Urinary Incontinence

Involuntary urine leakage can occur for a variety of reasons. It affects up to 1 in 3 women after the age of 40, and by the age of 60, 1 in 2 women suffer from the disorder. The incidence is not limited only to older women, as it can occur in men and people as young as 18 years of age.

At The University of Kansas Health System, we offer advanced diagnostic testing by fellowship-trained specialists to target the cause of incontinence. We offer a range of noninvasive therapies as well as surgical options to cater to each person's needs and condition.

Urinary incontinence is defined by a loss of bladder control. This can result in urine leakage, urgency and frequency that disrupts a person's life. Urinary incontinence can be an embarrassing condition that may also be associated with depression and social isolation. Both men and women can suffer from urinary incontinence.

The main symptom of urinary incontinence is a frequent, sudden urge to urinate – even if you've recently urinated. Leaking urine when coughing, sneezing, laughing or exercising is also very common.

Risk factors for urinary incontinence can vary depending on what type you have. However, the following may put you at risk:

• Being overweight (excessive weight may result in increased pressure on the bladder and pelvic muscles with activity).
• Changes in the anatomy of your urethra or bladder or pelvis after childbirth, menopause or prior surgery (changes in the normal bladder and urethral support can affect the integrity of the urinary system).
• Excessive intake of fluids (high water intake, such as when dieting or trying to satiate thirst, results in overfilling the bladder causing leakage).
• Medical conditions such as COPD and lower extremity swelling.
• Medications (whereas some medications can weaken the muscles of the urethra causing leakage, some others may weaken the bladder itself thus not allowing appropriate emptying. Also, some medications such as water pills cause your bladder to be overfilled rapidly causing leakage in some women).
• Menopause and hormonal changes (changes in estrogen levels and other hormones contribute to changes such as thinning in vaginal and urethral tissues).
• Recurrent bladder infections and bladder wall inflammation (recurrent infections often result in hypersensitivity of the bladder and the need for frequent emptying).
• Spine and neurological disease (some medical conditions, such as multiple sclerosis and stroke, affect the nerves and the function of the bladder and urethra directly).
• Weakness/deficits in pelvic floor strength and support (with age and deliveries, pelvic muscles often weaken despite performing Kegel exercises).

Your initial evaluation with your physician begins with a comprehensive history and assessment of your ability to urinate. You may be asked to complete a voiding diary. Your visit will also include a pelvic examination as well as a visual assessment of the urethral anatomy.

Occasionally, urodynamic studies and/or cystoscopy are also needed. Additional testing may be recommended only if indicated and is scheduled at a time that is convenient for you.

Once your evaluation is complete, your physician will discuss the findings with you and suggest options for your treatment plan. These options often include nonsurgical interventions as the first choice. If surgery is needed, our fellowship-trained surgeons are specialized in minimally invasive surgery.

Each type of urinary incontinence is treated differently. Some require only medical treatment, whereas other types require surgical management. Incontinence also often has multiple causes. To achieve a successful outcome, each of the underlying causes must be identified and addressed in the treatment plan.

Depending on the type of incontinence, treatments may vary. We offer many noninvasive state-of-the-art procedures. Treatment options include:

• Biofeedback techniques
• Bladder BOTOX® injections
• Bladder electrical stimulation
• Collagen injections
• Interstim/neuromodulation (pacemaker for the bladder)
• Noninvasive sling procedures
• Pelvic muscle strengthening