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Urinary Incontinence. What Every Woman Should Know...

Urinary incontinence is a problem that affects over 13 million Americans, and 85% of these people are women. It is more common than most chronic illnesses, affecting 25% of reproductive aged women and 50% of postmenopausal women.

A number of factors may contribute to the problem including:

  • Childbirth (where tissues, muscles, and nerves supporting the urethra may be damaged)
  • Obesity
  • Hysterectomy (which increases the risk of incontinence by 30-40%)
  • Recurrent bladder infections
  • Medical illness (diabetes, lung disease, stroke)

The most common types of incontinence are: stress incontinence, urge incontinence (often called overactive bladder), or a combination of both, called "mixed incontinence."

Incontinence is NOT a normal part of the aging process, and there are a variety of treatment options and strategies available.

Stress Incontinence is urine loss that results from an increase in pressure in the abdomen, which momentarily places increased physical stress on the pelvis. Coughing, sneezing, laughing, exercise, lifting, and even standing up are activities that can cause urine loss in women with this type of incontinence.

Treatment options include:

  • Behavioral treatment
  • Pessaries
  • Electrical Stimulation

  • Surgery

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Urge Incontinence is loss of urine that is associated with a sudden, strong desire to urinate, which cannot be postponed. People with urge incontinence may describe mounting pressure or sudden loss of urine in a rush to reach the toilet. This may commonly occur in association with certain triggering events, such as fumbling with the keys to open the front door, the sound or sensation of running water on the hands, or exposure to sudden cold. Other symptoms include a need to urinate frequently and waking often during the night to urinate.

Some people manage to avoid urine loss by urinating frequently, but find the continual need to have a bathroom available restrictive to their lifestyles. This condition has received more media attention recently and is also called OVERACTIVE BLADDER. A normally functioning bladder can wait until the appropriate opportunity to empty--an overactive bladder can not.

Treatment options include:

  • Behavioral treatment
  • Medications
  • Electrical Stimulation
  • Percutaneous Electrical Stimulation
  • Sacral Neuromodulation Therapy
  • Botox Bladder Injections

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Mixed Incontinence: It is quite common for a woman to experience a combination of both stress and urge-type urinary incontinence symptoms. Usually, one type is more bothersome than the other. For example, a woman may most often have stress incontinence and only rarely be unable to reach the toilet in time. Sometimes, this may make a clinical diagnosis difficult, and further testing of bladder function may be necessary.

These tests will help healthcare providers better tailor treatment to the individual patient and will result in a higher likelihood of success.

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Questions or comments about this Web site may be sent to
coe@obgyn.ucsf.edu. Last updated: 09/17/2009

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