Conquering Incontinence

The first step to ending the discomfort and embarrassment is a visit to your doctor or urologist. We can help.

UI can be slightly bothersome or truly debilitating. The embarrassment of “wetting” in public can interfere with normal everyday activities and cause tremendous emotional distress. And, too often, embarrassment keeps people with urinary incontinence from confiding in the doctors who can help them.

UI is twice as prevalent in women as in men. The effects of pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. Older women experience UI more often than younger women, but incontinence is not an inevitable part of aging. UI is a medical problem and your doctor can help you find a solution.

Incontinence occurs because of problems with the muscles and nerves that help to hold or release urine. The body stores urine—water and wastes removed by the kidneys—in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.

During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Incontinence will occur if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine.

Finding Relief There are several different types of UI, each with its own causes and each requiring a specific approach to treatment. The first step toward relief from UI is to see a doctor, like a urologist, who has experience treating incontinence. Your doctor’s first steps will include diagnosing the type of UI you are experiencing.

The doctor will ask about your symptoms and medical history. Your pattern of voiding and urine leakage may suggest the type of incontinence you have, so you’ll be asked to fill out a bladder diary over several days. This diary should note the times you urinate and the amounts of urine you produce, record your fluid intake, and note episodes of urine leakage and estimated amounts of leakage.

If your diary and medical history don’t provide enough clues for diagnosis, they will at least suggest which tests you need. In addition to a physical examination for signs of medical conditions that may cause UI, urologists use an array of techniques to examine the anatomy and function of the urinary system. Ultrasound, cystoscopy (using a thin tube with a tiny camera to see inside the urethra and bladder) and urodynamics can now help provide a clear view of the causes of a patient’s incontinence.