Don't Let Urinary Incontinence Disrupt Your Life

More than 18 million women in the United States suffer from urinary incontinence, often silently and always unnecessarily. 

On average, women wait 6 years or more to seek medical care for urinary incontinence, a condition that is wholly treatable; approximately 80 percent of diagnosed cases are fully cured. 

“Many women are worried the condition will lead to more serious health concerns or require invasive surgery. Others think urinary incontinence is something they just have to live with,” says Joseph Maccarone, MD, lead physician of Virtua’s female pelvic medicine program. “But it’s not something anyone needs to live with. As female pelvic medicine and reconstructive surgeon specialists, we strive to provide an unparalleled level of comfort and service and oftentimes deliver high rates of success with low risk.” 

Is it stress incontinence or urge incontinence?

Most frequently experienced by women in their 30s to 50s, stress incontinence is activity-related. “It’s the kind of leakage that happens when women jump, laugh, sneeze or cough,” says Sage Claydon, MD, Virtua female pelvic medicine specialist. 

Stress incontinence, she explains, is most frequently the result of weakened pelvic floor muscles that make it harder to close the urethra, the tube that keeps urine in the bladder. 

Urge incontinence—the “gotta-go-right-now” feeling—is common in post-menopausal women. It can be temporary or long term. Characterized by the sudden urge to urinate that leads to either urinary leakage or the fear of urinary leakage—urge incontinence may also accompany neurological disorders such as cerebral palsy, multiple sclerosis or Parkinson’s disease. 

Urinary incontinence treatments

There is no average urinary incontinence patient, and there is no preferred treatment. 

“But there are a plethora of safe, effective and minimally or noninvasive treatments available,” Dr. Claydon explains. “While we prefer a patient start with the least invasive approaches, the decision is hers. She knows her goals best, and we will arm her with the knowledge that will empower her to make the right decision for her lifestyle.” 

According to Dr. Claydon, sling procedures—those that may use synthetic mesh to hold the urethra properly in place—are often the most effective treatments available. Appropriate for stress incontinence, the mesh procedure for urinary incontinence is performed on an outpatient basis. “The mesh used is smaller and placed differently than the kind that was associated with potentially debilitating complications,” she confirms. 

Other stress incontinence treatments include physical therapy, bladder training and the use of devices such as vaginal pessaries and urethral inserts, both of which are intended to lift and support the urethra. The injection of materials intended to “bulk up” the area surrounding the urethra is another option. 

Physical therapy, bladder training and vaginal devices are also options for treating urge incontinence, as are electrical and nerve stimulation, oral medications and Botox injections. Dr. Maccarone recommends therapy in which a “pacemaker” is implanted in the buttocks and delivers mild electrical pulses to the nerves that control the bladder and surrounding muscles. 

Whichever route a patient ultimately decides on, Drs. Maccarone and Claydon both stress the importance of working with a doctor who is board-certified in female pelvic medicine (also known as urogynecology). 

“As specialists, we have unique experience and expertise, the kind that truly makes a difference in outcomes and that leads to greater patient satisfaction,” Dr. Maccarone says. 

“It’s your body,” adds Dr. Claydon. “If something is wrong, make noise. Once we know there’s a problem, we can help fix it.” 

Learn more about female pelvic medicine at Virtua, or call 1-844-896-6367 to schedule an appointment. 

Published with permission from Redbook/Women’s Day/Good Housekeeping magazines (June 2018).

Updated June 18, 2018