What is urinary incontinence?

Urinary incontinence is when urine leaks unintentionally. It is a common problem and many women have urinary leakage once a week or more. While accidental leakage of urine is common, it should not be considered normal.

What causes urinary incontinence?

Many things may cause involuntary leakage of urine. The first thing to do is to find out what is causing the problem. Your doctor will ask you questions and do a physical exam.

The two most common types of urinary incontinence are stress incontinence and urge incontinence.

Stress incontinence is when you leak urine during an activity that causes pressure (or “stress”) on the bladder. This can occur when you laugh, lift, cough or sneeze.

Urge incontinence is when you leak urine before you can get to the bathroom. You may also have frequent urges to urinate and wake up at night to urinate.

What treatment options are available?

Various treatments are available, some of which involve surgery and some of which involve exercises or use of special devices.

Stress incontinence can be treated with pelvic muscle exercises. It can also be treated with use of devices that “block” the urethra so that urine won't leak out. Surgery may be an option in some cases.

Urge incontinence is commonly treated with medications, biofeedback or electrical stimulation to the nerves that control the bladder. There is even a new treatment for urge incontinence that involves placement of an electrical stimulator under the skin (like a pacemaker).

How well does surgery for stress incontinence work?

Surgery can cure most women with stress incontinence. One new type of surgery, called the tension-free vaginal tape sling, can be done on an outpatient basis with local anesthesia.

No surgery is without risks, however. Potential problems from surgery may include difficulty emptying the bladder and development of urge incontinence.

Where can I find out more about urinary incontinence?

• National Association for Continence (NAFC)

  P.O. Box 8306

  Spartanburg, SC 29305-8306

  Telephone: 1-800-BLADDER

  Web site: www.nafc.org

• Agency for Healthcare Research and Quality (AHRQ) clinical practice guidelines for urinary incontinence in adults.

  Web site: http://www.ahcpr.gov/clinic/

• International Continence Society

  Web site: http://www.ics.org

• The “urology channel”—a comprehensive resource for patients and practitioners.

  Web site: http://www.urologychannel.com

• Urogynecology Associates of Louisville is an educational site designed for patients.

  Web site: http://www.mybladdermd.com