Urinary Incontinence

What is urinary incontinence ?

Urinary incontinence is the involuntary leaking of urine.  It is a common problem affecting many women as young as 30 or 40 years old.  Many women do not talk about their leaking out of embarrassment yet it significantly affects their lives.  There are four types of incontinence: stress, urge, overflow, and temporary.  You may have a combination of types, called mixed incontinence.

Why do I leak when I sneeze ?

Stress incontinence is the leaking that occurs when you cough, laugh, sneeze, exercise, or lift.  You may go to the bathroom often to “avoid accidents”.  Women have stress incontinence because of the following six factors:

  • Vaginal deliveries – a baby’s head is many times larger than the vagina.  As baby descends the birth canal, the support tissue of the bladder, rectum and pelvic floor is overstretched. 
  • Obesity – extra weight in the abdomen pushes down on the bladder adding to its workload.  Losing just 10% of your body weight may help.
  • Smoking – deprives all organs of oxygen causing weakness of bladder support.
  • Lifting/pushing – on a persistent basis (in a mill, on a ranch or at home) causing weakness in pelvic support.  Limit your lifting to <30 pounds.
  • Age – tissue gets weaker with age.
  • Genetics – determines the original strength of your tissues

How do you fix stress incontinence ?

For mild stress incontinence Kegel exercises or other physical therapy my help.

For moderate to severe stress incontinence surgery Dr. O’Sullivan performs a procedure called a Monarc urethral suspension.  A “Monarc” is performed in the operating room in 20 minutes, after which you may be able to go home.  It corrects stress incontinence in 95% of women, compared to the older techniques that were only 70% effective.

Are there other types of incontinence ?

Urge incontinence occurs when the bladder squeezes at the wrong time, also called overactive bladder.  You may go to the bathroom 10-15 times per day and several times at night because of a strong “urge”.  Medication is used to treat and relax the bladder.

Overflow incontinence occurs when the bladder is full and cannot squeeze efficiently to empty.  You may feel you cannot empty your bladder and often leak many times throughout the day and night.  Medication is used to help the bladder squeeze better.

Temporary incontinence is caused by a specific event: bladder infection, vaginal infection, constipation or medication side effect.  It starts suddenly and goes away when the event resolves.  Treatment identifies and corrects the underlying cause.

To learn more about urinary incontinence.