Urinary incontinence (UI), also known as urinary leakage or loss of bladder control, is the involuntary leaking of urine, either in the form of a few drops or something more severe. UI may include:

• Leaking urine before you can make it to the bathroom
• The sudden urge to urinate that can’t always be controlled
• Urine leakage while coughing or performing certain physical activities

Although there are several forms of UI, the most common types are:

Stress incontinence

The most prevalent type of UI involves leakage that occurs when physical movement puts pressure on the bladder. People with stress incontinence may leak urine when they cough, sneeze, laugh, exercise, or lift something heavy. It is the most common bladder control problem in young and middle age women. Some causes include menopause or inherent weakness of pelvic floor muscles or an effect from the stress of childbirth.

Treatment options include:

Surgical treatments:

• Injectable bulking agents (relatively non-invasive)
• Retropubic colposuspension (laparoscopically or by abdominal incision)
• Sling procedure (most common procedure in women)
• Inflatable artificial sphincter

Behavior Therapies:

• Pelvic floor muscle exercises (Kegel exercises)
• Fluid consumption
• Healthy lifestyle changes
• Bladder training (schedule for toileting if you have mixed incontinence)

Elective Procedure

• MonaLisa Touch

Urge incontinence

Often referred to as having an overactive bladder, urge incontinence involves the strong, sudden urge to urinate, followed by leakage. In other words, it occurs when a person feels the urge to urinate but is unable to hold back the urine long enough to get to the restroom. It sometimes occurs when it’s least expected, like during sleep or when you hear running water. This type of incontinence usually occurs in people who have had a stroke or have chronic diseases (i.e. Alzheimer’s, Parkinson’s, multiple sclerosis).

Treatment options include:

Behavior Therapies

• Bladder habit training: establish regular urination schedule with set intervals between urinations (i.e. 1 hour intervals and gradually increase the time between urination over time)
• Pelvic muscle exercise (Kegel exercises): exercise routine to help strengthen weak pelvic muscles and improve bladder control

Medications

• Ditropan
• Oxybutynin

Procedures

• MonaLisa Touch laser therapy
• Allergan BOTOX
• Uroplasty: PC Procedure

Mixed incontinence

Many people have mixed incontinence, meaning they experience symptoms related to stress incontinence as well as urge incontinence.

UI affects men and women alike, but usually for different reasons.

Men generally develop UI either because of a problem with the nerve signal from the brain that controls bladder function, or because of a problem with sphincter function. Male incontinence may be a side effect of prostate cancer treatment, or it may be a sign of undiagnosed prostate cancer. UI is also a common problem for older men with enlarged prostates.  

Women are twice as likely to have UI due to the stresses and changes brought on by pregnancy, childbirth, and menopause. Pregnancy puts increased pressure on pelvic floor muscles that can weaken them, while vaginal childbirth can exacerbate pelvic floor weakness and damage the nerves that control bladder function. Lower estrogen levels brought on by menopause can also contribute to UI by weakening urethral tissues.      

Because UI can often be successfully treated without having to resort to surgery, Dr. Yamada may start by recommending specific lifestyle changes, urgency suppression training, physical therapy, or bladder support devices.

Losing weight can help take pressure off your bladder, and performing Kegel exercises can help strengthen your pelvic floor muscles for better bladder control. Reducing the amount of sodium in your diet can help lower the need to urinate frequently.

You may also regain control by retraining your bladder, a process that involves going to the bathroom at set times, even when you don’t feel the urge.

A relatively new option is Botox injections. Yes, the same substance used to freeze facial muscles that make crow’s feet and frown lines is also effective in controlling bladder muscles. Injecting Botox directly into the bladder muscle calms the overactive bladders of women with urinary incontinence that had not responded to standard treatments. The benefit of a single Botox treatment can last six months.