Urinary incontinence in women

Urinary incontinence is a loss of bladder control that results in urine leaks. This leakage is often uncontrollable and can negatively impact your life. It is a common, curable condition that does not need to be accepted as a normal part of aging.

Our specialists with UF Health Jacksonville can offer you many treatment options to ease your symptoms and help you regain bladder control. If you have urinary incontinence, make an appointment with a UF Health specialist in Urogynecology and Reconstructive Pelvic Surgery to discuss treatment options.

Urinary incontinence: Types

There are several types of urinary incontinence:

1. Stress urinary incontinence: The most common type of urinary incontinence. It is defined as urine leakage that occurs with coughing, sneezing, changing positions, jumping, or any other body movements that increase pressure on the bladder.
2. Urge urinary incontinence: With this type of incontinence, patients may leak urine after a sudden urge to urinate that cannot be delayed.
3. Overactive bladder: This condition is associated with difficulty holding or storing urine. Patients can experience urinary urgency, urinary frequency, and urinary leakage with a sudden urge to urinate.
4. Mixed urinary incontinence: This most often happens after childbirth and as you age. You may experience a combination of stress urinary incontinence and urge urinary incontinence.

Urinary incontinence: Diagnosis

The first step is to see a specialist. During your visit:

• Your provider will take a detailed history of your urinary symptoms
• You will have a thorough physical exam to assess your bladder
• Your medical provider may test your urine for infection and assess how much urine remains in your bladder after you urinate.
• Additional testing may be needed to gain a better understanding. These may include blood tests, an ultrasound of your kidneys, or a complex procedure to assess how your bladder functions (aurodynamic study).

Urinary incontinence: Treatments

Our specialists will create a personalized treatment plan for your needs. There are multiple treatments available for urinary incontinence:

Nonsurgical procedures:

• Lifestyle modifications: Changing fluid intake and understanding urination patterns can help with bladder control.
• Botox injections: A specialist can inject Botox into the bladder to treat urge incontinence or an overactive bladder, helping the muscles relax and allowing more time to get to the bathroom when feeling the need to urinate.
• Medications: Several medications can help decrease bladder spasms, tighten the urinary sphincter and alleviate irritation to help with incontinence.
• Nonsurgical device: A pessary is a silicone device inserted into the vagina. It is designed to support the urethra and improve urinary leakage.
• Pelvic floor physical therapy: Exercises such as Kegels can strengthen your pelvic floor, giving you better bladder control.
• PTNS (Percutaneous Tibial Nerve Stimulation): A nonsurgical procedure using a very thin needle placed just above the ankle, with stimulation that works to block signals causing the bladder to be overactive
• Urethral bulking: A bulking agent, such as silicon, is injected into the wall of the urethra to add bulk and strengthen the sides of the urethra, allowing it to seal more tightly to prevent leakage.

Surgical procedures:

• Midurethral sling procedures: a minimally invasive procedure to insert a sling around the urethra to help support it. This has shown a high cure rate for stress urinary incontinence and a quick recovery time.
• SNM or Sacral Neuromodulation: An implanted device that provides gentle stimulation to the sacral nerve just above the tailbone to help control the bladder.