Gynecology Center: Urinary Incontinence

There are a number of types of urinary incontinence: stress incontinence, urge incontinence and mixed urinary incontinence are the most common diagnoses.

Follow the links below to get more information:

Stress Urinary Incontinence
Urge Urinary Incontinence
Mixed Urinary Incontinence

Stress Urinary Incontinence
Urinary stress incontinence is the involuntary loss of drops or spurts of urine with coughing, sneezing, laughing or exercise. For most women, this is an occasional problem. But about one in six women between 40-65 years old has a significant problem that affects her lifestyle choices.

Risk factors include:

Genetic
Childbirth (Large babies, forceps)
Menopause
Obesity
Smoking
Asthma
Heavy lifting
Chronic constipation

Treatment Options:

Kegel Exercises - strengthening your pelvic floor muscles through Kegel exercises should be a part of every woman's health care routine. Ask your physician for instruction in how to do them properly. When properly done, these exercises have been found to help up to 75% of women with mild to moderate stress incontinence issues.
Biofeedback Therapy - Biofeedback is a painless, safe and non-invasive physical therapy for the treatment of incontinence. It requires no surgery and no medication. Among patients who receive this type of treatment, 85% show significant improvement in four to six weeks for their incontinence concern.
Weight Loss - being overweight increases intra-abdominal pressure leading to more pressure on the bladder causing an urge to urinate. Even a 20 lb. weight loss can help improve a urinary incontinence condition.
Medication - there are a wide variety of medications available for treatment. A physician consultation is important to determine what is best for you.
Surgical - a consultation with our physicians will confirm whether a surgical procedure is necessary for a satisfactory result. Below is a partial list of options for treatment.
- Radiofrequency bladder neck suspension - this minimally invasive outpatient procedure uses controlled, low power radio frequency energy to heat and shrink stretched supports near the bladder and urethra to restore continence.
- Trans vaginal tape - a synthetic mesh tape that prevents urine leakage during sudden movement, such as laughing, coughing, and sneezing and while exercising by reinforcing the ligaments and tissues that support the urethra.
- Transobturator tape - synthetic mesh tape is placed under the bladder neck (urethra). This tape functions as a "hammock" supporting the urethra in times of stress, such as coughing, sneezing, laughing, jumping, etc.
- Anterior repair - anterior repair is performed vaginally through an incision in the anterior (upper) wall of the vagina. It tightens the supports and puts the bladder back in its normal position.
- Burch or MMK procedures - the bladder neck is elevated by lateral (sideways) sutures that pass through the vagina and pubic ligaments. (Lateral sutures prevent urethral obstruction and allow the repair of small hernias.) The vaginal wall and ligament are brought together, and the sutures are tied behind the pubic bone.
- Sling Procedures - involve placing a sling around the urethra to lift it back into a normal position and to exert pressure on the urethra to aid urine retention. The sling is attached to the abdominal wall.

Urge Urinary Incontinence or Overactive Bladder
Urge incontinence results when an overactive bladder contracts without your wanting it to do so. You may feel as if you can't wait to reach a toilet. At times, you may leak urine without any warning signs. A bladder can become overactive because of infection that irritates the bladder lining. The nerves that normally control the bladder can also be responsible for an overactive bladder. In other cases, the cause may be unclear.

Risk Factors:

Menopause and aging
Medical conditions such as diabetes, Multiple Sclerosis, strokes
Obesity
Smoking

Treatment Options:

Kegel Exercises-strengthening your pelvic floor muscles through Kegel exercises should be a part of every woman's health care routine. Ask your physician for instruction in how to do them properly. When properly done, these exercises have been found to help up to 75% of women with mild to moderate incontinence issues.
Biofeedback Therapy-Biofeedback is a painless, safe and non-invasive physical therapy for the treatment of incontinence. It requires no surgery and no medication. Among patients who receive this type of treatment, 85% show significant improvement in four to six weeks for their incontinence concern.
Behavioral Modification- a psychological approach to the treatment of urinary incontinence in which patients gradually:
- increase the length of the time between voidings and "retrain" the bladder
- Void every 2 hours by the clock; before the urge is present
- Avoiding bladder irritants such as:
  - Alcoholic beverages
  - Carbonated beverages
  - Soft drinks with caffeine
  - Milk and milk products
  - Coffee, even decaffeinated
  - Tea
  - Tomatoes and tomato based foods
  - Spicy foods
  - Chocolate
  - Sugar
  - Artificial sweeteners
Weight loss-even moderate weight loss will improve urinary incontinence conditions in most women
Medication-there are a wide variety of medications available for treatment. A physician consultation is important to determine what is best for you.
Surgical
- Interstim nerve stimulator- This therapy involves electrical stimulation, through a pace maker, of the sacral nerves that control voiding function

Mixed Urinary Incontinence
Mixed urinary incontinence is when a woman experiences both stress and urge incontinence. Our physicians will determine the worst component and begin treatment of that symptom.

Only your healthcare professional can correctly diagnose your bladder control problem and determine the right treatment for you.

Now Accepting New Patients.
Most Insurances Accepted.

Please call for an appointment.
Phone: 410-332-9200
Tollfree: 1-800-MD-Mercy (1-800-636-3729)