Urinary Incontinence Treated by Gynecologic Specialists at Mercy

Urinary incontinence is the loss of bladder control resulting in the uncontrolled leaking of urine. Urinary incontinence can be caused by any number of everyday habits, underlying medical conditions or physical problems.

 Symptoms of urinary incontinence range anywhere from the occasional leaking of urine to uncontrollable wetting, and are the result of the type incontinence experienced, including:

• Stress incontinence - the loss of bladder control when pressure is exerted on the bladder, such as coughing, sneezing or exercising
• Urge incontinence - the loss of bladder control resulting in the sudden, intense urge to urinate that cannot be halted
• Overflow incontinence - the loss of bladder control resulting in constant dribbling usually associated with urinating frequently and in small amounts
• Mixed incontinence - loss of bladder control in which symptoms of multiple types are experienced

A thorough medical examination, including urine and blood tests, ultrasounds and a review of your medical history may be used to diagnose urinary incontinence. Your doctor may also ask you to keep a bladder diary for several days, including how much you drink, when and how much you urinate, and any related urges and leakage.

A cystoscopy may be performed to diagnose urinary incontinence.

Treatment for urinary incontinence may depend on the type, severity and cause of your condition. Generally, less invasive treatments, such as lifestyle changes or therapies, will be tried first. Medications and surgeries may be required for more severe cases.

Treatment for urinary incontinence may include the following:

• Kegel exercises – a series of exercises aimed at strengthening the muscles that help control urination (pelvic floor muscles). They are performed by squeezing the muscles you would normally use to stop urination.
• Biofeedback therapy – a painless, safe and non-invasive physical therapy used to help teach a patient to control the body’s functions. Electrical sensors connected to the body help you receive information, or feedback, about your body. This information can then be used to make subtle changes in your reactions to conditions of the body and improve control of urinary functions.
• Sacral nerve stimulation – a procedure using electrodes to stimulate and strengthen pelvic floor muscles. A surgically implanted device delivers electrical impulses to the sacral nerves that control bladder activity.
• Surgery – Mercy’s physicians will help determine if surgery is a suitable option for your condition. Surgeries for urinary incontinence may include the following:
  • Trans vaginal tape - a synthetic mesh tape that prevents urine leakage during sudden movement, such as laughing, coughing, and sneezing and while exercising by reinforcing the ligaments and tissues that support the urethra.
  • Transobturator tape - synthetic mesh tape is placed under the bladder neck (urethra). This tape functions as a "hammock" supporting the urethra in times of stress, such as coughing, sneezing, laughing, jumping, etc.
  • Anterior repair - anterior repair is performed vaginally through an incision in the anterior (upper) wall of the vagina. It tightens the supports and puts the bladder back in its normal position.
  • Burch or MMK procedures - the bladder neck is elevated by lateral (sideways) sutures that pass through the vagina and pubic ligaments. (Lateral sutures prevent urethral obstruction and allow the repair of small hernias.) The vaginal wall and ligament are brought together, and the sutures are tied behind the pubic bone.
  • Sling Procedures - involve placing a sling around the urethra to lift it back into a normal position and to exert pressure on the urethra to aid urine retention. The sling is attached to the abdominal wall.