Incontinence FAQ

At The Woman’s Health Pavilion, we commonly see women complaining of urinary incontinence. Women often suffer stress and embarrassment for years before mentioning this problem to their doctor. While it’s widely accepted as a “fact of life,” no adult should have to live with the loss of bladder control. Here we have answered some of the questions we are commonly asked.

To discuss your concerns with one of our gynecologists or other experienced clinical practitioners, request an appointment at any of our Queens or Long Island locations. We see patients 7 days a week and offer same- or next-day appointments for urgent conditions.

What is incontinence?

When people talk about incontinence, they are usually referring to urinary incontinence, which is the involuntary leakage of urine from the bladder. This is the most common type of incontinence we treat at The Woman’s Health Pavilion.

What causes urinary incontinence?

While incontinence can be related to urinary tract infections, use of certain medications, or neurologic conditions such as stroke, this is not the case for the majority of women. Common causes of  incontinence in women include:

• Pregnancy/Childbirth: Urinary incontinence is more common in women who have carried and delivered a child. In many cases, childbirth weakens the pelvic supports which ordinarily keep women continent.
• Obesity: Carrying excess weight significantly worsens incontinence, because abdominal fat “sits” on top of the bladder when women are upright, making loss of urine more likely. In fact, many women will notice an improvement in their incontinence symptoms simply by losing weight.
• Genetics: Some women inherit naturally weak pelvic floor muscles, which weaken further with pregnancy, childbirth, and age.

What’s the difference between stress and urge incontinence?

The most common types of incontinence we treat are:

• Stress incontinence occurs when a sudden increase in abdominal pressure (caused, for example, by sneezing, coughing, laughing, or running) causes urine to leak.
• Urge incontinence refers to the involuntary loss of urine when there is a strong urge to go. Women with urge incontinence frequently leak on their way to the bathroom.

What is an “overactive bladder”?

Overactive bladder is not a disease; it’s another name for urge incontinence. In women with urge incontinence, bladder support may be normal, but the bladder does not wait for the brain to tell it to release urine.

Symptoms include:

• A sudden, overwhelming urge to urinate, often followed by leakage
• Going to the bathroom many times during the day and night

According to the American Urological Association, as many as 40% of U.S. women have overactive bladder.

How do I know which type of incontinence I have?

While stress and urge incontinence are two distinct conditions, most women do not have just one or the other. In fact, approximately 2/3 of the women who suffer from stress incontinence also experience urge incontinence to some degree.

What are the risk factors for incontinence?

• Women who are over 35 or obese are most affected by both types of incontinence.
• Vaginal delivery increases the risk of stress incontinence.
• Women who have a genetic predisposition toward weak pelvic floor muscles are at risk for stress incontinence.

How is it diagnosed?

We usually begin evaluating a woman’s loss of bladder control with a conversation. It’s important for your provider to clearly understand the symptoms that bother you. Questions to consider include:

• Is leakage mostly associated with activity, straining, or exercise?
• Do you leak on your way to the bathroom?
• Is leakage a problem during intercourse?
• Do you leak at night?
• Do you actually leak, or do you just feel an urgent need to urinate?
• Do you need to wear protection to keep your clothes dry?

Your answer to this last question is especially important. If you start wearing protection because of regular leakage, it indicates a problem that has become significant enough for you to change your habits. Women who have already started to adapt their habits to their incontinence seem to be more receptive to treatment.  

How do you determine the cause of incontinence?

If our conversation suggests and issue with incontinence, we can determine the likely cause with an examination and simple tests:

• Urine culture to check for a urinary tract infection (UTI).
• Physical exam to determine the position and support of the bladder, uterus, and rectum, and functioning of the pelvic floor muscles.
• Urodynamic evaluation to evaluate bladder function.

Are there natural treatments for incontinence?

A variety of lifestyle changes may reduce symptoms of incontinence. Options include:

• Dietary changes such as eliminating/reducing the intake of certain types of food and drinks such as caffeine, carbonated drinks, and spicy foods that may irritate the bladder.
• Kegel exercises to strengthen the muscles of the pelvic floor.
• Timed voiding where you go to the bathroom at scheduled times every day whether you feel the need or not.
• Weight loss to reduce pressure on the bladder.

What else can be done to treat incontinence?

Some women require further intervention to eliminate incontinence:

• Medication is often the first line of treatment for women with an overactive bladder (urge incontinence). Safe and effective treatment options are available.
• Minimally invasive surgical options are often preferred in women with stress incontinence. Many such women will benefit from placement of an obturator sling to permanently support the neck of the bladder. This is a highly effective treatment for stress incontinence.

If I have a baby, will I become incontinent?

Many­  women experience stress incontinence during pregnancy because of pressure on the bladder as the baby grows. Often, this incontinence resolves after delivery. Women who deliver vaginally are more likely to have incontinence after childbirth, but this varies with the specifics of the delivery and individual factors such as age and weight.

Why choose The Woman’s Health Pavilion for treatment of incontinence?

Our highly trained and experienced OBGYN team specializes in the care of gynecologic conditions including incontinence. We offer minimally invasive options for most patients when their conditions require a surgical treatment. In fact, The Woman’s Health Pavilion is nationally recognized as a Center of Excellence in Minimally Invasive Gynecology.