or a neurological disorder.
• Overflow incontinence — a urinary condition in women that may occur if your bladder does not empty completely; it is characterized by a thin stream of urine that frequently leaks from the bladder.
• Functional incontinence — can occur in patients who have a medical condition that makes it challenging for them to get to the bathroom in time for them to go.

Diagnosis of urinary incontinence in women

Urinary incontinence in women can be diagnosed during a physical exam with your primary care doctor, gynecologist or female urologist. During the exam, your doctor will evaluate your symptoms to determine which type of urinary incontinence you are suffering from.

To do this, he or she will take a full medical history and may order tests such as:

Urinalysis

A urinalysis is a diagnostic test that checks for signs of infection, blood or other abnormalities in your urine.

Bladder or urination diary

A bladder diary is a record of your urinary habits over the course of a few days. Your doctor will ask you to record:

• How much you drink
• When you urinate
• Amount of urine you expel
• Number of sudden urges you have had to urinate
• How many accidents or incontinence episodes you have had

Post-void residual measurement

A post-void residual measurement is a diagnostic test that examines urine output and the amount of urine leftover in your bladder after you urinate. If you have leftover urine in the bladder after you urinate, you could have a urinary tract blockage or another functional issue.

Cystoscopy

Cystoscopy is a diagnostic test that allows your doctor to see inside the urethra and bladder to diagnose a urinary condition such as female incontinence. During the test, your doctor will insert a thin tube with a camera into the urethra.

Treatments for urinary incontinence in women

Your Mercy Health doctor will evaluate your condition as well as the cause of your urinary incontinence to develop the most effective treatment plan. Patients with stress or urge incontinence may be able to find relief by making lifestyle changes, while other patients may need medication or surgery.

Treatments for urinary incontinence in women may include:

Lifestyle changes

• Training the bladder — you can train your bladder to stretch and hold more urine, so you can extend the time between using the restroom.
• Pelvic floor exercises — exercises called Kegels can help strengthen the pelvic floor to control urine flow.
• Quitting smoking — smoking causes you to cough more which can irritate the muscles around the bladder.

Devices

• Pessary — a vaginal pessary can be inserted into the vagina to help provide bladder support; it needs to be cleaned frequently and may fall out, but it could be an option for some patients before trying surgery.
• Urethral insert — a urethral insert is a disposable device that can stop leaks if they occur.

Medication

• Estrogen replacement therapy — helps prevent leakage around the urethra
• Pseudoephedrine — can help relieve stress incontinence

Surgery

Surgery is used when other more conservative treatments have been ineffective. Typically, surgery is very successful in relieving your symptoms of urinary incontinence.

Surgical procedures include:

• Sling procedure — during the procedure, your doctor will build a protective barrier using mesh that will support the urethra.
• Retropubic colposuspension — during this procedure, your doctor will surgically lift the bladder and support the tissues at the entrance of the bladder.

Electrical nerve stimulation

Some patients may benefit from electrical nerve stimulations that help you control your urges to urinate. These procedures are performed under general anesthesia on an outpatient basis. Electrical nerve stimulation procedures include:

Sacral nerve stimulation

During a sacral nerve stimulation, your doctor will implant a stimulator into the lower back near the sacral nerve. The device will send electrical impulses to block messages to the brain that indicate you need to go to the bathroom. The impulses may also act to increase blood flow to the bladder.

Tibial nerve stimulation

A tibial nerve stimulation technique sends electrical impulses to the spine from the tibial nerve to affect the nerves that control the bladder.