Stress Urinary Incontinence

If you have stress urinary incontinence symptoms, your evaluation will begin with a comprehensive history and exam to assess pelvic floor support and strength, gross neuromuscular function, urinalysis and screening for voiding dysfunction. You may be asked to complete a voiding diary. Occasionally, urodynamic studies and/ or cystoscopy are also needed.

Pelvic Floor Rehabilitation

Many patients notice that their incontinence symptoms began when their pelvic floor muscle strength begins to weaken. In stress urinary incontinence, a loss of support and weakening of the urethra contributes to changes in the ability of the urethra to hold urine. Improvement in regaining continence is commonly seen when patients begin doing their "Kegel exercises" at home. Additional improvements can be achieved with this approach when a specialist in pelvic floor physical therapy assesses the patient and assists in personalizing an exercise routine to meet the patient's specific needs. Sometimes biofeedback is also introduced by the therapist to assist the patient in isolating and strengthening the weakened pelvic floor muscles. Pelvic floor PT can benefit both stress urinary incontinence and urge urgency incontinence.

Pessary

A pessary is a device, usually made of silicone that is placed in the vagina to maintain support whether for incontinence or prolapse. Patients often elect to use a pessary if they want to avoid surgery, or have plans for childbearing before they will be able to undergo definitive surgical therapy. There are several pessaries that are designed to provide support under the urethra and can be an effective therapy for stress incontinence. Also, some patients who are only bothered by their stress incontinence when they run or exercise prefer to use these pessaries specifically during their workout activity.

Surgery

Your physician may suggest a sling procedure to support the urethra. Slings are considered to be the gold standard surgical therapy for stress incontinence. Slings are often made of mesh. Your physician will only suggest a sling that is FDA monitored. Sling placement is a procedure that takes less than an hour, can be done on an outpatient basis, and is cosmetic (with only two very small cuts within the pubic hair below the bikini line, each measuring less than a quarter of an inch).

Urethral bulking

Is a treatment for incontinence but often used for patient who cannot tolerate anesthesia well since this is a treatment performed in the office.

The Women's Health Urogynecology and Female Pelvic Medicinefellowship-trained surgeons are highly experienced and trained so as to help you manage your stress urinary incontinence and provide you with expert medical and surgical management.