Urinary Incontinence is defined as the involuntary loss of urine. It is a very common problem in both women and men. In women, it is commonly seen in those who have had several children and it usually worsens following menopause.

There are three types of urinary incontinence.

1. Urgency Urinary Incontinence. This occurs in individuals who, upon getting an urgency to urinate, leak urine before they have a chance to make it to the bathroom. These patients typically often have urinary frequency, as well. We know that caffeine-containing beverages such as coffee, tea, and soft drinks can result in these types of symptoms. Drinking a lot of fluids can also result in these symptoms. Therefore, as part of the evaluation, we will ask about your fluid intake and suggest changes if we feel that it could result in improvement in symptoms. There are no surgical procedures which cure this type of urinary incontinence. The most common cause of urinary urgency incontinence and frequency is an "unstable" bladder. This means that the bladder is inappropriately squeezing urine out before a bathroom becomes available. This is treated with medications that relax the bladder, giving the patient longer periods of time between urination. In addition, the treatment also consists of "time voiding" where the patient urinates on a regular schedule.

2. Stress Urinary Incontinence. This occurs where there is the involuntary loss of urine with activities such as coughing, sneezing, laughing, or sitting up from a chair. Stress urinary incontinence typically occurs because of weakness in the pelvic muscles. Based on the degree of incontinence, the treatment can vary from conservative measures such as Kegel exercises, medication, collagen injections, and surgery. Kegel exercises are pelvis tightening exercises designed to strengthen the pelvic muscles, and are appropriate for women with mild stress urinary incontinence. Collagen injections involve the injection of collagen around the urethra resulting in a "bulking up" of the urethra. This procedure is done as an outpatient with virtually no restrictions postoperatively. Surgical procedures for stress urinary incontinence are generally quite successful in curing it. They typically require a one or two night stay in the hospital.

3. Overflow Urinary Incontinence. This occurs when the bladder does not empty adequately. This results in the bladder retaining large volumes of urine and in essence being full most of the time. The treatment is to improve bladder emptying through voiding on a more frequent basis. Sometimes self-catheterization may be needed. This is a process whereby a small tube is inserted into the bladder through the urethra to empty it.

Diagnostic methods
Many patients will often have a combination of these types of incontinence. Besides physical examination and a urinalysis, the correct diagnosis often requires testing of the bladder with catheters which contain sensors that measure bladder pressures as the bladder is filled with water. Cystoscopy, which means looking into the bladder with a small scope, may also be required to help with the diagnosis and treatment.

Treatment options

• Pelvic strengthening exercises and medical treatment
• In-office urodynamic evaluation
• Collagen injections
• Bladder neck suspension including transvaginal and retropubic approaches
• Insertion of artificial genitourinary sphincter

To learn more
For general information about urinary incontinence and the treatment options, click on this link: Urinary Incontinence.

Adult & Pediatric Urology, P.L.L.P
www.apumn.com

Main Office
2351 Connecticut Avenue South, Suite 200, Sartell, MN 56377
Tel: 320.259.1411 | Fax: 320.259.8967
Toll-free: 888.559.1411 [ map ]

Buffalo Office
1700 Highway 25 North, Suite 120, Buffalo, MN 55313
Tel: 763.682.2268
[ map ]

Research Office
320.229.4547

(and 14 outreach clinics)