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Incontinence

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Incontinence is the inability to hold your urine or bowels, which can be caused by a pelvic disorder. If you plan your day around trips to the bathroom, you're not alone. Many women have pelvic disorders that can cause embarrassing symptoms like urine leakage.

There are different types of incontinence:

  • Stress urinary incontinence – Urine leakage during movements that put pressure on the bladder such as sneezing, coughing, or exercising
  • Urgency urinary incontinence – An urgent need to get to the bathroom to urinate, which often you can't do in time
  • Fecal incontinence – Loss of control of stool or gas, leading to accidental leakage

Risk Factors

Women are at greater risk of developing both types of incontinence. Childbirth and age are risk factors for incontinence because the pelvic weaken after delivery and after menopause. Also, other health conditions can cause incontinence, including muscle and nerve conditions, digestive disorders, dementia, diabetes, infections, and bladder problems.
If you’re overweight, you smoke, drink a lot of caffeine, or you have a family history of incontinence, these can increase your risk of developing urinary incontinence.

Symptoms

Symptoms of a bladder or bowel problem can include:

  • Feeling like you haven't emptied your bladder after urinating
  • Inability to get to the bathroom in time to empty your bladder or bowel
  • Frequent trips to the bathroom during the night
  • Leakage when you contract your pelvic muscles, such as during exercise or when you cough, sneeze, or laugh
  • Recurring urinary tract infections

At the University of Miami Health System, we offer advanced treatments – including noninvasive approaches – that can help. Our female pelvic medicine and reconstructive surgeons work with other specialists to give you complete care. We develop a treatment plan that relieves symptoms and lets you regain control of your life.

Tests

Physical Exam

Your doctor will do a complete physical and pelvic exam to determine the cause of your symptoms. They may also recommend a neurological exam to look for problems with your brain, spinal cord, or nerves that may be causing incontinence.

Pelvic Floor Strength Tests

During pelvic floor strength testing, your doctor tests the strength of your pelvic muscles. These muscles help control urination and bowel movements and support your uterus, bladder, and bowel.

Bladder Function Test

Also called urodynamic testing, bladder function tests discover how well and how much urine your bladder can store and release.

Bowel Tests

Your doctor may use a rectal exam to test the strength of your sphincter muscles and check for abnormalities. They may use a flexible tube or other devices to measure the muscles and functioning of your rectum.

Imaging Exams

In some instances, your doctor may use imaging tests to examine your abdominal or pelvic area, including ultrasound, X-rays, MRI, or colonoscopy.

Treatments for

Urgency Urinary Incontinence

Lifestyle Modifications

Your doctor may recommend lifestyle changes to relieve symptoms related to an overactive bladder, such as emptying your bladder on a regular schedule or avoiding foods or beverages that irritate your bladder.

Physical Therapy

Physical therapy of the pelvic floor can be used to develop the pelvic floor for better bladder and bowel control. This can be effective for both urgency and stress incontinence. Your therapist may use a technique called Biofeedback to help guide your therapy.
Your physical therapist may also show you how to use a transcutaneous electrical nerve stimulation (TENS) device, an external device that delivers mild electrical pulses to adhesive patches placed on the skin of your abdomen. This can improve blood flow to your bladder.

Medications

Your doctor may prescribe medicine to help relax overactive bladder muscles or reduce contractions.

Botox® Injections

These injections are given in the bladder to stop muscle spasms and relax muscles.

Sacral Nerve Stimulation (SNS)

This small, implanted device, similar to a heart pacemaker, can treat urinary and fecal incontinence by stimulating bladder or bowel nerves (also called neuromodulation). The device, implanted under the skin of your upper buttock, sends mild electrical impulses to correct abnormal nerve impulses and helps the muscles function properly.

Percutaneous Nerve Stimulation

This procedure uses a small acupuncture needle that targets the nerves that control the bladder. It helps improve bladder muscle function.

Stress Urinary Incontinence

Physical Therapy

Physical therapy of the pelvic floor can be used to develop the pelvic floor for better bladder and bowel control. This can be effective for both urgency and stress incontinence. Your therapist may use a technique called Biofeedback to help guide your therapy.
Your physical therapist may also show you how to use a transcutaneous electrical nerve stimulation (TENS) device, an external device that delivers mild electrical pulses to adhesive patches placed on the skin of your abdomen. This can improve blood flow to your bladder.

Vaginal Inserts

Your doctor may recommend vaginal inserts that change the angle of the urethra to help prevent leakage when you exercise or lift heavy objects.

Surgical Treatment

If nonsurgical treatments aren't successful, your doctor may use surgery to treat stress urinary incontinence. Options include a urethral bulking agent to narrow the opening of the bladder outlet or a sling – made out of mesh graft, your tissue, or biologic tissue (animal or human tissue) – that acts as a supportive hammock in the pelvic floor to prevent leakage.

Why Choose UHealth?

Pelvic health expertise. We offer comprehensive care and services focused on women’s health and well-being. As an academic medical center, we use the latest research and leading-edge approaches to help you feel better and get back your life as quickly as possible.

Care designed for women. Our doctors specialize in women’s health. You get individual attention and treatment that’s customized to your needs, with personal attention from trained, compassionate experts who understand women’s needs.

A team approach. Your doctor works with a team of specialists to give you complete care. You can be confident you’re working with a highly trained team that’s focused on women’s health.

Leaders in minimally invasive surgery. We have some of the world’s most experienced surgeons for minimally invasive surgical procedures. Our surgeons are trained in surgeries that result in minimal scarring and a quicker recovery.

Questions? We're here to help.

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