The most common urinary problems are leakage of urine (incontinence) and overactive bladder (OAB) which presents as urinary frequency and a strong urge to urinate. Another common disorder is Interstitial Cystitis (IC) which causes pelvic pain, painful urination as well as a frequent urge to urinate.
Incontinence can be a result of pregnancy and childbirth, surgery, chronic constipation, aging, and repeated heavy lifting to name a few. A careful medical history as well as physical exam with specific bladder testing can determine what is causing your problem and how best to treat it.
In order to understand why testing is necessary, it is important to understand that there are different types of urinary leakage or incontinence:
- Stress incontinence: This is leakage of urine during activities such as playing a sport, laughing or lifting.
- Urge incontinence, also known as Overactive Bladder: This is leakage when there is an urge to urinate-basically one can not “hold” their urine….”gotta go right now…”
- Overflow incontinence: Leakage of urine when bladder fills beyond its capacity
- Mixed incontinence: symptoms from more than one type of incontinence
It is important to know keep in mind that although urine leakage is very common, it is not normal in people of any age and treatment is successful for 80-90% of patients.
Urinary incontinence is commonly associated with bulging, sagging or falling of the pelvic organs—this is called Pelvic Organ Prolapse (POP). Prolapse tends to develop slowly, so the symptoms may be very mild and vague at first such as discomfort with intercourse and inability to comfortably wear a tampon. However, when it progresses it may suddenly become more noticeable; especially after menopause.
One important part of the evaluation of incontinence is Urodynamic testing. During this exam, a thin catheter is placed in your bladder and test its function during filling and to demonstrate what is causing your symptoms. [ insert urodynamic test info/?separate tab] This comprehensive evaluation will help me determine what your problem is so that we may work together to find the best treatment.
Incontinence can be treated in many ways, and no single treatment is appropriate for everyone. Therapies vary and include medication, specialized pelvic exercises, vaginal support devices and surgical repair.