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Pelvic Medicine

A-Z Index

Urinary incontinence is loss of bladder control which may be caused by a variety of reasons. Incontinence is an extremely common condition that affects about 50% of women, and it can occur at any time during adulthood. It also affects women about twice as often as men. Symptoms can range from a mild leaking to uncontrollable urination, and many people suffer unnecessarily with this condition because of embarrassment.

Some of the more common causes of incontinence are:

  • Multiple pregnancies/vaginal deliveries
  • Menopause/loss of estrogen
  • Persistent constipation
  • Certain medications
  • Weight gain/obesity

The two most common types of urinary incontinence are:

  • Stress incontinence
  • Urge incontinence

Stress incontinence
Stress incontinence is the unintentional loss of urine due to weakened pelvic floor muscles. It may be provoked by a physical movement or activity (like coughing, sneezing or exercising) that puts pressure or stress on the bladder.

Treatment options for stress incontinence include:

  • Physical therapy conducted in a private setting by specialized therapists. Techniques such as biofeedback, nerve stimulation, and weights strengthen the muscles that support pelvic organs. Physical therapy is valuable for all women to improve pelvic support, even if medication, devices or surgery was the primary form of treatment. Likewise, it may be useful as symptoms are just starting, to prevent a condition from developing.

  • Minimally invasive sling procedures may be used for more advanced conditions. This procedure involves the insertion of a “sling,” made of synthetic material, that cradles the urethra and helps keep it closed during a cough, sneeze or strain.

  • Several classes of medication

Urge incontinence

Urge incontinence is the strong, sudden need to urinate due to bladder spasms or contractions. Urge incontinence is a nerve function problem – different than the muscle weakness problem of stress incontinence. To hold urine, the urinary and nervous systems must coordinate properly.

Treatment option for urge incontinence:

  • Nerve stimulators – like pacemakers for the bladder –correct nerve function with excellent results. The tiny device is inserted under the skin, and a wire attaches it to a sacral nerve that controls the bladder, helping to reduce urges and frequency and to increase ability to hold urine longer.

  • Several classes of medication

Virtua locations specializing in Pelvic Medicine