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At Glen Meade Center for Women’s Health, we offer the experience of the region's first board certified urogynecologist, Dr, Timothy Chase to help you through the conditions you may face as you get older. We focus on the diagnosis and treatment of urinary incontinence and female pelvic disorders. You may feel embarrassed about your loss of bladder control or pelvic pain, but these are common conditions among women, and you have options.
Pelvic Organ Prolapse
A heaviness in your pelvic area can be a sign of pelvic organ prolapse. This occurs when muscles and tissues of the pelvic floor become weak, causing pelvic organs to slip or fall out of place. Risk factors include aging, obesity, and chronic respiratory disease.
Both noninvasive and surgical options may be considered for most types of pelvic organ prolapse:
- Kegel exercises or using vaginal cone weights – to strengthen pelvic floor
- Pessaries – medical devices inserted into vagina or rectum to support pelvic organs
- Surgery – minimally invasive techniques
Loss of bladder control is a highly treatable condition among women, especially those over age 40. We provide you with the most advanced diagnostic and surgical techniques available for the three types of urinary incontinence:
Do you sometimes leak urine when exercising, sneezing, coughing, or laughing? Stress incontinence accounts for approximately 60 percent of cases and affects nearly 15 million adult women. Weakened pelvic floor muscles and pelvic organ prolapse that places pressure on the bladder are both causes of stress incontinence.
Noninvasive and surgical solutions for stress incontinence include:
- Lifestyle and behavior modifications
- Physical therapy
Experiencing urge incontinence involves a strong, sudden urge to go to the bathroom. Also called overactive bladder, some causes include:
- Bladder outlet obstruction
- Neurologic disease or injury
Solutions to cure or significantly improve urge incontinence include:
- Lifestyle and behavior modifications
- Physical therapy
- Botox injections
If you have symptoms of both stress and urge incontinence, you may have mixed incontinence. Treatment involves addressing both symptoms. We typically treat stress incontinence with surgery and manage urge symptoms with medication therapy. Sometimes urge symptoms improve with treatment of stress incontinence alone.
Frequently Asked Questions About Incontinence
While it is very common, it is not “normal” to leak urine at any time. Involuntary release of urine is a symptom that something is not functioning properly in your body. It may be an issue with weakened pelvic floor muscles, brain-to-nerve miscommunication, or pelvic organ prolapse. You owe it to yourself to discuss your symptoms with us because almost all cases of female urinary incontinence can be cured or significantly improved.
We ask for your medical history, perform a physical exam and conduct a focused neurologic exam. We may also ask you to do a standing stress test for urine leakage while coughing. Diagnostic tests for urinary incontinence include:
- Urinalysis – determines any evidence or early signs of disease (such as diabetes, kidney disease, urinary tract infections) or detects blood in urine
- Urine culture – given if anything found in urinalysis indicates infection
- Ultrasound – imaging to see the size and shape of kidneys, ureters and bladder, and quick way to determine how completely the bladder empties, or the amount of residual urine
- Cystoscopy – imaging (usually optic fibers on the end of a catheter) to see inside the bladder and urethra
- Urodynamic testing – evaluates bladder’s function and efficiency, taking measurements of volume and rate bladder empties
- Q-Tip test – simple, in-office procedure determines whether stress incontinence is caused by intrinsic sphincter deficiency
- Pad tests – oral medication given turns urine orange. Pads placed in patient’s underwear changed every 6 hours over a 24-hour period to determine severity of leakage problem
Most definitely. In fact, your physician will diagnose the type of incontinence you are experiencing and make appropriate recommendations for controlling it. In almost all cases, the first approach will be to have you try noninvasive techniques, such as behavior modifications, bladder retraining and/or physical therapy. Simple dietary changes (limiting caffeine, alcohol, fruit juices, artificial sweeteners, etc.) can significantly reduce accidents, as can retraining your bladder through regularly scheduled trips to the toilet. The first step is to see a specialist who can prescribe treatment.
Various mid-urethral slings have greatly improved the lives of thousands of women who struggle with bladder control. However, they are not appropriate for every type of incontinence. Slings work very well for many women who have stress incontinence (although nonsurgical approaches will likely be attempted first). Women with urge incontinence are not candidates for mid-urethral slings because, unlike stress incontinence, urge incontinence is not caused by poor pelvic support.
It depends on the type of incontinence you are experiencing. As mentioned above, mid-urethral sling surgery is indicated for women with stress incontinence only. Likewise, all medications currently on the market for female urinary incontinence are effective on urge incontinence only. Your doctor will help you learn more about your options after reviewing your symptoms and conducting appropriate diagnostic tests.