gynecology

Incontinence in Women: Causes and Treatment

Author: Steven Harmon, DO

Urinary incontinence (or leaking of urine from the bladder) in women is caused by weak pelvic muscles, overactive bladder muscles or nerve damage. When pelvis muscles have a hard time supporting your bladder, the bladder drops down and pushes against the vagina, making it difficult to tighten the muscles that close off the urethra. When you cough, sneeze or laugh, urine may leak because of the extra pressure these activities cause. Other factors that may also contribute to incontinence are pregnancy, childbirth and menopause. The good news is female incontinence is common and can be treated in a number of ways:

Behavioral therapy: Urinary incontinence can often be relieved with simple changes to your lifestyle. For example, if you leak urine when you cough, sneeze or laugh, your doctor may recommend you limit your fluid intake. If you suddenly get the urge to urinate and can’t always make it to the bathroom, you may be consuming too much, caffeine, carbonated drinks, or spicy foods, which can irritate the bladder and make the problem worse.  Urinary incontinence may also be helped with Kegel exercises, or the strengthening of the pelvic floor muscles.

Medication: Overactive bladder problems can often be treated successfully through medications known as anticholinergics/antimuscarinics, which help control bladder spasms. Another possibility may be to have Botox injections into the bladder muscle, which helps it relax and increase the amount of urine the bladder can hold.

Pessary: In women with weakened pelvic muscles an option may be a pessary. It is a silicone disc that can be inserted into the vagina and removed by the woman as needed for extra support. They are pain less and allow a woman to be in control of its use. It is an option that may help a woman avoid surgery.  

Surgery: When other methods have failed, or are not a good option, surgery may be the best. A sling procedure, for example, involves putting a sling of mesh or natural tissue around the urethra to lift it back into a normal position, which helps with urine retention. There are also procedures to help “rebuild” the muscles of the pelvic floor.

If you have any symptoms of urinary incontinence, talk to your doctor. Together, you can find a treatment solution that’s right for you.