Urinary Incontinence Specialist

What is urinary incontinence?

Urinary incontinence (UI), also known as loss of bladder control, involves the involuntary leaking of urine. UI can be mild, causing you to leak just a few drops, or more severe, causing significant wetting. UI may include:

• A sudden urge to urinate that can’t always be controlled
• Leaking urine before you can make it to the bathroom
• Urine leakage while coughing or during sexual intercourse

What causes urinary incontinence?

Women are twice as likely as men to develop UI, partly for anatomical reason, but mostly because of the stresses and changes brought on by pregnancy, childbirth, and menopause.

Pregnancy increases pressure on pelvic floor muscles and can leave them weaker, while vaginal childbirth can intensify pelvic floor weakness and injure the nerves that control bladder function. Although these effects typically heal within a few months of childbirth, they may persist — particularly for women who have had more than one baby.

Many women experience UI for the first time following menopause, because declining estrogen levels make urethral tissues thinner and weaker than normal.   

Are there different types of urinary incontinence?

UI takes many different forms, each of which is categorized by its symptoms and underlying cause. Most women have one of the following types:

Stress Incontinence

The most prevalent form of UI involves leakage that occurs when physical movement puts pressure on the bladder. Women with stress incontinence usually leak urine when they cough, sneeze, laugh, exercise, or lift something heavy.

Urge Incontinence

Often referred to as having an overactive bladder, urge incontinence involves the strong, sudden urge to urinate, followed by involuntary leakage. Urge incontinence can occur when it’s not expected, such as when you’re asleep, or when you’re washing your hands.

Mixed Incontinence

Many women are diagnosed with mixed incontinence, which causes symptoms related to both stress incontinence and urge incontinence.

How is urinary incontinence diagnosed?

Before Dr. Caceres and her team can develop a UI treatment plan, they have to diagnose the underlying problem. UI diagnosis begins with a discussion of your medical history and a physical exam.

A urinalysis can help reveal if you have an infection, while a urodynamic test evaluates your bladder’s overall functionality. If a urodynamic test shows that your bladder doesn’t empty completely, it may indicate that you have a blockage in your urinary tract or a problem with the nerves or muscles that control your bladder.

If the underlying cause of your UI problem is still unclear, Dr. Caceres may order further testing, such as a diagnostic ultrasound, to get more information.

How is urinary incontinence treated?

UI can often be treated successfully without having to resort to surgery. Whenever possible, Dr. Caceres recommends specific lifestyle changes, bladder training, physical therapy, or bladder support devices such as a pessary.

Making certain dietary changes, such as reducing the amount of sodium in your diet, can help, as can changing any prescription medications that may exacerbate your UI problem. Losing excess body weight can help take pressure off your bladder, while performing Kegel exercises can strengthen your pelvic floor muscles for better bladder control.

You may also be able to regain control by retraining your bladder, a process that involves going to the bathroom at set times, even when you don’t feel the urge to go.

Patients with stress urinary incontinence can often find long-term relief through radiofrequency (RF) therapy, which uses controlled thermal heat energy to promote collagen renewal and help revitalize urinary tissues. Dr. Caceres uses TempSure™ by CynoSure®, one of the most advanced RF platforms available.  

If these methods don’t work, you may find success with bladder control medication, biofeedback therapy, or surgery. To learn more, call your nearest office or schedule an appointment online today.