Female Urinary Incontinence

Female urinary incontinence is a very common problem that will affect up to half of all women at some point in their lives. Although this not a life threatening illness it can have significant effects on quality of life. Many patients will stop activities and change their lifestyles because of their incontinence. The expense of urinary incontinence is significant if you consider the costs of pads, diapers, and clothes that will be required over the years that the condition persists. In most cases, urinary incontinence is a problem that can be cured.

Urinary Incontinence is divided into either stress incontinence or urge incontinence or a combination of the two.

Stress Incontinence

Stress incontinence is the involuntary loss of urine with activity. Patients will usually describe leakage of urine with coughing, straining or lifting. The amount of leakage varies with activity and fullness of bladder.

Urge Incontinence (overactive bladder)

Urge incontinence is also known as an overactive bladder (OAB), and is the involuntary loss of urine that can occur at any time. It may be brought about by activities such as opening the front door or by turning on a water faucet. The patient usually feels a sense of having to urinate and then has leakage before they can make it to the bathroom. In some cases it is very difficult to distinguish between the two.

Treatments

The next step in the workup is a urodynamic study and a pelvic examination to tell us what type of leakage is present.  Stress Urinary Incontinence (SUI) can be treated by either coaptite injections or a procedure known as a Transvaginal Tape which is a type of bladder suspension. 

• Coaptite injections are usually done in the office with local anesthesia and have minimal risks but may have to be repeated. 
• The Transvaginal Tape (TVT) is an outpatient procedure that takes about 30 minutes to perform under anesthesia.  Most patients go home the same day without a catheter.  Recovery is relatively quick and most patients are doing normal activities within 2-3 days.  Patients should not exercise, bend down or do any heavy lifting for 3 weeks.

Patients who have Overactive Bladder (OAB) can also be treated successfully.  The treatment options include medications, behavior modification and pelvic floor excercises.  In patients who do not respond these treatments a new device called Interstim is no available and is effective in many patients we were unable to help just a few years ago.