Urinary incontinence is fairly common, occurring with 3-17% of women, depending upon which patient group is studied. Urinary incontinence involves the involuntary loss or passing of urine in a way that is considered a problem by the patient.
In women over age 70 the incidence increases. Many women are afraid to discuss this sensitive topic. But it is important to bring up the subject with your physician like those at Randolph OB/GYN.
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Urinary Incontinence Causes
Urinary incontinence is caused by factors such as the impact of childbearing, aging and heredity.There are basically four types of urinary incontinence:
1. Urodynamic Stress Incontinence – associated with physical exertion
2. Detrusor Overactivity (Urge Incontinence) – overactivity of the muscle that squeezes the bladder to cause urination
3. Bladder Oversensitivity
4. Mixed Incontinence – multiple causes
Urinary Incontinence Diagnosis
A complete exam by a qualified physician is recommended to diagnose the problem and determine the best treatment. This exam should include but not be limited to
1. History of the problem and your overall health
2. Pelvic exam, checking for anatomical defects
3. Neurological exam, checking for neurological disorder which can affect the bladder, such as Multiple Sclerosis or Diabetes
4. Pelvic neurological exam
Another test often performed is a Urodynamics-cystometrogram. This involves filling the bladder and reproducing the loss of urine, while measuring pressures. It also includes voiding studies. These we can perform in our office at Randolph OB/GYN.
Urinary Incontinence Treatments
Conservative measures include Kegel exercises (strengthening muscles in the pelvic floor) and avoidance of dietary irritants of the bladder (such as caffeine). Pessaries, which are special plastic plugs, can also be helpful.
Surgical treatments involve mainly suburethral slings, which are implanted below the urethra to reduce pressure on the bladder, and what is called Burch-type urethropexy, involving surgical fixation to nearby tissue of a displaced urethra and relieve pressure.
Possible Complications of Surgery
Surgery for urinary incontinence involves the usual risks of any operation, including possible damage to other organs. The risks of infection, rejection or erosion when surgical mesh is used seem to be very low. In occasional cases surgery can also cause voiding dysfunction.
Post-Operative Activity
I believe it is critical to limit lifting for three months to not more than 10 pounds.
Learn More About Urinary Incontinence
If you have symptoms of urinary incontinence or would like to learn more about your options, schedule an appointment with me or other skilled physicians at Randolph OB/GYN using our online
contact form or calling 704-333-4104.
Dr. McNamara
As a urogynecology specialist,
Dr. McNamara founded and served as attending physician
of the GYN Urology Clinic at Carolinas Medical Center prior
to joining Randolph OB/GYN. See Dr. McNamara's
bio page
Urinary incontinence is a common problem for many women.
