Female Urinary Incontinence - Lawrence Eskew, MD

Incontinence is described as the involuntary leakage of urine and is a common condition that affects millions of women in our society. The resources that are spent on products designed to treat or control incontinence are tremendous. Incontinence can occur in both young and elderly women, however it occurs more commonly in the aging female. Incontinence can occur in mild or severe forms. In severe cases, incontinence can cause great embarrassment and lifestyle changes in the women who suffer from this condition. Incontinence can occur in several forms and the key to treatment is in recognizing the correct type of female incontinence.

Stress urinary incontinence is leakage of urine with coughing, straining, laughing, exercising or any other activity that increases the pressure in the abdomen causing urine to leak out of the bladder. This form of incontinence is caused by weakened pelvic floor muscles or a weak urinary sphincter muscle. Treatment is divided into non-surgical and surgical therapies. Non-surgical therapies include medicines, exercises to strengthen the pelvic muscles, and attempts to keep the bladder empty especially prior to strenuous activities. Surgical therapies include operations that provide support to the weakened pelvic floor or urinary sphincter. Generally stress incontinence is best treated by surgery, however in mild forms non-surgical therapies may reduce leakage.

Urgency incontinence is the leakage of urine from a sudden uncontrollable contraction of the bladder muscle. Women who have this type of incontinence will often leak without warning regardless of their activity. This leakage is caused from an “overactive bladder” and generally this is secondary to conditions which cause bladder irritation. This form of incontinence is best treated medically by drugs that slow down the activity of the bladder.

Overflow incontinence occurs when a bladder does not empty. When the bladder reaches its capacity, extra urine secreted into the bladder leaks out because there is no more room in the bladder for urine storage. Fortunately, this form of leakage is rare. It usually occurs in women with advanced diabetes. The ideal treatment consists of intermittently emptying the urinary bladder with a catheter.

Functional incontinence occurs frequently in our society as people are living longer. Functional incontinence describes leakage of urine which occurs because persons are too weak or handicapped to get to the bathroom by themselves. Alternatively, this form of incontinence can occur in persons with dementia who do not realize when they need to urinate until it is too late and an accident occurs. For many reasons functional incontinence is difficult to treat and often people who suffer from this incontinence must wear absorbent pads or appliances to help control their leakage.

If you or someone you know is suffering from urinary incontinence please realize that this is a common problem and that help exists for many forms of incontinence. Ask your doctor for help in diagnosing and treating this common condition.