Involuntary leakage of urine is a common problem affecting many women. It can be caused by an overactive bladder, and with laughing, coughing, sneezing, or exercise. While leakage with urgency is treated with medication and other non-surgical options, leakage with exertion can often be resolved with a surgical procedure to support the urethra.

What is the Difference Between Stress and Urge Incontinence?

Patients with stress incontinence report leaking urine with laughing, coughing, or sneezing. They also may notice urine leaking with exercise, bending over, or while lifting.

Alternatively, patients with urge incontinence (overactive bladder) report an urgent need to empty their bladder, sometimes with very little warning.

Urodynamics and Voiding Diary

There are multiple tools utilized to help diagnose incontinence, most importantly the history of the patient and her physical exam findings. In our practice, we often utilize an objective bladder test (Urodynamics) to examine the physiology of the bladder during the filling and storage of urine and also evaluate the function of the urethra and the pressure generated during coughing and voiding. This test also helps understand the muscle pattern utilized to empty the bladder of urine. Some patients may not completely empty their bladder, and this is very important information to have when developing treatment plans. The voiding diary is completed over a period of 24 hours while the patient is at home. Information that is collected includes volumes of fluid drank, volumes of urine voided, and times of day that correspond to any episodes of leaking.

Surgical Techniques for Incontinence

Currently, the best surgical cure for stress incontinence is by the placement of a sling. Urge incontinence is most often treated with medications, Bladder Botox, and other behavioral and dietary modifications.