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Urinary Incontinence

Urinary leaks are common and treatable. SLUCare experts can help.


Urinary incontinence, characterized by involuntary urine leakage, is extremely common, affecting approximately 1 in 4 adult women. For women age 65 and older, as many as 3 in 4 are affected.

Many women, however, are reluctant to discuss urinary incontinence with their physician. But there is no reason to be embarrassed and every reason to speak up! Incontinence can be treated, so you can once again engage in activities you love with confidence. 

SLUCare can help.

Identifying urinary leaks: stress incontinence versus urge incontinence

When you choose SLUCare Female Pelvic Medicine and Reconstructive Surgery, you’ll have a team that takes the time to identify the reasons behind the leaks. We’ll talk with you about your history of incontinence: when you experience leaks, how frequently, and under what circumstances. If needed, we can perform in-office urodynamic testing to reveal more about the causes of your leakage.

Through thorough evaluation, we will determine whether you are struggling with stress incontinence or urge incontinence, so we can develop a treatment plan tailored to your needs.

What’s stress incontinence? 

Stress incontinence is urine leakage that occurs during physical activity, sneezing, laughing, coughing or lifting heavy objects. Women who’ve given birth vaginally or have pelvic organ prolapse may be more likely to experience stress incontinence. Other risk factors include obesity, age, menopause, chronic cough or constipation.

Your SLUCare specialist may recommend one of several non-surgical treatments for relieving stress incontinence. This may include:

  • Lifestyle changes, such as developing a weight loss program to ease the effects of obesity or modifying diet to relieve constipation.
  • Addressing related medical conditions, such as chronic cough, to alleviate leaks.  
  • Pelvic floor physical therapy, which is designed to help women strengthen and rehabilitate the weakened muscles of the pelvic floor to improve urinary symptoms. Through regular exams and a program of exercises, specialized therapists help you regain control to reduce leaks when laughing, sneezing, coughing or engaging in physical activity.
  • Vaginal inserts. Available in disposable and non-disposable varieties, vaginal inserts work by applying slight pressure to the vaginal wall and urethra to prevent stress incontinence. Your SLUCare doctor can help determine whether a vaginal insert may help you.

Stress incontinence: surgical treatments

There are two minimally invasive options for treatment of stress urinary incontinence.

  • A mid-urethral sling is an outpatient procedure performed in the operating room. A small strip of surgical mesh is placed to support the urethra, reducing the risk of urine leakage during times of increased abdominal pressure such as laughing, coughing, sneezing and activity.
  • Urethral bulking is an outpatient procedure performed in the office or the operating room. A small scope is placed into the bladder and is used to inject small cushions of material into the urethra. This increases the urethral resistance, which reduces urine leakage during laughing, coughing, sneezing and activity.

Urge incontinence

Urge incontinence differs from stress incontinence in that urine leakage occurs because the bladder muscles squeeze, or contract, at the wrong times. This may result in symptoms such as the need to urinate suddenly and urgently, urinating more frequently, and being unable to control when you pass urine.

Urge incontinence is more common in postmenopausal women who have increased bladder and vaginal sensitivity related to genitourinary syndrome of menopause (GSM). The condition may be irritated by commonly consumed fluids, such as soda, coffee and tea. Obesity, medications, constipation, fibroids and neurological illnesses may also contribute to leakage.

Your SLUCare specialist may recommend non-surgical treatments for urge incontinence, including:

  • Lifestyle changes, such as developing a weight loss program to ease the effects of obesity or modifying diet to relieve constipation.
  • Addressing related medical conditions, such as diabetes, which may be treated with medications that produce unwanted urinary symptoms.
  • Pelvic floor physical therapy, which is designed to help women strengthen and rehabilitate the weakened muscles of the pelvic floor to improve urinary symptoms. With urge incontinence, the therapist will focus on exercises that help retrain the bladder to resist the urge to urinate and control the unwanted bladder contractions.
  • Medications are available to relieve symptoms of urge incontinence. Your SLUCare provider may recommend one of several oral medications that curb involuntary muscle movements, which can help with bladder control problems. Your doctor can answer your questions about the benefits and side effects of taking oral medication for urge incontinence.

Additional options for treating urge incontinence/overactive bladder

  • Botox injections may be recommended for urge incontinence or overactive bladder. Many patients find that this treatment is better tolerated than oral medications and more effective at controlling overactive bladder symptoms. Botox injections take place in the office under local anesthesia. If the injections are effective, they should be repeated every 6-9 months to continue providing relief from symptoms. Your SLUCare female pelvic medicine and reproductive surgeon can help you determine if this option is right for you.
  • A sacral nerve stimulator device (InterStim) stimulates the nerves that control the bladder, relieving symptoms that have not responded to non-surgical therapies, such as medication. Some patients enjoy near complete symptom relief. 
    Neuromodulation devices are implanted surgically in two stages and are controlled through an external remote. Your SLUCare physician can explain the benefits and risks of this treatment option. 

SLUCare Urogynecologists

Mary McLennan, MD
Fah Che Leong, MD
Andrew Steele, MD
Jennifer Bickhaus, MD
Alexander Hubb, MD

For an appointment, call 314-977-7455 or schedule online with a SLUCare urogynecology specialist.

Schedule Appointment Online