Urinary incontinence is a very troubling condition for many women.  It can happen at almost any age and is primarily caused by the birth of children.  In many ways, genetics plays a large role.  Some women can have one child and experience a lot of problems, but other women can have seven to eight children and not even have one problem.  (Sometimes things just are not fair.)  Urinary incontinence is not a normal part of aging, and you don't have to live with it if you don't want to.  Yes, it's a common condition and leaking once every six months is not a reason to get something done.  But if leaking is affecting your life, i. e., you can't do the things you want to because you're leaking, then we recommend getting something done.  Let's talk about it.

There are several reasons why women leak, again mostly related to child birth. Some women leak because their bladder contracts when it shouldn’t (i.e. your bladder thinks its time to go to the bathroom but none of the rest of the body thinks so). This condition is called urge incontinence and is primarily treated with medication. There are many different medication, and your doctor can help you decide which one is best for you.

The second form of incontinence is overflow incontinence. In other words your bladder does not empty properly, and it’s so large that urine just comes out like an overfull cup of water. This condition is more difficult to treat and usually requires physical therapy for bladder retraining.

The third most common form of incontinence is that when your urethra, the tube from your bladder to the outside, is weak and requires strengthening. This is done by a surgery called a urethral sling (see article in the “Clinical Services” section).

The fourth most common cause of urinary leakage is when the urethra bladder connections fall down below where they should be. This kind of leakage is called genuine stress incontinence and is also fixed by surgery.

Please keep in mind that some people actually have more than one type of incontinence and therefore may need more than one type of treatment.

For all patients with incontinence, we recommend testing in the office to differentiate between these types of incontinence. This testing is called urodynamics testing, is done in the office, and is usually covered by your insurance. The testing requires you to come in with a full bladder. You go through a process of measuring how you urinate.  You then have a small catheter placed to measure the strength of your urethra, the size of you bladder and whether you are having contractions.  Once this testing is done, you and your doctor can discuss what kind of therapy would be best for your condition.