Female Urinary Incontinence

Urinary incontinence is a condition where there is loss of control in managing the flow of urine from your body.

Approximately 17 million women in the U.S. encounter urinary incontinence in their lifetime. This condition can occur in women between the ages of 18 and 60 and beyond and is usually a result of the urethra not being closed tightly to keep urine in the bladder. Symptoms vary from:

• an inability to prevent leaking urine when exercising or other involuntary actions such as coughing or sneezing
• an overwhelming urge to urinate that often causes them to urinate before getting to a bathroom.

Treatment Options

Behavior therapies

Behavior modification is used to train one’s bladder and sphincter muscles by decreasing fluid intake and by prompting or scheduling voiding.

Pelvic muscle exercises

Called Kegel exercises, these exercises commonly are intended to strengthen weak muscles surrounding the bladder.

Protective undergarments

Basically these are pads undergarments designed to absorb leaked urine.

Catheter

These tubes are inserted into the urethra to collect urine into an external drainage bag. These are generally left in place 24 hours a day.

External devices

Called a Pessary, this device is designed to apply pressure to help reposition the urethra permitting it to close tightly.It features a stiff ring that is inserted into the vagina to exert pressure press against the wall of the vagina and urethra.

Bulking injections

Bulking agents such as collagen are injected directly into the urethral lining to firm and bulk up the urethral lining so that the urethra can close more tightly.

Medications

There are a number of medications to treat incontinence caused by urge to continually void. Where incontinence is stress related, there are no medications for to treat this. For incontinence caused by a combination of both urge and stress, drug therapy may be helpful in treating the urge component.

Surgery

There are a number of surgical approaches to strengthen, support, elevate and/or restore the urethra and bladder.These are employed when other treatments are not working and include:

• Retropubic Suspensions. Surgical procedures (Burch procedure) intended to restore the urethra and neck of the bladder to a higher anatomical position.
• Slings. Procedures used to treat that treats hypermobility in which a sling is used to support the urethra when there is increased abdominal pressure.
  -Bone-fixed slings – treat incontinence by supporting the urethra with a graft material attached to the pubic bone.
  -Self-fixated slings – can be used to support the urethra and are secured in place by friction and tissue ingrowth, and require no sutures or screws.